{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T05:43:00Z","timestamp":1780465380127,"version":"3.54.1"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,4,10]],"date-time":"2018-04-10T00:00:00Z","timestamp":1523318400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["20031004"],"award-info":[{"award-number":["20031004"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003180","name":"Academisch Medisch Centrum","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003180","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>A recent randomized clinical trial (ProTWIN) showed that a cervical pessary prevented preterm birth and improved neonatal outcome in women with multiple pregnancy and cervical length (CL)\u2009&lt;\u200938\u2009mm. In this follow\u2010up study, the long\u2010term developmental outcome of these children was evaluated at 3\u2009years' corrected age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a follow\u2010up study of ProTWIN, a multicenter trial conducted between 2009 and 2012 in which asymptomatic women with a multiple pregnancy were randomized to placement of a cervical pessary or no intervention. Current follow\u2010up and analysis were limited to mothers with a mid\u2010trimester CL\u2009&lt;\u200938\u2009mm (78 women (157 children) in the pessary group and 55 women (111 children) in the control group). At 3\u2009years of corrected age, surviving children were invited for a Bayley Scales of Infant and Toddler Development\u2010third edition (Bayley\u2010III) assessment. Death after randomization or neurodevelopmental disability (Bayley\u2010III score of \u2264\u200985, 1 SD below mean) rates were compared between the pessary and control groups, according to the intention\u2010to\u2010treat principle and using multiple imputation for missing data. Mean Bayley\u2010III scores in surviving children were also assessed. A linear mixed\u2010effects model was used to adjust for correlation between children of one mother.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From the time of entry in the ProTWIN trial until follow\u2010up at 3\u2009years of age, a total of 27 children had died (six (5%) in the pessary <jats:italic>vs<\/jats:italic> 21 (26%) in the control group; odds ratio (OR), 0.13; 95% CI, 0.04\u20130.48). Bayley\u2010III outcomes were collected for 173\/241 (72%) surviving children (114 (75%) in the pessary <jats:italic>vs<\/jats:italic> 59 (66%) in the control group). The cumulative incidence of death or survival with a neurodevelopmental disability was 12 (10%) in the pessary <jats:italic>vs<\/jats:italic> 23 (29%) in the control group (OR, 0.26; 95% CI, 0.09\u20130.73). No statistical or clinically relevant differences were found with respect to cognitive, language and motor development among surviving children between the groups. Comparable results were found after multiple imputation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In women with twin pregnancy and a CL\u2009&lt;\u200938\u2009mm, the use of a cervical pessary strongly improved survival of the children without affecting neurodevelopment at 3\u2009years' corrected age. Copyright \u00a9 2018 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.19029","type":"journal-article","created":{"date-parts":[[2018,2,22]],"date-time":"2018-02-22T08:46:36Z","timestamp":1519289196000},"page":"621-628","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Pessary for prevention of preterm birth in twin pregnancy with short cervix: 3\u2010year follow\u2010up study"],"prefix":"10.1002","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5303-1503","authenticated-orcid":false,"given":"J.","family":"van \u2018t Hooft","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.\u00a0H.","family":"van\u00a0der\u00a0Lee","sequence":"additional","affiliation":[{"name":"Pediatric Clinical Research Office, Emma Children's Hospital Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.\u00a0C.","family":"Opmeer","sequence":"additional","affiliation":[{"name":"Clinical Research Unit Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.\u00a0G.","family":"van Wassenaer\u2010Leemhuis","sequence":"additional","affiliation":[{"name":"Department of Neonatology and Pediatrics, Emma Children's Hospital Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. L.","family":"van Baar","sequence":"additional","affiliation":[{"name":"Child and Adolescent Studies, Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. J.","family":"Bekedam","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Onze Lieve Vrouwe Gasthuis\u2010Oost  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. J. P.","family":"Steenis","sequence":"additional","affiliation":[{"name":"Child and Adolescent Studies, Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Liem","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Schuit","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Cuijpers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Bleeker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. E.","family":"Vinke","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Simons","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. M.","family":"de Graaf","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-550X","authenticated-orcid":false,"given":"B. W. 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