{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T04:24:12Z","timestamp":1787631852782,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,2]],"date-time":"2024-06-02T00:00:00Z","timestamp":1717286400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010428","name":"Innovation and Technology Fund","doi-asserted-by":"publisher","award":["ITS\/252\/17FX"],"award-info":[{"award-number":["ITS\/252\/17FX"]}],"id":[{"id":"10.13039\/501100010428","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":[[2024,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate longitudinal changes in cervical length (CL) and mean cervical shear wave elastography (CSWE) score in women with a singleton or twin pregnancy who undergo spontaneous preterm birth (sPTB) compared with those who deliver at term.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective longitudinal study of unselected women with a singleton or twin pregnancy attending a dedicated research clinic for screening for sPTB at four timepoints during pregnancy: 11\u2009+\u20090 to 15\u2009+\u20096\u2009weeks, 16\u2009+\u20090 to 20\u2009+\u20096\u2009weeks, 21\u2009+\u20090 to 24\u2009+\u20096\u2009weeks and 28\u2009+\u20090 to 32\u2009+\u20096\u2009weeks. At each visit, a transvaginal ultrasound scan was conducted to measure the CL and the CSWE scores in six regions of interest (ROI) (inner, middle and external parts of anterior and posterior cervical lips). The mean CSWE score from the six ROIs was calculated for analysis. Log<jats:sub>10<\/jats:sub> transformation was applied to data to produce a Gaussian distribution prior to statistical analysis. A multilevel mixed\u2010effects analysis was performed to compare longitudinally CL and CSWE between the sPTB and term\u2010delivery groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The final cohort consisted of 1264 women, including 1143 singleton pregnancies, of which 57 (5.0%) were complicated by sPTB, and 121 twin pregnancies, of which 33 (27.3%) were complicated by sPTB. Compared to those who delivered at term, women with sPTB had a lower CL across gestation when controlling for history of cervical surgery, number of fetuses, gestational age (GA) at cervical assessment and the interaction between GA at cervical assessment and sPTB (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Specifically, CL in the sPTB group was significantly lower at 21\u2009+\u20090 to 24\u2009+\u20096\u2009weeks (<jats:italic>P<\/jats:italic>\u2009=\u20090.039) and 28\u2009+\u20090 to 32\u2009+\u20096\u2009weeks (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Twin pregnancies had significantly greater CL throughout pregnancy compared with singleton pregnancies (regression coefficient, 0.01864; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). After adjusting for maternal age, weight, height, body mass index and GA at cervical assessment, CSWE score in the sPTB group was significantly lower compared with that in the term\u2010delivery group across gestation (<jats:italic>P<\/jats:italic>\u2009=\u20090.013). However, on analysis of individual visits, CSWE score in the sPTB group was significantly lower than that in the term\u2010delivery group only at 11\u2009+\u20090 to 15\u2009+\u20096\u2009weeks (<jats:italic>P<\/jats:italic>\u2009=\u20090.036). There was no difference in CSWE score between singleton and twin pregnancies throughout gestation (regression coefficient, \u20130.00128; <jats:italic>P<\/jats:italic>\u2009=\u20090.937).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women with sPTB have a shorter and softer cervix across gestation compared with those who deliver at term. A shorter cervix in the sPTB group is observed from the late second trimester onwards, while lower cervical stiffness in the sPTB group is observed primarily in the first trimester. CL is significantly lower in singleton pregnancies compared with twin pregnancies, while cervical stiffness does not differ between the two. Our findings indicate that the cervix tends to undergo a softening process prior to shortening in sPTB cases. \u00a9 2024 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.27614","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T18:39:45Z","timestamp":1707935985000},"page":"789-797","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Longitudinal evaluation of cervical length and shear wave elastography in women with spontaneous preterm birth"],"prefix":"10.1002","volume":"63","author":[{"given":"L.","family":"Nguyen\u2010Hoang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Prince of Wales Hospital, The Chinese University of Hong Kong  Shatin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Chaemsaithong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y. K. Y.","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Prince of Wales Hospital, The Chinese University of Hong Kong  Shatin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2049-4066","authenticated-orcid":false,"given":"Q.","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking University Shenzhen Hospital  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Prince of Wales Hospital, The Chinese University of Hong Kong  Shatin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Affiliated Drum Tower Hospital Medical School of Nanjing University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. K. C.","family":"Chong","sequence":"additional","affiliation":[{"name":"The Jockey Club School of Public Health and Primary Care, Faculty of Medicine The Chinese University of Hong Kong  Shatin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9153-0343","authenticated-orcid":false,"given":"T. Y.","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Prince of Wales Hospital, The Chinese University of Hong Kong  Shatin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3944-4130","authenticated-orcid":false,"given":"L. C.","family":"Poon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Prince of Wales Hospital, The Chinese University of Hong Kong  Shatin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13195"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2018.04.003"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61970-9"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(18)30451-0"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60820-4"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2021-064547","article-title":"Interventions to prevent spontaneous preterm birth in women with singleton pregnancy who are at high risk: systematic review and network meta\u2010analysis","volume":"376","author":"Care A","year":"2022","journal-title":"BMJ"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10040627"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.05.010"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2022-0462"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.11.1369"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24839"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24765"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26020"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.04.014"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.05.017"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2018-0062"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2022.01.003"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000016449"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13874"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2015.06.020"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2014.10.009"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0230125"},{"key":"e_1_2_8_24_1","volume-title":"Mixed Models: A Flexible Approach to Correlated Data","author":"Seltman HJ","year":"2018"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.32"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2006.03.021"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1048"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.05.018"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.4274\/jtgga.galenos.2023.2022-7-3"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S251522"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2022.2050896"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04526-0"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.27614","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T09:03:11Z","timestamp":1737968591000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.27614"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/uog.27614"],"URL":"https:\/\/doi.org\/10.1002\/uog.27614","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6]]},"assertion":[{"value":"2023-09-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}