{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T19:18:30Z","timestamp":1788808710384,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Imperial Healthcare NHS Trust Biomedical Research Centre","award":["P45272"],"award-info":[{"award-number":["P45272"]}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2016,5]]},"abstract":"Objective<\/jats:title>To assess the effect of gestational age (GA<\/jats:styled-content>) and cervical length (CL<\/jats:styled-content>) measurements at transvaginal ultrasound (TVUS<\/jats:styled-content>) in the prediction of preterm birth in twin pregnancy.<\/jats:p><\/jats:sec>Design<\/jats:title>Individual patient data (IPD<\/jats:styled-content>) meta\u2010analysis.<\/jats:p><\/jats:sec>Setting<\/jats:title>International multicentre study.<\/jats:p><\/jats:sec>Population<\/jats:title>Asymptomatic twin pregnancy.<\/jats:p><\/jats:sec>Methods<\/jats:title>MEDLINE<\/jats:styled-content> and EMBASE<\/jats:styled-content> searches were performed and IPD<\/jats:styled-content> obtained from authors of relevant studies. Multinomial logistic regression analysis determined probabilities for birth at \u226428+0<\/jats:sup>, 28+1<\/jats:sup> to 32+0<\/jats:sup>, 32+1<\/jats:sup> to 36+0<\/jats:sup>, and \u226536+1<\/jats:sup>\u00a0weeks as a function of GA<\/jats:styled-content> at screening and CL<\/jats:styled-content> measurements.<\/jats:p><\/jats:sec>Main outcome measures<\/jats:title>Predicted probabilities for preterm birth at \u226428+0<\/jats:sup>, 28+1<\/jats:sup> to 32+0<\/jats:sup>, and 32+1<\/jats:sup> to 36+0<\/jats:sup>.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 6188 CL<\/jats:styled-content> measurements were performed on 4409 twin pregnancies in 12 studies. Both GA<\/jats:styled-content> at screening and CL<\/jats:styled-content> had a significant and non\u2010linear effect on GA<\/jats:styled-content> at birth. The best prediction of birth at \u226428+0<\/jats:sup>\u00a0weeks was provided by screening at \u226418+0<\/jats:sup>\u00a0weeks (P\u00a0<\/jats:italic><\u00a00.001), whereas the best prediction of birth between 28+1<\/jats:sup> and 36+0<\/jats:sup>\u00a0weeks was provided by screening at \u226524+0<\/jats:sup>\u00a0weeks (P\u00a0<\/jats:italic><\u00a00.001). Negative prediction value of 100% for birth at \u226428+0<\/jats:sup>\u00a0weeks is achieved at CL<\/jats:styled-content> 65\u00a0mm and 43\u00a0mm at ultrasound GA<\/jats:styled-content> at \u226418+0<\/jats:sup>\u00a0weeks and at 22+1<\/jats:sup> to 24+0<\/jats:sup>\u00a0weeks, respectively.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In twin pregnancies, prediction of preterm birth depends on both CL<\/jats:styled-content> and the GA<\/jats:styled-content> at screening. When CL<\/jats:styled-content> is <30\u00a0mm, screening at \u226418+0<\/jats:sup>\u00a0weeks is most predictive for birth at \u226428+0<\/jats:sup>\u00a0weeks. Later screening at >22+0<\/jats:sup>\u00a0weeks is most predictive of delivery at 28+1<\/jats:sup> to 36+0<\/jats:sup>\u00a0weeks. In twins, we recommend CL<\/jats:styled-content> screening in twins to commence from \u226418+0<\/jats:sup>\u00a0weeks.<\/jats:p><\/jats:sec>Tweetable abstract<\/jats:title>An individual patient meta\u2010analysis assessing gestation and CL<\/jats:styled-content> in the prediction of preterm birth in twins.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13575","type":"journal-article","created":{"date-parts":[[2015,9,2]],"date-time":"2015-09-02T18:13:28Z","timestamp":1441217608000},"page":"877-884","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["The effect of gestational age and cervical length measurements in the prediction of spontaneous preterm birth in twin pregnancies: an individual patient level meta\u2010analysis"],"prefix":"10.1111","volume":"123","author":[{"given":"LM","family":"Kindinger","sequence":"first","affiliation":[{"name":"Institute of Reproductive and Developmental Biology Imperial College London London UK"},{"name":"Fetal Medicine Unit St Mary's Hospital Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LC","family":"Poon","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St Mary's Hospital Imperial College Healthcare NHS Trust London UK"},{"name":"Harris Birthright Research Centre for Fetal Medicine Kings College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Cacciatore","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Developmental Biology Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DA","family":"MacIntyre","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Developmental Biology Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"NS","family":"Fox","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine Associates PLLC New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Schuit","sequence":"additional","affiliation":[{"name":"Stanford Prevention Research Center Stanford University Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BW","family":"Mol","sequence":"additional","affiliation":[{"name":"The Robinson Research Institute School of Paediatrics and Reproductive Health University of Adelaide Adelaide SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Liem","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Academic Medical Centre University of Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AC","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Academic Medical Centre University of Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Serra","sequence":"additional","affiliation":[{"name":"Maternal\u2010Fetal Medicine Unit Instituto Valenciano de Infertilidad University of Valencia Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Perales","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Obstetrics and Gynaecology La FE University and Polytechnic Hospital University of Valencia Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Hermans","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Academic Medical Centre University of Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Darzi","sequence":"additional","affiliation":[{"name":"Department of Academic Surgery St Marys Hospital Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Bennett","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Developmental Biology Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KH","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine Kings College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"TG","family":"Teoh","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit St Mary's Hospital Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,9]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Health and Social Care Centre.NHS maternity statistics \u2013 2012\u201313. 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