{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T22:04:28Z","timestamp":1789164268990,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T00:00:00Z","timestamp":1603065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["Dnr 2014\u201006998"],"award-info":[{"award-number":["Dnr 2014\u201006998"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To estimate the diagnostic performance of sonographic cervical length for the prediction of preterm birth (PTB).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective observational multicentre study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Seven Swedish ultrasound centres.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>A cohort of 11\u00a0456 asymptomatic women with a singleton pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cervical length was measured with transvaginal ultrasound at 18\u201320\u00a0weeks of gestation (C\u00d71) and at 21\u201323\u00a0weeks of gestation (C\u00d72, optional). Staff and participants were blinded to results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Area under receiver operating characteristic curve (AUC), sensitivity, specificity, positive and negative predictive values (PPV and NPV), positive and negative likelihood ratios (LR+ and LR\u2212), number of false\u2010positive results per true\u2010positive result (FP\/TP), number needed to screen to detect one PTB (NNS) and prevalence of \u2018short\u2019 cervix.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Spontaneous PTB (sPTB) at &lt;33\u00a0weeks of gestation occurred in 56\/11\u00a0072 (0.5%) women in the C\u00d71 population (89% white) and in 26\/6288 (0.4%) in the C\u00d72 population (92% white). The discriminative ability of shortest endocervical length was better the earlier the sPTB occurred and was better at C\u00d72 than at C\u00d71 (AUC to predict sPTB at &lt;33\u00a0weeks of gestation 0.76 versus 0.65, difference in AUC 0.11, 95%\u00a0CI 0.01\u20130.23). At C\u00d72, the shortest endocervical length of \u226425\u00a0mm (prevalence 4.4%) predicted sPTB at &lt;33\u00a0weeks of gestation with sensitivity 38.5% (10\/26), specificity 95.8% (5998\/6262), PPV 3.6% (10\/274), NPV 99.7% (5988\/6014), LR+ 9.1, LR\u2212 0.64, FP\/TP 26 and NNS 629.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Second\u2010trimester sonographic cervical length can identify women at high risk of sPTB. In a population of mainly white women with a low prevalence of sPTB its diagnostic performance is at best moderate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Cervical length screening to predict preterm birth in a white low\u2010risk population has moderate performance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16519","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T19:44:43Z","timestamp":1600717483000},"page":"195-206","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Second\u2010trimester transvaginal ultrasound measurement of cervical length for prediction of preterm birth: a blinded prospective multicentre diagnostic accuracy study"],"prefix":"10.1111","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9915-1201","authenticated-orcid":false,"given":"P","family":"Kuusela","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Centre of Perinatal Medicine and Health Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"},{"name":"S\u00f6dra \u00c4lvsborg Hospital Bor\u00e5s Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Jacobsson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Centre of Perinatal Medicine and Health Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"},{"name":"Department of Obstetrics Region Vastra Gotaland Sahlgrenska University Hospital Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Hagberg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Centre of Perinatal Medicine and Health Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"},{"name":"Department of Obstetrics Region Vastra Gotaland Sahlgrenska University Hospital Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Fadl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Faculty of Medicine and Health \u00d6rebro University \u00d6rebro Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Lindgren","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology Karolinska Institute Stockholm Sweden"},{"name":"Centre for Fetal Medicine Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Wesstr\u00f6m","sequence":"additional","affiliation":[{"name":"Centre for Clinical Research Dalarna Falun Hospital Falun Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U\u2010B","family":"Wennerholm","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Centre of Perinatal Medicine and Health Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"},{"name":"Department of Obstetrics Region Vastra Gotaland Sahlgrenska University Hospital Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3830-6414","authenticated-orcid":false,"given":"L","family":"Valentin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Sk\u00e5ne University Hospital Malm\u00f6 Sweden"},{"name":"Department of Medical Sciences Malm\u00f6 Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1471-0528.2003.00012.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.6085"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1331"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706475"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.12.1429"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602293340904"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.11.576"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.12.222"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.09.013"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1547327"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.32"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)34022-1"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2617"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(98)00346-9"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1047"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016348509156368"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13895"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13266"},{"key":"e_1_2_6_20_1","first-page":"8","article-title":"External review and validation of the Swedish national inpatient register","volume":"9","author":"Ludvigsson JF","year":"2011","journal-title":"BMC Public Health"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/140349489001800209"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2016.034"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(85)80031-4"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067815"},{"key":"e_1_2_6_25_1","first-page":"66","volume-title":"Effective care in pregnancy and childbirth","author":"Mohide P","year":"1989"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12087"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.16519","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.16519","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.16519","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T10:20:13Z","timestamp":1693563613000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.16519"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,19]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1111\/1471-0528.16519"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.16519","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,19]]},"assertion":[{"value":"2020-02-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}