{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:22:16Z","timestamp":1789842136169,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,12,6]],"date-time":"2017-12-06T00:00:00Z","timestamp":1512518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The aim of this study was to explore the association between small fetal thymus on ultrasound and adverse obstetrical outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Medline, Embase, Cochrane and Web of Science databases were searched. Primary outcome was the risk of preterm birth before 37 and 34\u00a0weeks of gestation in fetuses with, compared to those without, a small thymus on ultrasound. Secondary outcomes: occurrence of chorioamnionitis, intrauterine growth restriction, neonatal sepsis, gestational age at birth, birthweight, neonatal morbidity and preeclampsia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve studies including 1744 fetuses who had ultrasound assessment of thymus during pregnancy were included. Women with preterm premature rupture of the membranes or with preterm labor were at higher risk of preterm birth before 37\u00a0weeks (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.01), or before 34\u00a0weeks (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) for fetuses with a small fetal thymus compared to those without a small thymus, and the risk of chorioamnionitis was higher when the thymus was small (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). Fetuses with small thymus were not at higher risk of intrauterine growth restriction (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.3). A small thymus increased the risk of neonatal sepsis (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.007) and morbidity (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.003), but not the risk of preeclampsia (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.9).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A small fetal thymus is associated with a higher risk of preterm birth, chorioamnionitis, neonatal sepsis and morbidity, but not with intrauterine growth restriction and preeclampsia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13249","type":"journal-article","created":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T14:03:05Z","timestamp":1508767385000},"page":"111-121","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Small fetal thymus and adverse obstetrical outcome: a systematic review and a meta\u2010analysis"],"prefix":"10.1111","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6535-4497","authenticated-orcid":false,"given":"Claudia","family":"Caissutti","sequence":"first","affiliation":[{"name":"Department of Experimental Clinical and Medical Science DISM Clinic of Obstetrics and Gynecology University of Udine Udine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6353-9383","authenticated-orcid":false,"given":"Alessandra","family":"Familiari","sequence":"additional","affiliation":[{"name":"Department of Maternal Fetal Medicine Catholic University of The Sacred Heart Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2802-7670","authenticated-orcid":false,"given":"Asma","family":"Khalil","sequence":"additional","affiliation":[{"name":"Fetal medicine Unit Division of Developmental Sciences St. George's University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria E.","family":"Flacco","sequence":"additional","affiliation":[{"name":"Local Health Unit of Pescara Pescara"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamberto","family":"Manzoli","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences University of Ferrara Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Scambia","sequence":"additional","affiliation":[{"name":"Department of Maternal Fetal Medicine Catholic University of The Sacred Heart Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Cagnacci","sequence":"additional","affiliation":[{"name":"Department of Experimental Clinical and Medical Science DISM Clinic of Obstetrics and Gynecology University of Udine Udine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"D'antonio","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Faculty of Health Sciences UiT \u2013 the Arctic University of Norway Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4560"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1242\/dev.059998"},{"key":"e_1_2_8_4_1","volume-title":"The immune system","author":"Parham P","year":"2009"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.1989.8.12.669"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.257"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7578"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8854"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(99)70140-X"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6320"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8953"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196812122792401"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/hupa.2000.16676"},{"key":"e_1_2_8_14_1","volume-title":"Systematic reviews: CRD's guidance for undertaking reviews in health care","author":"NHS Centre for Reviews and Dissemination","year":"2009"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2015.09.001"},{"key":"e_1_2_8_16_1","unstructured":"Newcastle\u2010Ottawa Scale for assessing the quality of nonrandomised studies in meta\u2010analyses. 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