{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T08:15:04Z","timestamp":1780474504295,"version":"3.54.1"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T00:00:00Z","timestamp":1626912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The aim of the study is to compare the effect of cervical length measured with transvaginal ultrasound in the second trimester on the risk of spontaneous preterm delivery (PTD) between different risk groups of asymptomatic women with a singleton pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This is a pre\u2010planned exploratory analysis of the CERVIX study, a prospective blinded multicenter diagnostic accuracy study. Asymptomatic women with a singleton pregnancy were consecutively recruited at their second\u2010trimester routine ultrasound examination at seven Swedish ultrasound centers. Cervical length was measured with transvaginal ultrasound at 18\u201320\u00a0weeks (Cx1; <jats:italic>n<\/jats:italic>\u00a0=\u00a011\u00a0072) and 21\u201323\u00a0weeks (Cx2, optional; <jats:italic>n<\/jats:italic>\u00a0=\u00a06288). The effect of cervical length on the risk of spontaneous PTD and its discriminative ability was compared between women with: (i) previous spontaneous PTD, late miscarriage or cervical conization (high\u2010risk group; <jats:italic>n<\/jats:italic>\u00a0=\u00a01045); (ii) nulliparae without risk factors (<jats:italic>n<\/jats:italic>\u00a0=\u00a05173); (iii) parae without risk factors (<jats:italic>n<\/jats:italic>\u00a0=\u00a04740). Women with previous indicated PTD were excluded (<jats:italic>n<\/jats:italic>\u00a0=\u00a0114). Main outcome measures were: effect of cervical length on the risk of spontaneous PTD expressed as odds ratio per 5\u2010mm decrease in cervical length with interaction analysis using logistic regression to test whether the effect differed between groups, area under the receiver operating characteristic curve (AUC), sensitivity, specificity, number needed to screen to detect one spontaneous PTD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The effect of cervical length at Cx2 on the risk of spontaneous PTD &lt;33\u00a0weeks was similar in all groups (odds ratios 2.26\u20132.58, interaction <jats:italic>p<\/jats:italic> value 0.91). The discriminative ability at Cx2 was superior to that at Cx1 and was similar in all groups (AUC 0.69\u20130.76). Cervical length \u226425\u00a0mm at Cx2 identified 57% of spontaneous preterm deliveries &lt;33\u00a0weeks in the high\u2010risk group with number needed to screen 161. The number needed to screen for groups (ii) and (iii) were 1018 and 843.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The effect of cervical length at 21\u201323\u00a0weeks on the risk of spontaneous PTD &lt;33 weeks is similar in high\u2010 and low\u2010risk pregnancies. The differences in number needed to screen should be considered before implementing a screening program.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14203","type":"journal-article","created":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T04:10:52Z","timestamp":1623039052000},"page":"1644-1655","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Effect of second\u2010trimester sonographic cervical length on the risk of spontaneous preterm delivery in different risk groups: A prospective observational multicenter study"],"prefix":"10.1111","volume":"100","author":[{"given":"Tove","family":"Wikstr\u00f6m","sequence":"first","affiliation":[{"name":"Center of Perinatal Medicine and Health Department of Obstetrics and Gynecology Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"},{"name":"Department of Obstetrics Sahlgrenska University Hospital Gothenburg 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