{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:43:18Z","timestamp":1790800998252,"version":"4.1.0"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Taiwan Institute of Fetal Medicine","award":["2019-011"],"award-info":[{"award-number":["2019-011"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nBackground<\/jats:title>\nShortened cervical length is one of the primary predictors for spontaneous preterm deliveries in twin pregnancies. However, there is lack of consensus regarding cut-off values. Recent evidence highlights that established cut-offs for cervical length screening might not always apply across different populations. This study aims to present the distribution of cervical length in Taiwanese twin pregnancies and to assess its predictive value for spontaneous preterm birth during mid-trimester screening.<\/jats:p>\n<\/jats:sec>\n\nMaterials and methods<\/jats:title>\nThis retrospective analysis of cervical length screening in Taiwan evaluated 469 twin pregnancies between 20\u201324 weeks of gestation. Outcome data were obtained directly from the medical records of the delivery hospital. The study explored the predictive value of cervical length screening for spontaneous preterm birth and the characteristics of cervical length distribution in Taiwanese twin pregnancies.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nThe average gestational age at screening was 22.7 weeks. Cervical length values displayed a non-normal distribution (p-value<\/jats:italic> <0.001). The median, 5th<\/jats:sup> and 95th<\/jats:sup> centiles were 37.5 mm 25.1 mm, and 47.9 mm, respectively. Various cut-off values were assessed using different methods, yielding positive [negative] likelihood ratios for spontaneous preterm births between 32\u201337 weeks of gestational age (GA) (1.3\u201330.1 and [0.51\u20130.92]) and for very preterm births between 28\u201332 weeks GA (5.6\u201351.1 and [0.45\u20130.64]).<\/jats:p>\n<\/jats:sec>\n\nConclusions<\/jats:title>\nThe findings from our analysis of Taiwanese twin pregnancies uphold the moderate predictive potential of cervical length screening, consistent with prior investigations. The presented likelihood ratios for predicting preterm birth at different gestational ages equip clinicians with valuable tools to enhance their diagnostic rationale and resource utilization. By fine-tuning screening parameters according to the spontaneous preterm birth prevalence and clinical priorities of the particular population, healthcare providers can enhance patient care. Our data implies that a cervical length below 20 mm might provide an optimal balance between minimizing false negatives and managing false positives when predicting spontaneous preterm birth.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0292533","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T17:52:05Z","timestamp":1696528325000},"page":"e0292533","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Ultrasonographic cervical length screening at 20\u201324 weeks of gestation in twin pregnancies for prediction of spontaneous preterm birth: A 10-year Taiwanese cohort"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8973-2202","authenticated-orcid":true,"given":"Ksenia","family":"Olisova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hsuan","family":"Sao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8137-9953","authenticated-orcid":true,"given":"Eric C.","family":"Lussier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chan-Yu","family":"Sung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng-Hui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0690-7503","authenticated-orcid":true,"given":"Chang-Ching","family":"Yeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8217-5530","authenticated-orcid":true,"given":"Tung-Yao","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,10,5]]},"reference":[{"key":"pone.0292533.ref001","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.1016\/S0140-6736(12)60820-4","article-title":"National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications","volume":"379","author":"H Blencowe","year":"2012","journal-title":"Lancet Lond Engl"},{"key":"pone.0292533.ref002","first-page":"1","article-title":"Births: Final Data for 2021.","volume":"72","author":"MJK Osterman","year":"2023","journal-title":"Natl Vital Stat Rep Cent Dis Control Prev Natl Cent Health Stat Natl Vital Stat Syst."},{"key":"pone.0292533.ref003","doi-asserted-by":"crossref","first-page":"103.e1","DOI":"10.1016\/j.ajog.2016.01.004","article-title":"Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort.","volume":"215","author":"TA Manuck","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"pone.0292533.ref004","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.ajog.2010.04.031","article-title":"Twins: prevalence, problems, and preterm births.","volume":"203","author":"SP Chauhan","year":"2010","journal-title":"Am J Obstet Gynecol"},{"key":"pone.0292533.ref005","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1056\/NEJM199602293340904","article-title":"The Length of the Cervix and the Risk of Spontaneous Premature Delivery","volume":"334","author":"JD Iams","year":"1996","journal-title":"N Engl J Med"},{"key":"pone.0292533.ref006","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1046\/j.1469-0705.1998.12050312.x","article-title":"Cervical length at 23 weeks of gestation: prediction of spontaneous preterm delivery.","volume":"12","author":"VCF Heath","year":"1998","journal-title":"Ultrasound Obstet Gynecol"},{"key":"pone.0292533.ref007","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1097\/01.AOG.0000270112.05025.1d","article-title":"Gestational age at cervical length measurement and incidence of preterm birth.","volume":"110","author":"V Berghella","year":"2007","journal-title":"Obstet Gynecol."},{"key":"pone.0292533.ref008","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/S0002-9378(96)80051-2","article-title":"The preterm prediction study: risk factors in twin gestations. 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