{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:13:07Z","timestamp":1790669587192,"version":"4.1.0"},"reference-count":87,"publisher":"Walter de Gruyter GmbH","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,7,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpm-2018-0062_s_999_w2aab3b7c45b1b6b1aab1c16b1Aa\">\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>To determine whether a soft cervix identified by shear-wave elastography between 18 and 24 weeks of gestation is associated with increased frequency of spontaneous preterm delivery (sPTD).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2018-0062_s_998_w2aab3b7c45b1b6b1aab1c16b2Aa\">\n                  <jats:title>Materials and methods:<\/jats:title>\n                  <jats:p>This prospective cohort study included 628 consecutive women with a singleton pregnancy. Cervical length (mm) and softness [shear-wave speed: (SWS) meters per second (m\/s)] of the internal cervical os were measured at 18\u201324 weeks of gestation. Frequency of sPTD &lt;37 (sPTD&lt;37) and &lt;34 (sPTD&lt;34) weeks of gestation was compared among women with and without a short (\u226425 mm) and\/or a soft cervix (SWS &lt;25<jats:sup>th<\/jats:sup> percentile).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2018-0062_s_997_w2aab3b7c45b1b6b1aab1c16b3Aa\">\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>There were 31\/628 (4.9%) sPTD&lt;37 and 12\/628 (1.9%) sPTD&lt;34 deliveries. The combination of a soft and a short cervix increased the risk of sPTD&lt;37 by 18-fold [relative risk (RR) 18.0 (95% confidence interval [CI], 7.7\u201343.9); P&lt;0.0001] and the risk of sPTD&lt;34 by 120-fold [RR 120.0 (95% CI 12.3\u20131009.9); P&lt;0.0001] compared to women with normal cervical length. A soft-only cervix increased the risk of sPTD&lt;37 by 4.5-fold [RR 4.5 (95% CI 2.1\u20139.8); P=0.0002] and of sPTD&lt;34 by 21-fold [RR 21.0 (95% CI 2.6\u2013169.3); P=0.0003] compared to a non-soft cervix.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2018-0062_s_996_w2aab3b7c45b1b6b1aab1c16b4Aa\">\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>A soft cervix at 18\u201324 weeks of gestation increases the risk of sPTD &lt;37 and &lt;34 weeks of gestation independently of cervical length.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpm-2018-0062","type":"journal-article","created":{"date-parts":[[2018,5,30]],"date-time":"2018-05-30T22:18:06Z","timestamp":1527718686000},"page":"489-501","source":"Crossref","is-referenced-by-count":69,"title":["A soft cervix, categorized by shear-wave elastography, in women with short or with normal cervical length at 18\u201324 weeks is associated with a higher prevalence of spontaneous preterm delivery"],"prefix":"10.1515","volume":"46","author":[{"given":"Edgar","family":"Hernandez-Andrade","sequence":"first","affiliation":[{"name":"Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services , Wayne State University\/Hutzel Women\u2019s Hospital , 3990 John R, Box 4 , Bethesda, MD and Detroit, MI 48201 , USA"},{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit, MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli","family":"Maymon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit, MI , USA"},{"name":"Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services , Bethesda, MD and Detroit, MI , USA"},{"name":"Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beersheba , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchaya","family":"Luewan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit, MI , USA"},{"name":"Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services , Bethesda, MD and Detroit, MI , USA"},{"name":"Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynecology, Faculty of Medicine , Chiang Mai University , Chiang Mai , Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Bhatti","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit, MI , USA"},{"name":"Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services , Bethesda, MD and Detroit, MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Mehrmohammadi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering , College of Engineering, Wayne State University , Detroit, MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Offer","family":"Erez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit, MI , USA"},{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit, MI , USA"},{"name":"Department of Obstetrics and Gynecology , Soroka University Medical Center, School of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev , Beersheba , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Percy","family":"Pacora","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit, MI , USA"},{"name":"Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services , Bethesda, MD and Detroit, MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan","family":"Done","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit, MI , USA"},{"name":"Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services , Bethesda, MD and Detroit, MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia S.","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit, MI , USA"},{"name":"Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services , Bethesda, MD and Detroit, MI , USA"},{"name":"Department of Physiology , Wayne State University School of Medicine , Detroit, MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Romero","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services , Wayne State University\/Hutzel Women\u2019s Hospital , 3990 John R, Box 4 , Bethesda, MD and Detroit, MI 48201 , USA"},{"name":"Department of Obstetrics and Gynecology , University of Michigan , Ann Arbor, MI , 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