Diagnostic Efficacy of Cervical Elastography in Predicting Spontaneous Preterm Birth in Pregnancies with Threatened Preterm Labor †
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Maternal Clinical Variables
2.3. Cervical Length and Elastographic Measurements
2.4. Statistical Analysis
3. Result
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Term Delivery (n = 66) | Preterm Birth (n = 84) | p-Value | |
---|---|---|---|
Age (year) | 33 (26–42) | 34 (21–40) | 0.64 |
nulliparity | 44 (66.7) | 50 (59.5) | 0.40 |
Pre-pregnancy BMI | 24.42 (18.31–31.30) | 24.30 (17.62–35.71) | 0.86 |
Smoking | 0 (0) | 1 (1.2) | 1.00 |
Twin pregnancy | 8 (12.1) | 29 (34.5) | <0.01 |
Prior preterm birth | 4 (6.1) | 11 (13.1) | 0.18 |
History of LEEP | 0 (0) | 5 (6.0) | 0.07 |
DM | 1 (1.5) | 1 (1.2) | 1.00 |
HTN | 0 (0.0) | 2 (2.4) | 0.50 |
GDM | 9 (15.0) | 11 (13.3) | 0.81 |
Preeclampsia | 1 (1.7) | 3 (3.6) | 0.64 |
GA at exam (weeks) | 29.0 ± 3.3 | 28.9 ± 3.6 | 0.86 |
CL at exam (mm) | 25.4 (9.0–45.0) | 18.7 (2.7–41.8) | <0.01 |
<15 mm | 14 (21.2) | 29 (34.5) | |
15 mm–25 mm | 22 (33.3) | 37 (44.1) | |
>25 mm | 30 (45.5) | 18 (21.4) | |
Funneling | 9 (13.6) | 26 (31.0) | 0.02 |
Cerclage after enrollment | 0 (0) | 2 (2.4) | 0.50 |
Tocolytics after enrollment | 58 (87.9) | 78 (94.0) | 0.25 |
Progesterone after enrollment | 27 (40.9) | 39 (47.0) | 0.51 |
GA at delivery (days) | 38.7 ± 1.0 | 33.8 ± 2.7 | <0.01 |
Cesarean delivery | 31 (47.0) | 26 (31.3) | 0.06 |
Term Delivery (n = 52) | Preterm Birth (n = 55) | p-Value | |
---|---|---|---|
Age (year) | 32 (27–42) | 34 (21–40) | 0.46 |
Nulliparity | 34 (65.4) | 36 (65.5) | 1.00 |
Pre-pregnancy BMI | 24.35 (18.31–31.31) | 24.03 (18.65–32.30) | 0.82 |
Smoking | 0 (0) | 1 (1.8) | 1.00 |
Twin pregnancy | 6 (11.5) | 18 (32.7) | 0.01 |
Prior preterm birth | 4 (7.7) | 6 (10.9) | 0.74 |
History of LEEP | 0 (0) | 3 (5.5) | 0.24 |
DM | 1 (1.9) | 1 (1.8) | 1.00 |
HTN | 0 (0.0) | 2 (3.6) | 0.50 |
GA at exam (weeks) | 28.6 ± 3.51 | 28.4 ± 3.81 | 0.95 |
CL at exam (mm) | 27.5 (15.0–45.0) | 21.9 (15.0–41.8) | <0.01 |
≤25 mm | 22 (42.3) | 37 (67.3) | |
>25 mm. | 30 (57.7) | 18 (32.7) | |
Funneling | 4 (7.7) | 10 (18.2) | 0.15 |
Tocolytics after enrollment | 46 (88.5) | 50 (92.6) | 0.52 |
Progesterone after enrollment | 19 (36.5) | 20 (37.0) | 1.00 |
GA at delivery (days) | 38.7 ± 1.05 | 33.9 ± 2.53 | <0.01 |
Parameters | Term Delivery (n = 52) | Preterm Birth (n = 55) | p-Value |
---|---|---|---|
IOS | 0.26 (0.17–0.45) | 0.30 (0.18–0.50) | 0.04 |
EOS | 0.32 (0.19–0.56) | 0.32 (0.12-0.51) | 0.37 |
IOS/EOS ratio | 0.84 (0.36–1.55) | 0.99 (0.63–1.95) | 0.02 |
ECI | 3.33 (1.99–5.72) | 3.62 (2.46–6.67) | 0.04 |
HR | 65.90 (27.78–77.42) | 59.37 (24.90–87.65) | 0.17 |
p-Value | aOR | 95% CI | |
---|---|---|---|
CL ≤ 25 mm | 0.02 | 2.62 | 1.17–5.89 |
Twin pregnancy | 0.09 | 2.69 | 0.86–8.41 |
IOS | 0.18 | 1.46 | 0.84–2.51 |
IOS/EOS ratio | 0.01 | 10.45 | 1.82–59.98 |
ECI | 0.04 | 1.55 | 1.01–2.37 |
ROC/AUC | 95% CI | p-Value | Cutoff | Sensitivity (%) | Specificity (%) | Youden Index | |
---|---|---|---|---|---|---|---|
CL ≤ 25 mm | 0.63 | 0.52–0.73 | 0.03 | 62.7 | 62.5 | 0.25 | |
IOS/EOS ratio | 0.68 | 0.58–0.78 | <0.01 | ≥0.96 | 65.5 | 30.8 | 0.35 |
ECI | 0.61 | 0.51–0.72 | 0.04 | ≥3.21 | 70.9 | 51.9 | 0.19 |
Models for predicting preterm birth | |||||||
CL ≤ 25 mm + IOS/EOS ratio | 0.71 | 0.61–0.81 | <0.01 | ≥0.87 | 73.0 | 54.5 | 0.41 |
CL ≤ 25 mm + ECI | 0.68 | 0.58–0.78 | <0.01 | ≥2.99 | 83.8 | 59.1 | 0.37 |
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Kwon, H.; Sung, J.-H.; Park, H.S.; Kwon, J.-Y.; Jung, Y.J.; Seol, H.-J.; Kim, H.M.; Seong, W.J.; Hwang, H.S.; Oh, S.-Y.; et al. Diagnostic Efficacy of Cervical Elastography in Predicting Spontaneous Preterm Birth in Pregnancies with Threatened Preterm Labor. Diagnostics 2025, 15, 1934. https://doi.org/10.3390/diagnostics15151934
Kwon H, Sung J-H, Park HS, Kwon J-Y, Jung YJ, Seol H-J, Kim HM, Seong WJ, Hwang HS, Oh S-Y, et al. Diagnostic Efficacy of Cervical Elastography in Predicting Spontaneous Preterm Birth in Pregnancies with Threatened Preterm Labor. Diagnostics. 2025; 15(15):1934. https://doi.org/10.3390/diagnostics15151934
Chicago/Turabian StyleKwon, Hayan, Ji-Hee Sung, Hyun Soo Park, Ja-Young Kwon, Yun Ji Jung, Hyun-Joo Seol, Hyun Mi Kim, Won Joon Seong, Han Sung Hwang, Soo-Young Oh, and et al. 2025. "Diagnostic Efficacy of Cervical Elastography in Predicting Spontaneous Preterm Birth in Pregnancies with Threatened Preterm Labor" Diagnostics 15, no. 15: 1934. https://doi.org/10.3390/diagnostics15151934
APA StyleKwon, H., Sung, J.-H., Park, H. S., Kwon, J.-Y., Jung, Y. J., Seol, H.-J., Kim, H. M., Seong, W. J., Hwang, H. S., Oh, S.-Y., & on behalf of The Korean Consortium for the Study of Cervical Elastography in Prediction of Preterm Delivery. (2025). Diagnostic Efficacy of Cervical Elastography in Predicting Spontaneous Preterm Birth in Pregnancies with Threatened Preterm Labor. Diagnostics, 15(15), 1934. https://doi.org/10.3390/diagnostics15151934