The Novel Ultrasonographic Marker of Uterocervical Angle for Prediction of Spontaneous Preterm Birth in Singleton and Twin Pregnancies: A Systematic Review and Meta-Analysis

The alteration of the uterocervical angle (UCA) has been proposed to play an important role in spontaneous preterm birth (sPTB). The aim of this systematic review and meta-analysis was to evaluate the evidence on the UCA predictive role in sPTB. In this study, PubMed, Web of Science, Scopus, and Google scholar were systematically searched from inception up to June 2020. Inter-study heterogeneity was also assessed using Cochrane’s Q test and the I2 statistic. Afterward, the random-effects model was used to pool the weighted mean differences (WMDs) and the corresponding 95% confidence intervals (CIs). Eleven articles that reported second-trimester UCA of 5,061 pregnancies were included in this study. Our meta-analysis results indicate that a wider UCA significantly increases the risk of sPTB in following cases: all pregnancies (WMD = 15.25, 95% CI: 11.78–18.72, p < 0.001; I2 = 75.9%, p < 0.001), singleton (WMD = 14.43, 95% CI: 8.79–20.06, p < 0.001; I2 = 82.4%, p < 0.001), and twin pregnancies (WMD = 15.14, 95% CI: 13.42–16.87, p < 0.001; I2 = 0.0%, p = 0.464). A wider ultrasound-measured UCA in the second trimester seems to be associated with the increased risk of sPTB in both singleton and twin pregnancies, which reinforces the clinical evidence that UCA has the potential to be used as a predictive marker of sPTB.

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Association between maternal sleep duration and quality, and the risk of preterm birth: a systematic review and meta-analysis of observational studies

10.21203/rs.2.12630/v6 ◽

2020 ◽

Author(s):

ling wang ◽

Feng Jin

Keyword(s):

Systematic Review ◽

Preterm Birth ◽

Sleep Quality ◽

Sleep Duration ◽

Meta Analysis ◽

Controlled Study ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Increased Risk ◽

Study Heterogeneity

Abstract Background : To assess the association of sleep duration and quality with the risk of preterm birth. Methods : Relevant studies were retrieved from the PubMed and Web of Science databases up to September 30, 2018. The reference lists of the retrieved articles were reviewed. Random effects models were applied to estimate summarized relative risks (RRs) and 95% confidence intervals (CIs). Results : Ten identified studies (nine cohort studies and one case-controlled study) examined the associations of sleep duration and quality with the risk of preterm birth. As compared with women with the longest sleep duration, the summary RR was 1.23 (95% CI = 1.01–1.50) for women with the shortest sleep duration, with moderate between-study heterogeneity ( I 2 = 57.4%). Additionally, as compared with women with good sleep quality, the summary RR was 1.54 (95% CI = 1.18–2.01) for women with poor sleep quality (Pittsburgh Sleep Quality Index > 5), with high between-study heterogeneity ( I 2 = 76.7%). Funnel plots as well as the Egger’s and Begg’s tests revealed no evidence of publication bias. Conclusions : This systematic review and meta-analysis revealed that short sleep duration and poor sleep quality may be associated with an increased risk of preterm birth. Further subgroup analyses are warranted to test the robustness of these findings as well as to identify potential sources of heterogeneity.

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Association between maternal sleep duration and quality, and the risk of preterm birth: a systematic review and meta-analysis of observational studies

10.21203/rs.2.12630/v4 ◽

2020 ◽

Author(s):

ling wang ◽

Feng Jin

Keyword(s):

Systematic Review ◽

Preterm Birth ◽

Sleep Quality ◽

Sleep Duration ◽

Meta Analysis ◽

Controlled Study ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Increased Risk ◽

Study Heterogeneity

Abstract Study Objectives: To assess the association between sleep duration and quality, and the risk of preterm birth.Methods: Relevant studies were retrieved from the PubMed and Web of Science databases up to September 30, 2018. The reference lists of the retrieved articles were reviewed. Random effects models were applied to estimate summarized relative risks (RRs) and 95% confidence intervals (CIs).Results: Ten identified studies (nine cohort studies and one case-controlled study) examined the associations between sleep duration and quality and the risk of preterm birth. As compared with women with the longest sleep duration, the summary RR was 1.23 (95% CI = 1.01–1.50) for women with the shortest sleep duration, with moderate between-study heterogeneity (I2 = 57.4%). Additionally, as compared with women with good sleep quality, the summary RR was 1.54 (95% CI = 1.18–2.01) for women with poor sleep quality (Pittsburgh Sleep Quality Index > 5), with high between-study heterogeneity (I2 = 76.7%). The results of stratified analysis by trimester, geographical location, study design, type of preterm birth, and adjustment for potential confounders were comparable to those of the main meta-analysis. Funnel plots as well as the Egger’s and Begg’s tests showed no evidence of publication bias. Conclusions: This systematic review and meta-analysis revealed that short sleep duration and poor sleep quality may be associated with an increased risk of preterm birth.

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Association between maternal sleep duration and quality, and the risk of preterm birth: a systematic review and meta-analysis of observational studies

10.21203/rs.2.12630/v5 ◽

2020 ◽

Author(s):

ling wang ◽

Feng Jin

Keyword(s):

Systematic Review ◽

Preterm Birth ◽

Sleep Quality ◽

Sleep Duration ◽

Meta Analysis ◽

Controlled Study ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Increased Risk ◽

Study Heterogeneity

Abstract Study Objectives: To assess the association of sleep duration and quality with the risk of preterm birth. Methods: Relevant studies were retrieved from the PubMed and Web of Science databases up to September 30, 2018. The reference lists of the retrieved articles were reviewed. Random effects models were applied to estimate summarized relative risks (RRs) and 95% confidence intervals (CIs). Results: Ten identified studies (nine cohort studies and one case-controlled study) examined the associations of sleep duration and quality with the risk of preterm birth. As compared with women with the longest sleep duration, the summary RR was 1.23 (95% CI = 1.01–1.50) for women with the shortest sleep duration, with moderate between-study heterogeneity (I2 = 57.4%). Additionally, as compared with women with good sleep quality, the summary RR was 1.54 (95% CI = 1.18–2.01) for women with poor sleep quality (Pittsburgh Sleep Quality Index > 5), with high between-study heterogeneity (I2 = 76.7%). Funnel plots as well as the Egger’s and Begg’s tests revealed no evidence of publication bias. Conclusions: This systematic review and meta-analysis revealed that short sleep duration and poor sleep quality may be associated with an increased risk of preterm birth. Further subgroup analyses are warranted to test the robustness of these findings as well as to identify potential sources of heterogeneity.

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Association between maternal sleep duration and quality, and the risk of preterm birth: a systematic review and meta-analysis of observational studies

10.21203/rs.2.12630/v3 ◽

2019 ◽

Author(s):

ling wang ◽

Feng Jin

Keyword(s):

Systematic Review ◽

Preterm Birth ◽

Sleep Quality ◽

Sleep Duration ◽

Meta Analysis ◽

Controlled Study ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Increased Risk ◽

Study Heterogeneity

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Association between maternal sleep duration and quality and the risk of preterm birth: a systematic review and meta-analysis of observational studies

10.21203/rs.2.12630/v1 ◽

2019 ◽

Author(s):

ling wang ◽

Feng Jin

Keyword(s):

Systematic Review ◽

Preterm Birth ◽

Sleep Quality ◽

Sleep Duration ◽

Meta Analysis ◽

Controlled Study ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Increased Risk ◽

Study Heterogeneity

Abstract Abstract Background: The association between sleep duration and quality and the risk of preterm birth remains controversial. Methods: Relevant studies were retrieved from the PubMed and Web of Science databases up to the end of September 2018 and the reference lists of the retrieved articles were reviewed. Random effects models were applied to estimate summarized relative risks (RRs) and 95% confidence intervals (CIs). Results: Ten identified studies (nine cohort studies and one case-controlled study) examined the associations between sleep duration and quality and the risk of preterm birth. Compared with women with the shortest sleep duration, the summary RRs were 0.76 (95% CI = 0.64–0.89) for women with the longest sleep duration, without between-study heterogeneity (I2 = 0%). Additionally, as compared with women with good sleep quality, the summary RRs were 1.54 (95% CI = 1.18–2.01) for women with poor sleep quality (Pittsburgh Sleep Quality Index > 5), with high between-study heterogeneity (I2 = 76.7%). The results of stratified analysis by trimester, geographical location, study design, type of preterm birth, and adjustment for potential confounders were comparable to those of the main meta-analysis. Funnel plots as well as the Egger’s and Begg’s tests showed no evidence of publication bias. Conclusions: This systematic review and meta-analysis revealed that short sleep duration and poor sleep quality may be associated with an increased risk of preterm birth.

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Association between maternal sleep duration and quality and the risk of preterm birth: a systematic review and meta-analysis of observational studies

10.21203/rs.2.12630/v2 ◽

2019 ◽

Author(s):

ling wang ◽

Feng Jin

Keyword(s):

Systematic Review ◽

Preterm Birth ◽

Sleep Quality ◽

Sleep Duration ◽

Meta Analysis ◽

Controlled Study ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Increased Risk ◽

Study Heterogeneity

Abstract Study Objectives: The association between sleep duration and quality and the risk of preterm birth remains controversial.Methods: Relevant studies were retrieved from the PubMed and Web of Science databases up to the end of September 2018 and the reference lists of the retrieved articles were reviewed. Random effects models were applied to estimate summarized relative risks (RRs) and 95% confidence intervals (CIs).Results: Ten identified studies (nine cohort studies and one case-controlled study) examined the associations between sleep duration and quality and the risk of preterm birth. Compared with women with the longest sleep duration, the summary RR was 1.23 (95% CI = 1.01-1.50) for women with the shortest sleep duration, with moderate between-study heterogeneity (I2 = 57.4%). Additionally, as compared with women with good sleep quality, the summary RR was 1.54 (95% CI = 1.18-2.01) for women with poor sleep quality (Pittsburgh Sleep Quality Index > 5), with high between-study heterogeneity (I2 = 76.7%). The results of stratified analysis by trimester, geographical location, study design, type of preterm birth, and adjustment for potential confounders were comparable to those of the main meta-analysis. Funnel plots as well as the Egger’s and Begg’s tests showed no evidence of publication bias. Conclusions: This systematic review and meta-analysis revealed that short sleep duration and poor sleep quality may be associated with an increased risk of preterm birth.

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Role of progesterone, cerclage and pessary in preventing preterm birth in twin pregnancies: A systematic review and network meta-analysis

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2021.04.023 ◽

2021 ◽

Vol 261 ◽

pp. 166-177

Author(s):

Francesco D’Antonio ◽

Vincenzo Berghella ◽

Daniele Di Mascio ◽

Gabriele Saccone ◽

Filomena Sileo ◽

...

Keyword(s):

Systematic Review ◽

Preterm Birth ◽

Meta Analysis ◽

Twin Pregnancies

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Accelerated Fetal Growth in Early Pregnancy and Risk of Preterm Birth: A Prospective Cohort Study

10.21203/rs.3.rs-39242/v1 ◽

2020 ◽

Author(s):

Evangelia Elenis ◽

Anna-Karin Wikström ◽

Marija Simic

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Prospective Cohort Study ◽

Fetal Growth ◽

Early Pregnancy ◽

Prospective Cohort ◽

Late Gestation ◽

Second Trimester ◽

Spontaneous Preterm Birth ◽

Increased Risk

Abstract Background: Preterm birth (occurring before 37 completed weeks of gestation) affects 15 million infants annually, 7.5% of which die due to related complications. The detection and early diagnosis are therefore paramount in order to prevent the development of prematurity and its consequences. So far, focus has been laid on the association between reduced intrauterine fetal growth during late gestation and prematurity. The aim of the current study was to investigate the association between accelerated fetal growth in early pregnancy and the risk of preterm birth. Methods: This prospective cohort study included 69 617 singleton pregnancies without congenital malformations and with available biometric measurements during the first and second trimester. Estimation of fetal growth was based on measurements of biparietal diameter (BPD) at first and second trimester scan. We investigated the association between accelerated fetal growth and preterm birth prior to 37 weeks of gestation. The outcome was further stratified into very preterm birth (before 32 weeks of gestation) or moderate preterm birth (between 32 and 37 weeks of gestation) and medically induced or spontaneous preterm birth and was further explored. Results: The odds of prematurity were increased among fetuses with accelerated BPD growth (> 90th centile) estimated between first and second ultrasound scan, even after adjustment for possible confounders (aOR 1.36; 95% CI 1.20-1.54). The findings remained significant what regards moderate preterm births but not earlier births. Regarding medically induced preterm birth, the odds were found to be elevated in the group of fetuses with accelerated growth in early pregnancy (aOR 1.34; 95% CI 1.11-1.63). On the contrary, fetuses with delayed fetal growth exhibited lower risk for both overall and spontaneous preterm birth.Conclusions: Fetuses with accelerated BPD growth in early pregnancy, detected by ultrasound examination during the second trimester, exhibited increased risk of being born preterm. The findings of the current study suggest that fetal growth in early pregnancy should be taken into account when assessing the likelihood for preterm birth.

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