The prediction of preterm birth in twin pregnancy: an individual patient level meta-analysis.

Lindsay Kindinger; Chiu Yee Liona Poon; Stefano Cacciatore; David MacIntyre; Nathan Fox; E Schuit; Ben Mol; S  Liem; A Lim; F Hermans; V Serra; A Perales; Ara Darzi; Philip Bennet; Kypros Herodotou Nicolaides; TG Teoh

doi:10.1111/1471-0528.13575

The prediction of preterm birth in twin pregnancy: an individual patient level meta-analysis.

Lindsay Kindinger, Chiu Yee Liona Poon, Stefano Cacciatore, David MacIntyre, Nathan Fox, E Schuit, Ben Mol, S Liem, A Lim, F Hermans, V Serra, A Perales, Ara Darzi, Philip Bennet, Kypros Herodotou Nicolaides, TG Teoh

Women & Children's Health

Research output: Contribution to journal › Review article › peer-review

49 Citations (Scopus)

Abstract

Objective: To assess the effect of gestational age (GA) and cervical length (CL) measurements at transvaginal ultrasound (TVUS) in the prediction of preterm birth in twin pregnancy.
Design: Individual patient data (IPD) meta-analysis
Setting: International multicentre study
Population: Twin pregnancies
Methods: MEDLINE and EMBASE searches were performed and IPD obtained from authors of relevant studies. Multinomial logistic regression analysis determined probabilities for birth at ≤28+0, 28+1 to 32+0, 32+1 to 36+0, and ≥36+1 weeks as a function of GA at screening and CL measurements.
Main outcome measure: Predicted probabilities for preterm birth at ≤28+0, 28+1 to 32+0, and 32+1 to 36+0.
Results: A total of 6188 CL measurements were performed on 4409 twin pregnancies in twelve studies. Both GA at screening and CL had a significant and non-linear effect on GA at birth. The best prediction of birth ≤28+0 weeks was provided by screening at ≤18+0 weeks (p<0.001), whereas the best prediction of birth between 28+1 and 36+0 weeks was provided by screening at ≥24+0 weeks (p<0.001).
Conclusion: In twin pregnancies, prediction of preterm birth depends on both CL and the GA at screening. Screening ≤18+0 weeks is most predictive for birth at ≤28+0 weeks.

Original language	English
Number of pages	8
Journal	British Journal of Obstetrics and Gynaecology
DOIs	https://doi.org/10.1111/1471-0528.13575
Publication status	E-pub ahead of print - 1 Sept 2015

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10.1111/1471-0528.13575

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Kindinger, L., Poon, C. Y. L., Cacciatore, S., MacIntyre, D., Fox, N., Schuit, E., Mol, B., Liem, S., Lim, A., Hermans, F., Serra, V., Perales, A., Darzi, A., Bennet, P., Nicolaides, K. H., & Teoh, TG. (2015). The prediction of preterm birth in twin pregnancy: an individual patient level meta-analysis. British Journal of Obstetrics and Gynaecology. Advance online publication. https://doi.org/10.1111/1471-0528.13575

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title = "The prediction of preterm birth in twin pregnancy: an individual patient level meta-analysis.",

abstract = "Objective: To assess the effect of gestational age (GA) and cervical length (CL) measurements at transvaginal ultrasound (TVUS) in the prediction of preterm birth in twin pregnancy.Design: Individual patient data (IPD) meta-analysis Setting: International multicentre studyPopulation: Twin pregnanciesMethods: MEDLINE and EMBASE searches were performed and IPD obtained from authors of relevant studies. Multinomial logistic regression analysis determined probabilities for birth at ≤28+0, 28+1 to 32+0, 32+1 to 36+0, and ≥36+1 weeks as a function of GA at screening and CL measurements. Main outcome measure: Predicted probabilities for preterm birth at ≤28+0, 28+1 to 32+0, and 32+1 to 36+0.Results: A total of 6188 CL measurements were performed on 4409 twin pregnancies in twelve studies. Both GA at screening and CL had a significant and non-linear effect on GA at birth. The best prediction of birth ≤28+0 weeks was provided by screening at ≤18+0 weeks (p<0.001), whereas the best prediction of birth between 28+1 and 36+0 weeks was provided by screening at ≥24+0 weeks (p<0.001).Conclusion: In twin pregnancies, prediction of preterm birth depends on both CL and the GA at screening. Screening ≤18+0 weeks is most predictive for birth at ≤28+0 weeks.",

author = "Lindsay Kindinger and Poon, {Chiu Yee Liona} and Stefano Cacciatore and David MacIntyre and Nathan Fox and E Schuit and Ben Mol and S Liem and A Lim and F Hermans and V Serra and A Perales and Ara Darzi and Philip Bennet and Nicolaides, {Kypros Herodotou} and TG Teoh",

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doi = "10.1111/1471-0528.13575",

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T1 - The prediction of preterm birth in twin pregnancy: an individual patient level meta-analysis.

AU - Kindinger, Lindsay

AU - Poon, Chiu Yee Liona

AU - Cacciatore, Stefano

AU - MacIntyre, David

AU - Fox, Nathan

AU - Schuit, E

AU - Mol, Ben

AU - Liem, S

AU - Lim, A

AU - Hermans, F

AU - Serra, V

AU - Perales, A

AU - Darzi, Ara

AU - Bennet, Philip

AU - Nicolaides, Kypros Herodotou

AU - Teoh, TG

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Objective: To assess the effect of gestational age (GA) and cervical length (CL) measurements at transvaginal ultrasound (TVUS) in the prediction of preterm birth in twin pregnancy.Design: Individual patient data (IPD) meta-analysis Setting: International multicentre studyPopulation: Twin pregnanciesMethods: MEDLINE and EMBASE searches were performed and IPD obtained from authors of relevant studies. Multinomial logistic regression analysis determined probabilities for birth at ≤28+0, 28+1 to 32+0, 32+1 to 36+0, and ≥36+1 weeks as a function of GA at screening and CL measurements. Main outcome measure: Predicted probabilities for preterm birth at ≤28+0, 28+1 to 32+0, and 32+1 to 36+0.Results: A total of 6188 CL measurements were performed on 4409 twin pregnancies in twelve studies. Both GA at screening and CL had a significant and non-linear effect on GA at birth. The best prediction of birth ≤28+0 weeks was provided by screening at ≤18+0 weeks (p<0.001), whereas the best prediction of birth between 28+1 and 36+0 weeks was provided by screening at ≥24+0 weeks (p<0.001).Conclusion: In twin pregnancies, prediction of preterm birth depends on both CL and the GA at screening. Screening ≤18+0 weeks is most predictive for birth at ≤28+0 weeks.

AB - Objective: To assess the effect of gestational age (GA) and cervical length (CL) measurements at transvaginal ultrasound (TVUS) in the prediction of preterm birth in twin pregnancy.Design: Individual patient data (IPD) meta-analysis Setting: International multicentre studyPopulation: Twin pregnanciesMethods: MEDLINE and EMBASE searches were performed and IPD obtained from authors of relevant studies. Multinomial logistic regression analysis determined probabilities for birth at ≤28+0, 28+1 to 32+0, 32+1 to 36+0, and ≥36+1 weeks as a function of GA at screening and CL measurements. Main outcome measure: Predicted probabilities for preterm birth at ≤28+0, 28+1 to 32+0, and 32+1 to 36+0.Results: A total of 6188 CL measurements were performed on 4409 twin pregnancies in twelve studies. Both GA at screening and CL had a significant and non-linear effect on GA at birth. The best prediction of birth ≤28+0 weeks was provided by screening at ≤18+0 weeks (p<0.001), whereas the best prediction of birth between 28+1 and 36+0 weeks was provided by screening at ≥24+0 weeks (p<0.001).Conclusion: In twin pregnancies, prediction of preterm birth depends on both CL and the GA at screening. Screening ≤18+0 weeks is most predictive for birth at ≤28+0 weeks.

U2 - 10.1111/1471-0528.13575

DO - 10.1111/1471-0528.13575

M3 - Review article

SN - 0306-5456

JO - British Journal of Obstetrics and Gynaecology

JF - British Journal of Obstetrics and Gynaecology

ER -

The prediction of preterm birth in twin pregnancy: an individual patient level meta-analysis.

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