The introduction of a universal transvaginal cervical length screening program is associated with a reduced preterm birth rate

International audience ; BACKGROUND: Midtrimester sonographic short cervix is a goodpredictor of preterm birth in singleton pregnancies.OBJECTIVE: This study aimed to assess the impact of implementing auniversal transvaginal cervical length screening program on preterm birthrate.STUDY DESIGN: This study consisted of 2 parts: a before-and-aftermulticenter study and a study on the ECHOCOL (“echo”=“ultrasound” and“col”=“cervix” in French) prospective cohort. We compared the rate ofpreterm birth before and after the introduction of universal cervical lengthscreening at the time of midtrimester anatomy ultrasound. The multicenterbefore-and-after regional study included all women with a singleton pregnancywho gave birth after 24 weeks’ gestation in the South East of Francefrom January 1, 2012 to April 30, 2018. In parallel, the ECHOCOL cohortstudy was prospectively conducted from May 2015 to July 2018, including17 maternity hospitals in the South East region of France. In case ofasymptomatic short cervix<25mm, treatments offered included 200 mg ofvaginal progesterone, or cerclage, or a pessary until 34 weeks’ gestation.RESULTS: We observed a significant decrease rate of preterm birthbetween periods A and B after multivariate analysis. (respectively, 5.8% vs5.6%; adjusted odds ratio, 0.92; 95% confidence interval, 0.89e0.95;P<.0001). In parallel, the percentage of cervical length screeningsignificantly increased from 28.9% in period A to 52.9% in period B (oddsratio, 2.76; 95% confidence interval, 2.71e2.80; P<.0001). Among the3468 patients of the ECHOCOL prospective cohort, 38 (1.1%) asymptomaticshort cervices were detected, and 192 patients gave birth prematurely(11 with an asymptomatic short cervix and 181 without). In theECHOCOL cohort, a marked but statistically insignificant tendency towarda reduced rate of preterm birth before 37 weeks of gestation was observed(from 5.8% to 5.5%; adjusted odds ratio, 0.72; 95% confidence interval,0.51e1.03; P¼.068).CONCLUSION: This study showed a significantly lower ...