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Record W4409486685 · doi:10.1136/bmjmed-2024-000877

Prognostic value of cervical length for spontaneous preterm birth in asymptomatic women with twin pregnancy: meta-analysis of individual participant data

2025· article· en· W4409486685 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueBMJ Medicine · 2025
Typearticle
Languageen
FieldMedicine
TopicPreterm Birth and Chorioamnionitis
Canadian institutionsUniversity of Toronto
FundersNational Health and Medical Research CouncilMedical Research CouncilMonash University
KeywordsMedicineObstetricsPregnancyHazard ratioGestationAsymptomaticConfidence intervalGestational agePremature birthGynecologyInternal medicine

Abstract

fetched live from OpenAlex

Objective: To quantify the prognostic value of mid-trimester cervical length for spontaneous preterm birth in asymptomatic women with twin pregnancy and to assess whether other factors may modify any association. Designs: A two stage meta-analysis of individual participant data in a Cox proportional hazard model was performed using cervical length as a continuous variable. Data sources: Medline, Embase, Cochrane, and LILACS, among others, were searched to identify eligible studies; the search was from 1 January 2000 to 30 September 2020. Risk of bias was assessed with the QUIPS tool. Studies were from eight countries between 2001 and 2018. Eligibility criteria: Individual participant data were sought for eligible studies that reported mid-trimester (defined between 16 and 26 weeks) transvaginal sonographic cervical length and also gestational age at birth in asymptomatic women with twin pregnancy. The primary outcome was spontaneous preterm birth before 37 weeks. Results: Among 29 eligible studies, authors of 17 studies provided individual participant data for 6437 women with a twin pregnancy (69.1% of individual participant data). Mean cervical length measurement was 39 mm (SD=9, range 1-74 mm). 2889 women (44.9%) delivered before 37 weeks' gestation, and 934 (14.9%) delivered before 34 weeks. Each 1 mm increase in cervical length was associated with a 4.0% reduction in the rate of spontaneous preterm birth before 37 weeks (hazard ratio 0.96 (95% confidence interval 0.95 to 0.97)), and a 6.8% reduction in the rate of spontaneous preterm birth before 34 weeks' gestation (0.93 (0.92 to 0.95)). The prognostic value remained stable in models adjusting for different sets of variables. Conclusion: The prognostic value of cervical length for spontaneous preterm birth in twin pregnancy is on a continuous scale. No specific cervical length has been identified that can reliably predict or exclude all spontaneous preterm births. Study registration: CRD42020146987.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.002
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Meta-analysis · Consensus signal: Meta-analysis
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.109
Threshold uncertainty score0.718

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0020.000
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0010.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.106
GPT teacher head0.363
Teacher spread0.257 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it