Performance of the First-Trimester Cervical Consistency Index to Predict Preterm Birth

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Reproductive Health

Background:

• Preterm birth (PTB) is a major global health concern with limited first-trimester prediction methods.
• Cervical length measurements have yielded contradictory results for early PTB prediction.
• The cervical consistency index (CCI) quantifies cervical changes and shows potential for mid-trimester PTB prediction.

Purpose of the Study:

• To evaluate the efficacy of the cervical consistency index (CCI) in predicting spontaneous preterm birth (sPTB) during the first trimester.
• To assess CCI's performance in identifying sPTB before 37 and 34 weeks of gestation.

Main Methods:

• A prospective cohort study including women with singleton pregnancies, with or without a history of sPTB.
• CCI measurements were performed between 11 and 13 weeks 6 days gestation.
• Receiver operating characteristic (ROC) curves and intraclass correlation coefficients (ICC) were used for analysis.

Main Results:

• The study analyzed 667 patients, with sPTB rates of 9.2% before 37 weeks and 1.8% before 34 weeks.
• CCI demonstrated an area under the curve (AUC) of 0.62 for PTB before 37 weeks and 0.80 for PTB before 34 weeks.
• High intraobserver (ICC: 0.862) and interobserver (ICC: 0.833) reliability were observed.

Conclusions:

• First-trimester CCI measurement is a valuable tool for predicting preterm birth before 34 weeks gestation.
• CCI exhibits strong reliability, making it a promising method for early PTB risk assessment.
• Further research can explore integrating CCI into routine first-trimester obstetric care.