Correlation analysis of risk factors for early preterm birth in twin pregnancy
Objective To investigate the risk factors of early preterm birth(＜34 weeks)in twin pregnancy and the correlation of between different risk factors on early preterm birth.Methods In this retrospective study,233 preterm twins with complete case data and preterm delivery were selected from Peking University First Hospital from January 2018 to December 2022.Binary logistic regression analysis was used to analyze the independent risk factors of early preterm birth and the correlation between different risk factors and early preterm birth.Results ① There were statistically significant differences in average cervical length(CL)between 20 to 23+6 weeks of gestation and 24 to 28 weeks of gestation(P＜0.05),and the incidence of cervical shortening(＜25 mm)was higher in the delivery group before 34 weeks,and the cervical ceration rate was higher in the early preterm delivery group.The difference was statistically significant(P＜0.05).(2)Binary Logistic multivariate regression analysis indicated that shortened cervical length at 20 to 23+6 weeks of gestation was an independent risk factor for preterm birth of twins before 34 weeks(OR=4.251,95％CI:1.942-9.305,P＜0.05).③ The risk of preterm birth before 34 weeks was 12.67 times(95％CI,3.301～48.606)and 7.74 times(95％CI,1.920-31.213)higher than that of cervical length＞37.8 mm and 15＜CL ≤ 25 mm at 20 to 23+6 weeks gestation.④ The cervical length of 15 mm,20 mm and 25 mm was used as the threshold to predict premature birth of twins before 34 weeks.With the increase of the threshold,the sensitivity to predict premature birth before 34 weeks was 18.6％、21.6％、33％,respectively,but the specificity and positive predictive value gradually decreased,and the negative predictive value did not change much.Conclusions Cervical shortening at 20～23+6 weeks of gestation is an independent risk factor for early preterm birth in twins.Cervical length ≤ 15 mm at 20～23+6 weeks gestation is a higher risk of early preterm birth than cervical length＞15 mm.
twin pregnancycervical lengthearly preterm birthrisk factorspredictive value
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