TY - JOUR
T1 - Trajectory of Postpartum Cervical Remodeling in Women Delivering Full-Term and Spontaneous Preterm
T2 - Sensitivity to Quantitative Ultrasound Biomarkers
AU - Villegas-Downs, Michelle
AU - Mohammadi, Mehrdad
AU - Han, Aiguo
AU - O'Brien, William D.
AU - Simpson, Douglas G.
AU - Peters, Tara A.
AU - Schlaeger, Judith M.
AU - McFarlin, Barbara L.
N1 - The authors acknowledge the support from the National Institute of Nursing Research and the National Institute of Child Health and Human Development of the National Institutes of Health under Award Numbers F31NR019716 and R01HD089935 , respectively. The Center for Clinical and Translational Science which hosted the data via Research Electronic Data Capture (REDCap) was supported by the National Center for Advancing Translational Sciences, National Institutes of Health , through Grant UL1TR002003 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would also like to thank Samantha Germino, RDMS, RVT and Ewa Dymek-Kolanko, RDMS, RVT for their expertise and assistance in conducting the transvaginal scans and the women who participated in this study.
The authors acknowledge the support from the National Institute of Nursing Research and the National Institute of Child Health and Human Development of the National Institutes of Health under Award Numbers F31NR019716 and R01HD089935, respectively. The Center for Clinical and Translational Science which hosted the data via Research Electronic Data Capture (REDCap) was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1TR002003. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would also like to thank Samantha Germino, RDMS, RVT and Ewa Dymek-Kolanko, RDMS, RVT for their expertise and assistance in conducting the transvaginal scans and the women who participated in this study. Data are available on reasonable request from the corresponding author.
PY - 2024/12
Y1 - 2024/12
N2 - Objective: Women with a history of spontaneous preterm birth (sPTB) face an increased risk of recurrence. Yet, the factors contributing to the increased risk are unknown, hampering the development of targeted interventions. Noninvasive quantitative ultrasound (QUS) has been validated in the characterization of cervical tissue and has the potential to provide information about postpartum cervical remodeling. The objective of this study was to determine the postpartum cervical remodeling trajectories of women over 12 mo post-delivery and to determine whether there were differences between women who delivered full-term and spontaneous preterm that were sensitive to QUS biomarkers. Methods: Data were collected prospectively from 55 women: 41 who delivered full-term and 14 who delivered spontaneously preterm at 6 wk, 3, 6, 9 and 12 mo (±2 wk) postpartum. Data from QUS biomarkers: Attenuation Coefficient; Backscatter Coefficient; Shear Wave Speed; and Lizzi–Feleppa Slope, Intercept and Midband were analyzed from the acquired radiofrequency data using a Siemens S2000 ultrasound system with a transvaginal MC 9–4 MHz probe. The biomarkers were analyzed using descriptive statistics and linear mixed-effects models. Results: QUS biomarkers, Backscatter Coefficient and Lizzi–Feleppa Intercept showed significant differences during the year after delivery between women who had a full-term birth and sPTB (p < 0.05), suggesting that there are differences in the cervical remodeling trajectories between the two groups. All QUS biomarkers demonstrated significant variations between the full-term birth and sPTB groups over time (p < 0.05), indicating ongoing cervical remodeling for both groups during the 12-mo postpartum period. Conclusion: QUS biomarkers identified cervical microstructure differences and trajectories in the year after delivery between women who delivered full-term and spontaneous preterm.
AB - Objective: Women with a history of spontaneous preterm birth (sPTB) face an increased risk of recurrence. Yet, the factors contributing to the increased risk are unknown, hampering the development of targeted interventions. Noninvasive quantitative ultrasound (QUS) has been validated in the characterization of cervical tissue and has the potential to provide information about postpartum cervical remodeling. The objective of this study was to determine the postpartum cervical remodeling trajectories of women over 12 mo post-delivery and to determine whether there were differences between women who delivered full-term and spontaneous preterm that were sensitive to QUS biomarkers. Methods: Data were collected prospectively from 55 women: 41 who delivered full-term and 14 who delivered spontaneously preterm at 6 wk, 3, 6, 9 and 12 mo (±2 wk) postpartum. Data from QUS biomarkers: Attenuation Coefficient; Backscatter Coefficient; Shear Wave Speed; and Lizzi–Feleppa Slope, Intercept and Midband were analyzed from the acquired radiofrequency data using a Siemens S2000 ultrasound system with a transvaginal MC 9–4 MHz probe. The biomarkers were analyzed using descriptive statistics and linear mixed-effects models. Results: QUS biomarkers, Backscatter Coefficient and Lizzi–Feleppa Intercept showed significant differences during the year after delivery between women who had a full-term birth and sPTB (p < 0.05), suggesting that there are differences in the cervical remodeling trajectories between the two groups. All QUS biomarkers demonstrated significant variations between the full-term birth and sPTB groups over time (p < 0.05), indicating ongoing cervical remodeling for both groups during the 12-mo postpartum period. Conclusion: QUS biomarkers identified cervical microstructure differences and trajectories in the year after delivery between women who delivered full-term and spontaneous preterm.
KW - Cervical remodeling
KW - Postpartum
KW - Preterm birth
KW - Quantitative Ultrasound
KW - Recurrent
KW - Spontaneous
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U2 - 10.1016/j.ultrasmedbio.2024.06.015
DO - 10.1016/j.ultrasmedbio.2024.06.015
M3 - Article
C2 - 39237426
AN - SCOPUS:85203072628
SN - 0301-5629
VL - 50
SP - 1777
EP - 1784
JO - Ultrasound in Medicine and Biology
JF - Ultrasound in Medicine and Biology
IS - 12
ER -