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This work was funded with support of the Erasmus+ Programme of the European Union (Framework Agreement number: 2013-0040). This publication reflects the views only of the author, and the Commission cannot be held responsible for any use that may be made of the information contained therein. Additionally, the research leading to these results has received funding partially from 'la Caixa' Foundation; Cerebra Foundation for the Brain Injured Child (Carmarthen, Wales, UK); AGAUR 2014 SGR grant No. 928 and 'la Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement de la Generalitat de Catalunya (A.P: 2014DI083)'.

Analysis of institutional authors

Baños NCorresponding AuthorMurillo-Bravo CAuthorMigliorelli FAuthorPerez-Moreno AAuthorRios JAuthorGratacos EAuthorPalacio MAuthor

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June 9, 2017
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Mid-trimester sonographic Cervical Consistency Index to predict spontaneous preterm birth in a low-risk population.

Publicated to:Ultrasound In Obstetrics & Gynecology. 51 (5): 629-636 - 2018-05-01 51(5), DOI: 10.1002/uog.17482

Authors: Banos, N; Murillo-Bravo, C; Julia, C; Migliorelli, F; Perez-Moreno, A; Rios, J; Gratacos, E; Valentin, L; Palacio, M

Affiliations

Ctr Biomed Res Rare Dis CIBER ER, Barcelona, Spain      CIBERER    CIBER - Centro de Investigacion Biomedica en Red       - Author
Hosp Clin Barcelona, IDIBAPS, Med Stat Core Facil, Barcelona, Spain      Hospital Clinic de Barcelona    IDIBAPS    University of Barcelona - Author
Lund Univ, Lund, Sweden      Lund University - Author
Skane Univ Hosp, Malmo, Sweden      Lund University    Skane University Hospital - Author
Transmural Biotech SL, Barcelona, Spain - Author
Univ Autonoma Barcelona, Lab Biostat & Epidemiol, Barcelona, Spain      Autonomous University of Barcelona - Author
Univ Barcelona, Fetal I D Fetal Med Res Ctr, BCNatal Barcelona Ctr Maternal Fetal & Neonatal M, Hosp Clin, Sabino de Arana 1, E-08028 Barcelona, Spain.      University of Barcelona    Hospital Clinic de Barcelona - Author
Univ Barcelona, Hosp Clin, Ctr Maternal Fetal & Neonatal Med, Fetal I D Fetal Med Res Ctr,BCNatal Barcelona, Barcelona, Spain      Hospital Clinic de Barcelona    University of Barcelona - Author
Univ Barcelona, Hosp St Joan de Deu, Inst Clin Ginecol Obstet & Neonatol, Inst Invest Biomed August Pi i Sunyer, Barcelona, Spain      IDIBAPS    University of Barcelona    Hospital Clinic de Barcelona - Author
Univ Barcelona, IDIBAPS, Hosp St Joan de Deu, Sabino de Arana 1, E-08028 Barcelona, Spain.      Hospital Clinic de Barcelona    University of Barcelona    IDIBAPS - Author
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Abstract

To investigate the effectiveness of mid-trimester sonographic cervical consistency index (CCI) for the prediction of spontaneous preterm birth (sPTB) in low-risk pregnancies and to compare its performance with that of mid-trimester sonographic cervical-length (CL) measurement.This was a prospective cohort study of women with a singleton pregnancy examined by ultrasound at 19?+?0 to 24?+?6?weeks' gestation. All women underwent transvaginal ultrasound examination of the cervix, but CCI and CL were measured, offline, only in women without a risk factor for sPTB. Staff and participants were blinded to CL and CCI results. CCI was obtained by calculating the ratio between the anteroposterior diameter of the uterine cervix at maximum compression and at rest. The primary outcome was prediction of sPTB before 37?+?0?weeks. Receiver-operating characteristics (ROC) curves were produced and sensitivity and specificity were calculated for the optimal cut-off based on the ROC curve and for the 1st , 5th and 10th centiles of CCI and CL. Intraclass correlation coefficients (ICC) and Bland-Altman plots were used to estimate intra- and interobserver agreement and reliability for measurement of CCI and CL.Of the 749 women who underwent ultrasound examination of the cervix, 532 were included for analysis. The rates of sPTB before 37?+?0 and before 34?+?0?weeks were 4.1% (22/532) and 1.3% (7/532), respectively. The rates of short cervix ?0.90 both for CCI and CL, while interobserver ICC was 0.89 for CCI and 0.90 for CL.Second-trimester CCI is a better predictor of sPTB

Keywords

cervical consistency indexcervical-length measurementscervix uterilengthpessarypregnancyprogesteronespontaneous preterm birthultrasonographyAdultCervical consistency indexCervical length measurementCervical-length measurementsCervix uteriFemaleGestational ageHumansPregnancyPregnancy trimester, secondPremature birthProspective studiesReference standardsReproducibility of resultsRisk factorsRoc curveSingle-blind methodSpontaneous preterm birthUltrasonographyWomen

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Ultrasound In Obstetrics & Gynecology due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2018, it was in position 3/83, thus managing to position itself as a Q1 (Primer Cuartil), in the category Obstetrics & Gynecology. Notably, the journal is positioned above the 90th percentile.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 1.04. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Field Citation Ratio (FCR) from Dimensions: 7.77 (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-18, the following number of citations:

  • WoS: 19
  • Scopus: 17
  • Europe PMC: 9

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-18:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 80.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 84 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 0.75.
  • The number of mentions on the social network Facebook: 1 (Altmetric).
  • The number of mentions on the social network X (formerly Twitter): 1 (Altmetric).

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Sweden.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Baños López, Núria) and Last Author (Palacio Riera, Montserrat).

the author responsible for correspondence tasks has been Baños López, Núria.