Magnetic resonance imaging evaluation of cervical length by the women’s age: a retrospective cohort study

Published:September 25, 2020DOI:



      The anthropometric characteristics of the uterus evolve with pubertal development in girls. It is therefore permissible to ask until these anthropometric characteristics change, in order to know if the cervical length criterion defined for preterm delivery threats is applicable to all ages. The main objective of our study was to analyze the evolution of cervical length with the women’s age outside pregnancy to overcome factors related to pregnancy that can affect cervical length.

      Material and methods

      This retrospective descriptive study over a period of 1 year from March 2017 to March 2018. The cervical length measurements were performed by Magnetic Resonnance Imaging. The cervical length was defined by sagittal T2-weighted magnetic resonance imaging (MRI) as the distance on a straight line between the external cervical os (at the point of divergence of the anterior and posterior lips) and the internal cervical os identified by an intersection between the line of the hypersignal of the glandular epithelium and a line passing through the isthmus.


      A total of 209 patients were included. The cervical length ranged from 25.2 mm on average in children under 16 years (23.6-27.1 mm) to 39.7 mm between 36 and 40 years (27.9 -58.9 mm). There was a linear association between age and cervical length, irrespective of maternal anthropometric data (Pearson’s coefficient ρ = 0.43, 95% CI 0.32-0.54 (p < 0.01). In multivariate analysis, the only factors associated with cervical length were women’s age (p < 0.01) and the prior delivery (p < 0.01).


      The cervical length is correlated with women age and the prior delivery.


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        • Benoist G.
        [Prediction of preterm delivery in symptomatic women (preterm labor)].
        J Gynecol Obstet Biol Reprod (Paris). 2016; 45: 1346-1363
        • Hagen C.P.
        • Mouritsen A.
        • Mieritz M.G.
        • Tinggaard J.
        • Wohlfahrt-Veje C.
        • Fallentin E.
        • et al.
        Uterine volume and endometrial thickness in healthy girls evaluated by ultrasound (3-dimensional) and magnetic resonance imaging.
        Fertil Steril. 2015; 104452-459.e2
        • Brandão R.S.
        • Pires C.R.
        • de Souza E.
        • Avanza L.L.
        • Mattar R.
        • Araujo Júnior E.
        • et al.
        Magnetic resonance imaging vs. transvaginal ultrasound for cervical length assessment in the second half of pregnancy.
        Ultrasound Med Biol. 2010; 36: 571-575
        • Razzaghy-Azar M.
        • Ghasemi F.
        • Hallaji F.
        • Ghasemi A.
        • Ghasemi M.
        Sonographic measurement of uterus and ovaries in premenarcheal healthy girls between 6 and 13 years old: correlation with age and pubertal status.
        J Clin Ultrasound JCU. 2011; 39: 64-73
        • Scoutt L.M.
        • McCauley T.R.
        • Flynn S.D.
        • Luthringer D.J.
        • McCarthy S.M.
        Zonal anatomy of the cervix: correlation of MR imaging and histologic examination of hysterectomy specimens.
        Radiology. 1993; 186: 159-162
        • Sterne J.A.C.
        • White I.R.
        • Carlin J.B.
        • Spratt M.
        • Royston P.
        • Kenward M.G.
        • et al.
        Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls.
        BMJ. 2009; 338: b2393
        • Van Buuren S.
        • Groothuis-Oudshoorn K.
        mice: Multivariate Imputation by Chained Equations in R.
        • D’Agostini C.
        • de Oliveira M.
        • D’Souza-Li L.
        Comparison of cervical length in adult and adolescent nulliparae at mid-gestation.
        J Pediatr Adolesc Gynecol. 2013; 26: 209-211
        • Hernandez-Andrade E.
        • Romero R.
        • Ahn H.
        • Hussein Y.
        • Yeo L.
        • Korzeniewski S.J.
        • et al.
        Transabdominal evaluation of uterine cervical length during pregnancy fails to identify a substantial number of women with a short cervix.
        J Matern-Fetal Neonatal Med Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet. 2012; 25: 1682-1689
        • Albayrak M.
        • Ozdemir I.
        • Koc O.
        • Coskun E.
        Can maternal height predict shorter cervical length in asymptomatic low-risk pregnant women?.
        Eur J Obstet Gynecol Reprod Biol. 2011; 157: 161-165
        • van der Ven A.J.
        • van Os M.A.
        • Kleinrouweler C.E.
        • de Groot C.J.M.
        • Haak M.C.
        • Mol B.W.J.
        • et al.
        Is cervical length associated with maternal characteristics?.
        Eur J Obstet Gynecol Reprod Biol. 2015; 188: 12-16
        • Venkatesh K.K.
        • Manuck T.A.
        Maternal body mass index and cervical length among women with a history of spontaneous preterm birth.
        J Matern-Fetal Neonatal Med. 2018; : 1-6
        • Berghella V.
        • Tolosa J.E.
        • Kuhlman K.
        • Weiner S.
        • Bolognese R.J.
        • Wapner R.J.
        Cervical ultrasonography compared with manual examination as a predictor of preterm delivery.
        Am J Obstet Gynecol. 1997; 177: 723-730
        • Roh H.-J.
        • Ji Y.I.
        • Jung C.H.
        • Jeon G.H.
        • Chun S.
        • Cho H.J.
        Comparison of cervical lengths using transabdominal and transvaginal sonography in midpregnancy.
        J Ultrasound Med Off J Am Inst Ultrasound Med. 2013; 32: 1721-1728
        • Kelsey T.W.
        • Ginbey E.
        • Chowdhury M.M.
        • Bath L.E.
        • Anderson R.A.
        • Wallace W.H.B.
        A Validated Normative Model for Human Uterine Volume from Birth to Age 40 Years.
        PloS One. 2016; 11e0157375
        • Demirci O.
        • Yılmaz E.
        • Tosun Ö
        • Kumru P.
        • Arınkan A.
        • Mahmutoğlu D.
        • et al.
        Effect of Young Maternal Age on Obstetric and Perinatal Outcomes: Results from the Tertiary Center in Turkey.
        Balk Med J. 2016; 33: 344-349
        • Torchin H.
        • Ancel P.-Y.
        [Epidemiology and risk factors of preterm birth].
        J Gynecol Obstet Biol Reprod (Paris). 2016; 45: 1213-1230
        • Chen X.-K.
        • Wen S.W.
        • Fleming N.
        • Demissie K.
        • Rhoads G.G.
        • Walker M.
        Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study.
        Int J Epidemiol. 2007; 36: 368-373
        • Scholl T.O.
        • Hediger M.L.
        • Salmon R.W.
        • Belsky D.H.
        • Ances I.G.
        Association between low gynaecological age and preterm birth.
        Paediatr Perinat Epidemiol. 1989; 3: 357-366
        • Stevens-Simon C.
        • Beach R.K.
        • McGregor J.A.
        Does incomplete growth and development predispose teenagers to preterm delivery? A template for research.
        J Perinatol Off J Calif Perinat Assoc. 2002; 22: 315-323