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Follow-up cervical length in asymptomatic high-risk women and the risk of spontaneous preterm birth

Journal of Perinatology volume 31, pages 318–323 (2011)Cite this article

Subjects

Abstract

Objective:

To determine whether further cervical length shortening by transvaginal ultrasonography in asymptomatic high-risk women with a short cervical length adds additional predictive value for spontaneous preterm birth and perinatal morbidity.

Study Design:

Women with a history of spontaneous preterm birth, loop electrosurgical excision procedure, cone biopsy or uterine anomaly, who were pregnant with singleton gestations and were found by transvaginal ultrasonography to have a cervical length <3.0 cm at 20 to 28 weeks’ gestation, and who underwent a follow-up cervical length within 3 weeks were evaluated, comparing those with further cervical length shortening (>10%) to those without further shortening. Primary outcomes were spontaneous preterm birth <35 weeks’ gestation and perinatal morbidity. Secondary outcomes included spontaneous preterm birth <37 weeks, <34 weeks, <32 weeks, birth weight <2500 g, maternal and other neonatal outcomes.

Result:

Compared with women without further cervical shortening, those with further shortening were found by univariate analyses to have higher rates of spontaneous preterm birth <35 weeks (34.8 versus 8.5%, P=0.014), <37 weeks (56.5 versus 21.3%, P=0.003), <34 weeks (30.4 versus 2.1%, P=0.001), <32 weeks (21.7 versus 0%, P=0.003), birth weight <2500 g (60.9 versus 17.0%, P<0.0001), neonatal intensive care unit admission (47.8 versus 17.0%, P=0.006) and composite perinatal morbidity (43.5 versus 14.9%, P=0.009). Logistic regression revealed the only independent predictors of spontaneous preterm birth <35 weeks were further cervical length shortening (adjusted odds ratio (aOR) 5.73; 95% confidence interval (CI) 1.31 to 24.43) and gestational age at short cervical length (aOR 0.95; 95% CI 0.91 to 0.99).

Conclusion:

Further cervical length shortening in asymptomatic high-risk women with a short cervical length is an important independent predictor of spontaneous preterm birth <35 weeks and perinatal morbidity.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Eastern Health, Memorial University, St John's, Newfoundland, Canada

    J M G Crane & D Hutchens

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Correspondence to J M G Crane.

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Crane, J., Hutchens, D. Follow-up cervical length in asymptomatic high-risk women and the risk of spontaneous preterm birth. J Perinatol 31, 318–323 (2011). https://doi.org/10.1038/jp.2010.149

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