Am J Perinatol 2020; 37(06): 598-602
DOI: 10.1055/s-0039-1685444
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Change in Cervical Length across Pregnancies and Preterm Delivery

Annie Dude
1  Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
,
Emily S. Miller
1  Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
› Author Affiliations
Funding Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences (Grant Number UL1TR001422).
Further Information

Publication History

20 October 2018

22 February 2019

Publication Date:
12 April 2019 (online)

Abstract

Objective This study aimed to determine whether a decrease in midtrimester cervical length across pregnancies is associated with preterm delivery in a subsequent pregnancy.

Study Design This is a cohort study of women who had two consecutive singleton births at the same institution. Midtrimester cervical length change across pregnancies was measured as the difference in centimeters (cm) between cervical lengths using the measurement taken closest to 200/7 weeks' gestation in each pregnancy. Cervical length shortening was defined as present if the cervical length decreased by at least one standard deviation in the subsequent pregnancy.

Results Among 1,552 women, 114 (7.4%) experienced a preterm delivery in the subsequent pregnancy. Compared with women whose subsequent pregnancy cervical length remained stable or increased, women whose cervical length shortened were more likely to experience a preterm delivery (10.3 vs. 6.7%; p = 0.04). Cervical length shortening remained associated with preterm delivery even when accounting for a woman's prior preterm delivery, prior pregnancy short cervix, interdelivery interval, progesterone use, and cervical length in the subsequent pregnancy (adjusted odds ratio = 1.89; 95% confidence interval = 1.11–3.20).

Conclusion Midtrimester cervical length shortening across pregnancies is independently associated with an increased risk of preterm delivery.

Note

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. A version of this paper was presented at the 38th Annual Meeting of the Society for Maternal-Fetal Medicine, Dallas, TX, January 29 to February 3, 2018 (Abstract #971).