Racial and social predictors of longitudinal cervical measures: the Cervical Ultrasound Study
E W Harville1, K S Miller2, L R Knoepp3
1Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Summary
Racial and socioeconomic disparities in cervical parameters linked to preterm birth are present early in pregnancy. African-American race and government insurance are associated with adverse cervical findings.
Area of Science:
- Maternal-Fetal Medicine
- Reproductive Health
- Obstetrics
Background:
- Cervical length and shape are critical indicators for predicting preterm birth risk.
- Existing research suggests potential disparities in adverse pregnancy outcomes, but the timing and specific factors are not fully understood.
Purpose of the Study:
- To investigate the presence and developmental timing of racial and socioeconomic disparities in adverse cervical parameters.
- To identify sociodemographic predictors of short cervix or U/funnel shape in women with a history of preterm birth.
Main Methods:
- A prospective cohort study involving 175 women with prior preterm birth.
- Up to four endovaginal ultrasounds were performed between 16 and 24 weeks of gestation.
- Logistic and linear regression analyses examined sociodemographic factors (race, insurance, education) as predictors of cervical parameters.
Main Results:
- African-American race was strongly associated with a short cervix (<25 mm) or U/funnel shape (aOR 5.52).
- Government-funded insurance was also linked to a short cervix (<30 mm) or U/funnel shape (aOR 3.10).
- These cervical changes were evident early in pregnancy and did not significantly change over time or with pressure.
Conclusions:
- Racial and socioeconomic disparities, particularly related to African-American race and insurance status, are associated with adverse cervical parameters predictive of preterm birth.
- These disparities manifest early in pregnancy, highlighting a critical window for intervention.
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