Maternal Characteristics, Short Mid-Trimester Cervical Length, and Preterm Delivery

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Reproductive Health

Background:

• Short mid-trimester cervical length (CL) is a risk factor for spontaneous preterm delivery (SPTD).
• Maternal characteristics may influence both CL and SPTD risk.

Purpose of the Study:

• To identify maternal factors associated with short CL (≤ 25 mm).
• To determine if short CL mediates the relationship between maternal characteristics and SPTD (delivery before 34 weeks).

Main Methods:

• Retrospective cohort study of 3,296 women with singleton pregnancies.
• CL measured between 20-24 weeks gestation.
• Multivariate and logistic regression analyses adjusted for confounders.

Main Results:

• Obstetric history and prior cervical excisional procedures were associated with short CL.
• Short CL and obstetric history were significantly associated with SPTD.
• A history of SPTD, but not prior cervical excisional procedure, independently predicted SPTD.

Conclusions:

• While prior cervical procedures and SPTD history increase short cervix risk, only SPTD history is an independent predictor of SPTD.
• Short cervical length does not fully explain the association between these maternal factors and SPTD.