Change in cervical length after arrested preterm labor and risk of preterm birth

K N Rennert, S Breuking, E Schuit, M N Bekker, M Woiski, M A de Boer, M Sueters, H C J Scheepers, M T M Franssen, E Pajkrt, B W J Mol, M Kok, F J R Hermans

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Abstract

Objective: To assess the association between preterm birth and cervical length after arrested preterm labor in high-risk pregnant women. Methods: In this post-hoc analysis of a randomized clinical trial, transvaginal cervical length was measured in women whose contractions had ceased 48 h after admission for threatened preterm labor. At admission, women were defined as having a high risk of preterm birth based on a cervical length of < 15 mm or a cervical length of 15–30 mm with a positive fetal fibronectin test. Logistic regression analysis was used to investigate the association of cervical length measured at least 48 h after admission and of the change in cervical length between admission and at least 48 h later, with preterm birth before 34 weeks' gestation and delivery within 7 days after admission. Results: A total of 164 women were included in the analysis. Women whose cervical length increased between admission for threatened preterm labor and 48 h later (32%; n = 53) were found to have a lower risk of preterm birth before 34 weeks compared with women whose cervical length did not change (adjusted odds ratio (aOR), 0.24 (95% CI, 0.09–0.69)). The risk in women with a decrease in cervical length between the two timepoints was not different from that in women with no change in cervical length (aOR, 1.45 (95% CI, 0.62–3.41)). Moreover, greater absolute cervical length after 48 h was associated with a lower risk of preterm birth before 34 weeks (aOR, 0.90 (95% CI, 0.84–0.96)) and delivery within 7 days after admission (aOR, 0.91 (95% CI, 0.82–1.02)). Sensitivity analysis in women randomized to receive no intervention showed comparable results. Conclusion: Our study suggests that the risk of preterm birth before 34 weeks is lower in women whose cervical length increases between admission for threatened preterm labor and at least 48 h later when contractions had ceased compared with women in whom cervical length does not change or decreases.

Original languageEnglish
Pages (from-to)750-756
Number of pages7
JournalUltrasound in Obstetrics and Gynecology
Volume58
Issue number5
Early online date16 Apr 2021
DOIs
Publication statusPublished - Nov 2021

Keywords

  • arrested preterm labor
  • cervical length
  • change in cervical length
  • preterm birth
  • threatened preterm labor

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