947 Recurrence risk of short cervix in women with history of short cervix and term delivery

Abstract

Little is known about the recurrence risk for short cervix in women with an obstetric history of short cervix with term delivery. The objective of our study was to determine the recurrence risk of short cervix in this population of women. We performed a cross-sectional study of women who delivered at a single tertiary care center from 1/1/2015–12/31/2019 with an obstetric history of short cervix - defined as a cervical length <2.5cm - who delivered at term in an index pregnancy. At our institution, universal transvaginal cervical length screening is performed at the anatomical survey between 16 and 24 weeks. Measurements were performed in compliance with the Cervical Length Education and Review program. Women were included if the index and subsequent pregnancies and deliveries were within our institution during the study period. Women with a history of preterm birth, multiple gestations, fetal anomalies, stillbirth and missing data were excluded. Data were collected via chart abstraction and compared between women with and without recurrent short cervix. 54 women met our inclusion criteria. 21 (39%) women had recurrent short cervix in the subsequent pregnancy. In unadjusted univariate analysis, women with short cervix diagnosed at ≥20 weeks in the index pregnancy were at increased risk of recurrent short cervix in the subsequent pregnancy (Table 1). This persisted after controlling for age, race, body mass index, and vaginal progesterone use during the index pregnancy (aOR 7.86, 95% CI 1.30-47.38) (Table 2). There was no difference in the overall and spontaneous preterm birth (PTB) rates between women with and without recurrent short cervix (overall PTB 9.52% vs 9.09%, p=0.99; spontaneous PTB 4.76% vs 3.03%, p=0.99). In women with an obstetric history of short cervix with a term birth, gestational age at diagnosis of short cervix in the index pregnancy was associated with an increased risk of recurrent short cervix in the subsequent pregnancy. However, there was no increased risk of preterm birth based on recurrent short cervix.View Large Image Figure ViewerDownload Hi-res image Download (PPT)