Ethnic differences in risk factors for cervical incompetence

Abstract

Objective: African-American women (AA) have a higher premature birth rate than Caucasian women (Ca). We studied risk factors for cervical incompetence (CI) to determine if there are ethnic differences. Study design: We did a retrospective review of 199 pregnancies in 48 women with CI diagnoses over 5 years. Maternal demographics and outcomes were evaluated. Univariate and multivariate analyses were performed. Results: Eighteen AA (93 pregnancies) and 30 Ca (103 pregnancies) were studied. No significant differences in gravidity, previous preterm (PT) delivery, or presenting symptoms were found. Longitudinal analysis detected an overall successful pregnancy rate of 92%, with 42% PT. No significant differences were detected in hospitalizations, infections, PT labor interventions, gestational age at delivery, delivery mode, or mean cervical lengths (10–29 weeks). African-American women were more likely to: 1) be diagnosed in later pregnancies ( P = 0.004), 2) be younger at diagnosis ( P = 0.001), 3) have more second- and third-trimester losses ( P = 0.004), 4) not have had cervical conization ( P = 0.04), and 5) have more dilation and curettage procedures before diagnosis of CI ( P = 0.003). Conclusion: We have demonstrated significant ethnic differences in risk factors for CI. Knowledge of ethnic-specific risk factors may improve detection of this treatable cause of PT birth.