Racial Disparities in Cervical Length Surveillance in Patients With a History of Spontaneous Preterm Birth [ID: 1378309

Abstract

INTRODUCTION: Racial disparities in preterm birth are well established. We sought to identify racial disparities in cervical length surveillance in patients with a history of spontaneous preterm birth. METHODS: This was a subgroup analysis performed on data collected from a multi-institutional retrospective cohort study of pregnant patients with a history of early (<34 weeks) and late (≥34 weeks) spontaneous preterm birth (PTB) that underwent transvaginal cervical length surveillance between November 2016 and March 2022. MedStar Health Research Institute IRB approval was obtained. Twin pregnancies were excluded. Data was compared between Black patients and non-Black patients using χ2 tests, t tests, and ANOVA analyses, as appropriate (α=0.05). RESULTS: Of 324 patients, 231 (71.3%) were Black and 93 (28.7%) were non-Black. When comparing patients who had early PTB to late PTB, Black patients were more likely than non-Black patients to have early PTB (76.3 versus 61.3%, P=.005). Average gestational age at time of last spontaneous PTB was significantly earlier in Black patients compared to non-Black patients (28 weeks 3 days versus 30 weeks 4 days, P=.008). Black patients were further along in current gestation at the time of cerclage placement than non-Black patients (16 weeks 6 days versus 14 weeks 1 day, P=.041). CONCLUSION: Black patients are more likely to have later cerclage placement compared to non-Black patients despite a predisposition to earlier gestational age at time of prior preterm birth.