Risk factors of cervical insufficiency in puerperae and their effects on pregnancy outcomes

Abstract

Objective To analyze the risk factors of cervical insufficiency in puerperae and observe their effects on pregnancy outcomes. Methods The clinical data of 82 puerperae with cervical insufficiency (an observation group) in our hospital were retrospectively analyzed; and 78 puerperae with normal pregnancy at the same time period were included as a control group. The age, gravidity, parity, and medical history of the two groups were recorded. Logistic regression analysis was used to evaluate the risk factors affecting cervical insufficiency in puerperae. And the pregnancy outcomes were compared between the two groups. Results There was no statistical difference in the age between the two groups (P>0.05). The incidences of gravidity>4 times and parity>twice as well as prevalence rates of curettage history, extension of second stage of labor, history of cervical laceration, history of cervical conization, and history of cervicovaginal infection in the observation group were higher than those in the control group (P 4 times, parity>twice, curettage history, extension of second stage of labor, history of cervical laceration, history of cervical conization, and history of cervicovaginal infection were independent risk factors affecting cervical insufficiency in puerperae (OR=2.221, 2.326, 2.512, 1.777, 1.972, 1.523, and 1.929; all P<0.05). Among the 82 cases in the observation group, 55 cases (67.07%) were treated with cervical cerclage and 27 cases (32.93%) were given conservative treatment. The neonatal survival rate and full-term delivery rate were significantly lower while the incidence rates of premature delivery, abortion and infection were higher in observation group than in control group (P<0.05) than those in control group (all P<0.05). Conclusions Patients with gravidity>4 times, parity>twice, curettage history, extension of second stage of labor, history of cervical laceration, history of cervical conization, and history of cervicovaginal infection are prone to cervical insufficiency, and have high risk of adverse pregnancy outcomes. It is necessary to actively give prevention and control measures to improve maternal-infant health. Key words: Pregnancy; Cervical insufficiency; Pregnancy outcomes; Risk factors