HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by HARTMANN, K. Articles by GRANADOS, J. L. Search for Related Content PubMed PubMed Citation Articles by HARTMANN, K. Articles by GRANADOS, J. L.

Cervical Dimensions and Risk of Preterm Birth: A Prospective Cohort Study

From the Department of Obstetrics and Gynecology, School of Medicine, and the Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill; and the Department of Obstetrics and Gynecology, Wake Medical Center, Raleigh, North Carolina.

Objective: To examine the relation between cervical dilatation and length and the risk of spontaneous preterm birth, including its subtypes preterm labor and preterm premature rupture of membranes (PROM).

Methods: Cervical dimensions assessed by clinical examination were recorded prospectively at 24–29 weeks’ gestation in 871 subjects with singleton pregnancies who were followed to delivery. Relative risks (RRs) of preterm birth, preterm labor, and preterm PROM were calculated for clinically distinguishable categories of cervical dilatation and length and for cervical score (length minus dilatation). Regression analysis was used to adjust for confounding. Time to delivery from baseline examination was summarized using survival analysis.

Results: There were 73 spontaneous preterm births (8.3%), 46 preterm labors and 27 cases of preterm PROM. All cervical measurements were associated with increased risks of preterm birth, with increasing abnormality more strongly predictive of risk. The adjusted RR for preterm birth with dilatation of at least 0.5 cm was 2.9 (95% confidence interval [CI] 1.2, 7.3); for length of 1.5 cm or less, the RR was 2.1 (95% CI 1.0, 4.5), and for cervical score less than 2.0, the RR was 2.8 (95% CI 1.4, 5.6). The association with cervical measurements was stronger for preterm PROM than for preterm labor, although precision was limited. These measurements had high specificity (93–99%) and low sensitivity (8–20%) for predicting preterm birth.

Conclusion: In asymptomatic women at 24–29 weeks’ gestation, greater cervical dilatation and shorter length were associated with increased risk of spontaneous preterm delivery, particularly preterm PROM.

This article has been cited by other articles:

				H. N. Simhan and S. N. Caritis Prevention of Preterm Delivery N. Engl. J. Med., August 2, 2007; 357(5): 477 - 487. [Full Text] [PDF]

				V. Berghella, J. Owen, C. MacPherson, N. Yost, M. Swain, G. A. Dildy III, M. Miodovnik, O. Langer, B. Sibai, and for the National Institute of Child Health and Hum Natural History of Cervical Funneling in Women at High Risk for Spontaneous Preterm Birth Obstet. Gynecol., April 1, 2007; 109(4): 863 - 869. [Abstract] [Full Text] [PDF]