Does hospitalization prevent preterm delivery in the patient with a short cervix?
Abstract
This study considers whether admission to the hospital of a patient diagnosed with a short cervix delayed delivery, prevented preterm delivery, and/or decreased the rate of change in the cervical length (CL) on follow-up measurements. The design was a retrospective cohort study of women carrying singleton pregnancies with cervical lengths <or= 25 mm at gestational ages 16 to 28 weeks managed expectantly from July 2002 through July 2005. Eighty-two patients met criteria for inclusion, 26 (32%) of whom were hospitalized. On univariate analysis, hospitalization correlated with delivery < 34 weeks ( p=0.027), an earlier gestational age (GA) at delivery ( p=0.046), and a shorter time from diagnosis to delivery ( p< .001). Multivariate regression analysis of significant factors (age, prior preterm births, initial CL, GA at diagnosis, and hospitalization) showed a correlation between hospitalization and increased rate of cervical shortening ( p=0.005), and a trend toward hospitalization as an independent risk factor for delivery less than 34 weeks ( p=0.066), an earlier GA at delivery ( p=0.058), and a shorter time from diagnosis to delivery ( p=0.078). There also was no benefit seen from hospitalization when the initial CL was < 15 mm, although we were underpowered for this analysis. Admission to the hospital was not associated with a decreased rate of preterm delivery and there was a trend toward hospitalization as an independent risk factor for delivery at < 34 weeks, an earlier GA at delivery, and a shorter time from diagnosis to delivery. Hospitalization was independently associated with an increased rate of cervical shortening.
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In a retrospective cohort of women with cervical length less than 25 mm, hospitalization showed a trend toward being an independent risk factor for delivery before 34 weeks (P=.066) and earlier gestational age at delivery (P=.058).
“Another retrospective cohort study of women with a cervical length less than 25 mm identified a trend toward hospitalization as an independent risk factor for delivery before 34 weeks of gestation (P=.066) and an earlier gestational age at delivery (P=.058).21”
From Society for Maternal-Fetal Medicine Consult Series #50: The role of activity restriction in obstetric management (2020) · cites this paper as [21]
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Self-citation
- Authors
- Fox, N., Jean-Pierre, C., Predanic, M., & Chasen, S.
- Affiliations
- Cornell University (US)
- ORCID
- Fox, Nathan
- Venue
- American Journal of Perinatology
- Publisher
- Georg Thieme Verlag KG
- Published
- 2007-01
- Volume
- 24
- Issue
- 1
- Pages
- 049-053
- ISSN
- 0735-1631 (ISSN-L)
- 1098-8785
- OpenAlex
- W2039198052
- Cited by
- 15
- References
- 0
- Citations by year
- 2026: 1 · 2020: 2 · 2017: 2 · 2016: 1 · 2015: 1 · 2013: 4
- FWCI
- 0.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Perinatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- short cervix, preterm birth, cervical length, hospitalization, expectant management, cervical shortening, singleton pregnancy, gestational age at delivery
- MeSH terms
- Adult, Cervix Uteri, Female, Gestational Age, Hospitalization, Humans, Obstetric Labor, Premature, Length of Stay, Medical Records, New York City, Pregnancy, Pregnancy Trimester, Second, Pregnancy Trimester, Third, Prenatal Care, Retrospective Studies, Risk Factors, Cohort Studies
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