Activity restriction among women with a short cervix
Open accessAbstract
OBJECTIVE: To estimate determinants of and outcomes associated with activity restriction among women with a short cervix. METHODS: This was a secondary analysis of a randomized trial of 17-α hydroxyprogesterone caproate for prevention of preterm birth among nulliparous women with singleton gestations and cervices less than 30 mm by midtrimester ultrasonography. Women were asked weekly whether they had been placed on pelvic, work, or nonwork rest. "Any activity restriction" was defined as being placed on any type of rest. Factors associated with any activity restriction were determined and the association between preterm birth and activity restriction was estimated with multivariable logistic regression. RESULTS: Of the 657 women in the trial, 646 (98%) responded to questions regarding activity restriction. Two hundred fifty-two (39.0%) were placed on any activity restriction at a median of 23.9 weeks (interquartile range 22.6-27.9 weeks). Women on activity restriction were older, more likely to have private insurance, less likely to be Hispanic, had a shorter cervical length, and were more likely to have funneling and intra-amniotic debris. Preterm birth at less than 37 weeks of gestation was more common among women placed on activity restriction (37% compared with 17%, P<.001). After controlling for potential confounding factors, preterm birth remained more common among those placed on activity restriction (adjusted odds ratio 2.37, 95% confidence interval 1.60-3.53). Results were similar for preterm birth at less than 34 weeks of gestation. CONCLUSION: Activity restriction did not reduce the rate of preterm birth in asymptomatic nulliparous women with a short cervix.
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In a secondary analysis by Grobman et al, after controlling for confounders, activity restriction was associated with increased risk of delivery at less than 37 weeks (aOR 2.37; 95% CI 1.60-3.53) and at less than 34 weeks (aOR 2.28; 95% CI 1.36-3.80).
“they found an increase in the risk of delivery at less than 37 weeks of gestation (aOR, 2.37; 95% CI, 1.60–3.53) and at less than 34 weeks of gestation (aOR, 2.28; 95% CI, 1.36–3.80) in women who were placed on activity restriction.”
From Society for Maternal-Fetal Medicine Consult Series #50: The role of activity restriction in obstetric management (2020) · cites this paper as [20]
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- Authors
- Grobman, W. A., Gilbert, S. A., Iams, J. D., Spong, C. Y., Saade, G., Mercer, B. M., Tita, A. T. N., Rouse, D. J., Sorokin, Y., Leveno, K. J., Tolosa, J. E., Thorp, J. M., Caritis, S. N., & Peter Van Dorsten, J.
- Affiliations
- Northwestern University (US)
- ORCID
- Venue
- Obstetrics & Gynecology
- Published
- 2013-06
- Volume
- 121
- Issue
- 6
- Pages
- 1181-1186
- ISSN
- 0029-7844 (ISSN-L)
- PMC
- PMC4019312
- OpenAlex
- W2049154141
- Cited by
- 72
- References
- 20
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 6 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 6 · 2019: 4 · 2018: 7 · 2017: 11 · 2016: 7 · 2015: 2 · 2014: 3 · 2013: 3
- FWCI
- 3.65
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (2r24hd050924-06, UL1TR000005, UL1TR000150)
- National Center for Research Resources (M01RR000080, UL1RR024989, UL1RR024153, UL1RR025764, M01RR00080)
- National Center for Advancing Translational Sciences
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD40512, HD53118, U01HD036801, R24 HD-050924, HD27917, U10HD040544, U10HD034208, HD-27915, U10HD040512, HD34116, UG1HD034116, HD40545, (HD40500, UG1HD053097, U10HD027915, U10HD040545, U10HD040560, HD 40544, HD40560, HD53097, U10HD027917, U10HD036801, U10HD021410, HD 34208, HD 36801, U10HD053097, U10HD034116, HD27869, [HD21410, U10HD040500, U10HD040485, U10HD053118, U10HD027869, UG1HD034208, U24HD036801, UG1HD040500, UG1HD040512, UG1HD027869, UG1HD040544, UG1HD040485, UG1HD027915, UG1HD040560, UG1HD040545, HD 40485)
- 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
- activity limitation, short cervix, cervical length, preterm birth, 17-hydroxyprogesterone caproate, nulliparous women, cervical funneling, preterm birth prevention
- MeSH terms
- Activities of Daily Living, Adult, Uterine Cervical Diseases, Female, Humans, Pregnancy, Exercise, Randomized Controlled Trials as Topic, Treatment Failure, Premature Birth, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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