Independent association between uterine malformations and cervical insufficiency: a retrospective population-based cohort study

Salvatore Andrea Mastrolia, Yael Baumfeld, Reli Hershkovitz, David Yohay, Giuseppe Trojano, Adi Y. Weintraub

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Objective: The purpose of our study was to explore maternal and fetal outcomes in the second and third trimester in women with uterine malformations. Study design: This was a retrospective population-based cohort study including women with a diagnosis of uterine malformation arised from workup for infertility or recurrent pregnancy loss, was accidental during pregnancy, or was noticed at the time of cesarean delivery. Results: A total of 280,721 pregnancies met the inclusion criteria and were divided into two study groups: (1) pregnancies in women with uterine malformations (n = 1099); and (2) controls (n = 279,662). The rate of women presenting uterine malformations was 0.39%. The prevalence of cervical os insufficiency was significantly higher in women with a uterine malformation than in the control group (3.6 vs. 0.4%, p < 0.001). A multivariate analysis, performed to evaluate risk factors for cervical insufficiency in women with uterine malformations. Mullerian anomalies (OR 6.19, 95% CI 4.41–8.70, p < 0.001), maternal age (OR 1.05, 95% CI 1.04–1.06, p < 0.001), recurrent abortions (OR 12.93, 95% CI 11.43–14.62, p < 0.001), and ethnicity (OR 2.86, 95% CI 2.454–3.34, p < 0.001) were found to be independently associated with the development of cervical insufficiency. Conclusion: Uterine anomalies have a strong association with cervical insufficiency. Women with uterine anomalies have an increased risk to develop pregnancy complications that arise from a loss in cervical function during the midtrimester or early third trimester.

Original languageEnglish
Pages (from-to)919-926
Number of pages8
JournalArchives of Gynecology and Obstetrics
Volume297
Issue number4
DOIs
StatePublished - 1 Apr 2018
Externally publishedYes

Keywords

  • Cervical incontinence
  • Preterm labor
  • Recurrent abortion
  • Retrospective study

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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