OBJECTIVE: To evaluate whether increasing body mass index (BMI) alters the efficacy of ultrasound-directed cerclage in women with a history of preterm birth. METHODS: This was a planned secondary analysis of a multicenter trial in which women with a singleton gestation and prior spontaneous preterm birth (17 to 33 + 6 weeks' gestation) were screened for a short cervix by serial transvaginal ultrasound evaluations between 16 and 22 + 6 weeks. Women with a short cervix (cervical length < 25 mm) were randomly assigned to cerclage or not. Linear and logistic regression were used to assess the relationship between BMI and continuous and categorical variables, respectively. RESULTS: Overall, in the screened women (n = 986), BMI was not associated with cervical length (P = 0.68), gestational age at delivery (P = 0.12) or birth at < 35 weeks (P = 0.68). For the cerclage group (n = 148), BMI had no significant effect. For the no-cerclage group (n = 153), BMI was associated with a decrease in gestational age at delivery, with an estimated slope of - 0.14 weeks per kg/m(2) (P = 0.03; including adjustment for cervical length). This result was driven primarily by several women with BMI > 47 kg/m(2) . CONCLUSION: In women at high risk for recurrent preterm birth, BMI was not associated with cervical length or gestational age at birth. BMI did not appear to adversely affect ultrasound-indicated cerclage.
RCT Entities:
OBJECTIVE: To evaluate whether increasing body mass index (BMI) alters the efficacy of ultrasound-directed cerclage in women with a history of preterm birth. METHODS: This was a planned secondary analysis of a multicenter trial in which women with a singleton gestation and prior spontaneous preterm birth (17 to 33 + 6 weeks' gestation) were screened for a short cervix by serial transvaginal ultrasound evaluations between 16 and 22 + 6 weeks. Women with a short cervix (cervical length < 25 mm) were randomly assigned to cerclage or not. Linear and logistic regression were used to assess the relationship between BMI and continuous and categorical variables, respectively. RESULTS: Overall, in the screened women (n = 986), BMI was not associated with cervical length (P = 0.68), gestational age at delivery (P = 0.12) or birth at < 35 weeks (P = 0.68). For the cerclage group (n = 148), BMI had no significant effect. For the no-cerclage group (n = 153), BMI was associated with a decrease in gestational age at delivery, with an estimated slope of - 0.14 weeks per kg/m(2) (P = 0.03; including adjustment for cervical length). This result was driven primarily by several women with BMI > 47 kg/m(2) . CONCLUSION: In women at high risk for recurrent preterm birth, BMI was not associated with cervical length or gestational age at birth. BMI did not appear to adversely affect ultrasound-indicated cerclage.
Authors: Maria Regina Torloni; Ana Pilar Betrán; Silvia Daher; Mariana Widmer; Siobhan M Dolan; Ramkumar Menon; Eduardo Bergel; Tomas Allen; Mario Merialdi Journal: J Matern Fetal Neonatal Med Date: 2009-11
Authors: Amy A Flick; Kathleen F Brookfield; Lesley de la Torre; Carmen Maria Tudela; Lunthita Duthely; Víctor Hugo González-Quintero Journal: Am J Perinatol Date: 2009-12-10 Impact factor: 1.862
Authors: John Owen; Gary Hankins; Jay D Iams; Vincenzo Berghella; Jeanne S Sheffield; Annette Perez-Delboy; Robert S Egerman; Deborah A Wing; Mark Tomlinson; Richard Silver; Susan M Ramin; Edwin R Guzman; Michael Gordon; Helen Y How; Eric J Knudtson; Jeff M Szychowski; Suzanne Cliver; John C Hauth Journal: Am J Obstet Gynecol Date: 2009-10 Impact factor: 8.661
Authors: Hugh M Ehrenberg; Jay D Iams; Robert L Goldenberg; Roger B Newman; Steven J Weiner; Baha M Sibai; Steve N Caritis; Menachem Miodovnik; Mitchell P Dombrowski Journal: Obstet Gynecol Date: 2009-01 Impact factor: 7.661