Wang Hua1, Zhang Wei1, Fan Ling2, Yu Song2, Ma Jian-Rong1, Wang Ping1. 1. Neonatal Intensive Care Unit. 2. Department of obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Abstract
OBJECTIVE: This study aimed to determine the impact of maternal cervical incompetence (with or without McDonald cerclage) on mortality and morbidity of preterm infant with birth weight <2000g. METHODS: 581 neonates were eligible for this study, 79 with cervical incompetence and 502 without it (control). Incidences of neonatal respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), neonatal necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), periventricular leukomalacia (PVL), severe asphyxia, small for gestational age (SGA), early-onset sepsis (EOS), and mortality were compared between the two groups. FINDINGS: Mean gestational age was earlier in cervical incompetence group than in control (30.2±2.1 vs 30.7±1.9, P<0.05). Except lower frequency of SGA, there were no significant differences in the incidences of RDS, BPD, ROP, PVL, IVH, NEC, EOS, severe asphyxia and mortality between the two groups. Infants with no cerclage had a higher prevalence of RDS (21/66 vs 9/13, P<0.05) compared to cerclage group due to lower mean gestational age (30.68±2.1 vs 28.6±1.4, P<0.01) and birth weight (1519.5±274.6 vs 1205.8±204.4, P<0.001), and clinical neonatal outcomes of the elective cerclage were similar to emergency cerclage in cervical incompetence groups. CONCLUSION: Maternal cervical incompetence was not associated with postnatal adverse neonatal outcomes. Lower mean gestational age was a major risk associated with higher prevalence of RDS in preterm neonates with no McDonald cerclage, and emergency cerclage did not predict poor clinical neonatal outcomes.
OBJECTIVE: This study aimed to determine the impact of maternal cervical incompetence (with or without McDonald cerclage) on mortality and morbidity of preterm infant with birth weight <2000g. METHODS: 581 neonates were eligible for this study, 79 with cervical incompetence and 502 without it (control). Incidences of neonatal respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), neonatal necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), periventricular leukomalacia (PVL), severe asphyxia, small for gestational age (SGA), early-onset sepsis (EOS), and mortality were compared between the two groups. FINDINGS: Mean gestational age was earlier in cervical incompetence group than in control (30.2±2.1 vs 30.7±1.9, P<0.05). Except lower frequency of SGA, there were no significant differences in the incidences of RDS, BPD, ROP, PVL, IVH, NEC, EOS, severe asphyxia and mortality between the two groups. Infants with no cerclage had a higher prevalence of RDS (21/66 vs 9/13, P<0.05) compared to cerclage group due to lower mean gestational age (30.68±2.1 vs 28.6±1.4, P<0.01) and birth weight (1519.5±274.6 vs 1205.8±204.4, P<0.001), and clinical neonatal outcomes of the elective cerclage were similar to emergency cerclage in cervical incompetence groups. CONCLUSION: Maternal cervical incompetence was not associated with postnatal adverse neonatal outcomes. Lower mean gestational age was a major risk associated with higher prevalence of RDS in preterm neonates with no McDonald cerclage, and emergency cerclage did not predict poor clinical neonatal outcomes.
Authors: T F McElrath; J L Hecht; O Dammann; K Boggess; A Onderdonk; G Markenson; M Harper; E Delpapa; E N Allred; A Leviton Journal: Am J Epidemiol Date: 2008-08-27 Impact factor: 4.897
Authors: Sophie Berglund; Mikael Norman; Charlotta Grunewald; Hans Pettersson; Sven Cnattingius Journal: Acta Paediatr Date: 2008-06 Impact factor: 2.299