Iben Sundtoft1, Jens Langhoff-Roos2, Puk Sandager1, Steffen Sommer3, Niels Uldbjerg1. 1. Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark. 2. Clinic of Obstetrics and Gynecology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark. 3. Department of Obstetrics and Gynecology, The Regional Hospital Horsens, Horsens, Denmark.
Abstract
INTRODUCTION: Preterm cervical shortening and cervical insufficiency may be caused by a constitutional weakness of the cervix. The aim of this study was to assess the cervical collagen concentration in non-pregnant women with a history of cervical insufficiency or of a short cervix in the second trimester of pregnancy. MATERIAL AND METHODS: In this case-control study we included non-pregnant women one year or more after pregnancy: 55 controls with a history of normal delivery; 27 women with a history of cervical insufficiency; and 10 women with a history of a short cervix (<5th percentile) and 10 women with a history of a long cervix (>95th percentile) at gestational weeks 18-20. We obtained biopsies (3 × 3-4 mm) from the ectocervix and determined the collagen concentration by measuring the hydroxyproline concentration. RESULTS: Women with cervical insufficiency had lower collagen concentrations (63.5 ± 5.1%; mean ± SD) compared with controls (68.2 ± 5.4%; p = 0.0004); area under the ROC curve 0.73 (95% CI 0.62-0.84). A cut-off value at 67.6% collagen resulted in a positive likelihood ratio of 3.2, a sensitivity of 60%, and a specificity of 81%. Also, women with a short cervix in the second trimester had lower collagen concentrations in a non-pregnant state (62.1% ± 4.9%) compared with women with a long cervix (67.8% ± 5.0%; p = 0.02). CONCLUSIONS: Both cervical insufficiency and a short cervix in the second trimester of pregnancy are associated with low cervical collagen concentrations in a non-pregnant state more than one year after pregnancy.
INTRODUCTION: Preterm cervical shortening and cervical insufficiency may be caused by a constitutional weakness of the cervix. The aim of this study was to assess the cervical collagen concentration in non-pregnant women with a history of cervical insufficiency or of a short cervix in the second trimester of pregnancy. MATERIAL AND METHODS: In this case-control study we included non-pregnant women one year or more after pregnancy: 55 controls with a history of normal delivery; 27 women with a history of cervical insufficiency; and 10 women with a history of a short cervix (<5th percentile) and 10 women with a history of a long cervix (>95th percentile) at gestational weeks 18-20. We obtained biopsies (3 × 3-4 mm) from the ectocervix and determined the collagen concentration by measuring the hydroxyproline concentration. RESULTS:Women with cervical insufficiency had lower collagen concentrations (63.5 ± 5.1%; mean ± SD) compared with controls (68.2 ± 5.4%; p = 0.0004); area under the ROC curve 0.73 (95% CI 0.62-0.84). A cut-off value at 67.6% collagen resulted in a positive likelihood ratio of 3.2, a sensitivity of 60%, and a specificity of 81%. Also, women with a short cervix in the second trimester had lower collagen concentrations in a non-pregnant state (62.1% ± 4.9%) compared with women with a long cervix (67.8% ± 5.0%; p = 0.02). CONCLUSIONS: Both cervical insufficiency and a short cervix in the second trimester of pregnancy are associated with low cervical collagen concentrations in a non-pregnant state more than one year after pregnancy.
Authors: Joy Vink; Victoria Yu; Sudip Dahal; James Lohner; Conrad Stern-Asher; Mirella Mourad; George Davis; Zenghui Xue; Shuang Wang; Kristin Myers; Jan Kitajewski; Xiaowei Chen; Ronald J Wapner; Cande V Ananth; Michael Sheetz; George Gallos Journal: Reprod Sci Date: 2020-07-22 Impact factor: 2.924
Authors: Natalie Suff; Rajvinder Karda; Juan Antinao Diaz; Joanne Ng; Julien Baruteau; Dany Perocheau; Peter W Taylor; Dagmar Alber; Suzanne M K Buckley; Mona Bajaj-Elliott; Simon N Waddington; Donald Peebles Journal: Front Immunol Date: 2020-02-11 Impact factor: 7.561