Does a Longer Cervix in Obese Women Protect Against Preterm Birth?
Women with elevated BMI appear to have a reduced risk for spontaneous preterm birth (SPTB). This study by Palatnik et al. (American Journal of Perinatology, 2017) sought to determine if this apparently protective association of BMI and SPTB is related to mid-trimester cervical length.
Retrospective Cohort Study
18,100 women with singleton pregnancies and no prior SPTB were included in the survey. The women had routine transvaginal cervical length assessment between 18 and 24 weeks gestation. The women were placed into four BMI groups: 18.5-24.9; 25-29.9; 30-34.9; and ≥ 35 kg/m2; 43.5% of the women had a BMI of ≥ 30. Univariate analysis did in fact demonstrate that increasing BMI was associated with decreased risk of SPTB and longer cervical length. However, once multivariate analysis was applied, increasing BMI remained associated with lower rates of SPTB < 37 weeks but this lower SPTB risk was not related to cervical length. The mechanism for protecting against premature birth remains unclear and the authors recommend further studies.
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