title: Prognosis in cervical insufficiency at less than 32 weeks of gestation.
abstract: OBJECTIVE
  To identify prenatal events associated with adverse outcome in babies at less than 32 weeks of gestation in cases of cervical insufficiency and preterm labor (PTL)/premature rupture of the membranes (PROM).
  
  
  METHODS
  A case-control study was performed using a logistic regression model at 17 tertiary hospitals in Japan. Adverse outcome was defined as neonatal death or abnormal cerebral ultrasound scans (intraventricular hemorrhage [IVH] and periventricular leukomalacia [PVL]) prior to discharge from hospital.
  
  
  RESULTS
  Data were analyzed for 307 cases (74 for cervical insufficiency and 233 for PTL/PROM). Neonatal death and IVH/PVL were noted in 25 and 29 cases, respectively. A significant association of cervical insufficiency (odds ratio (OR) 1.32, 95% confidence interval (CI) 1.02-1.68), gestational age at delivery (<26 weeks) (OR 4.64, 95% CI 1.73-12.44), and Apgar score <7 at 5 min (OR 3.3, 95% CI 1.42-7.64) with combined neonatal death or IVH and PVL was found in a logistic regression model that controlled for in utero transportation, gestational age on admission, clinical chorioamnionitis, and histopathologic chorioamnionitis.
  
  
  CONCLUSIONS
  Cervical insufficiency is a significant factor related to the occurrence of adverse outcome.
authors: Department of Obstetrics and Gynecology, Perinatal Medical Center, Tokyo Women's Medical University Hospital, Tokyo 162-8666, Japan.
authors: Minoru
authors: M
authors: Mitani
authors: Yoshio
authors: Y
authors: Matsuda
authors: Erina
authors: E
authors: Ono
authors: Yoshika
authors: Y
authors: Akizawa
authors: Hiroaki
authors: H
authors: Ohta
mesh_terms: D016022:Case-Control Studies; D023802:Cerclage, Cervical; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011379:Prognosis; D015149:Tocolytic Agents / Q000627:therapeutic use; D002581:Uterine Cervical Incompetence / Q000188:drug therapy
chemical_list: D015149:Tocolytic Agents