Health disparities in risk for cervical insufficiency.
BACKGROUND
The purpose of the study was to examine racial/ethnic differences in cervical insufficiency risk.


METHODS
We used the US 2005 Natality data file. Analysis was limited to singleton births. The prevalence of cervical insufficiency was examined by the maternal characteristic for each racial group. Unconditional logistic regression modeling was used to assess the association between race and cervical insufficiency while controlling for confounders.


RESULTS
Cervical insufficiency risk for Black women was more than twice that for their White counterparts [odds ratio (OR) (95% confidence interval (CI)) of 2.45 (2.22-2.71)]. Prior pregnancy termination showed a dose-response relationship with cervical insufficiency. Compared with women with no history of prior pregnancy termination, primiparous women who have had one pregnancy termination had an OR (95% CI) of 2.49 (2.23-2.77). The OR for two, three and four or more terminations were 4.66 (4.07-5.33), 8.07 (6.77-9.61) and 12.36 (10.19-15.00), respectively. Other predictors of cervical insufficiency included previous preterm birth, parity, marital status, renal disease, history of diabetes, polyhydramnios and anemia.


CONCLUSIONS
There were significant racial/ethnic disparities with Black women having increased cervical insufficiency risk, independent of other studied factors. Prior pregnancy termination is also a major risk factor for cervical insufficiency. The White/Black disparity is evident in both primiparous and multiparous women.
Anum
Emmanuel A
EA
Department of Obstetrics and Gynecology, Virginia Commonwealth University, Center on Health Disparities and Institute for Women's Health, MCV Campus, Sanger Hall, 1st Floor, Room 1-071, Richmond, VA 23298, USA.
Brown
Haywood L
HL
Strauss
Jerome F
JF
D000026:Abortion, Habitual / Q000453:epidemiology; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D010298:Parity; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D002581:Uterine Cervical Incompetence / Q000453:epidemiology* / Q000209:etiology; D044465:White People / Q000706:statistics & numerical data