title: Pre-pregnancy body mass index (BMI) and cerclage success.
abstract: OBJECTIVE
  This study was performed to evaluate the effect of pre-pregnancy body mass index (BMI) on the success of cerclage.
  
  
  METHODS
  A retrospective cohort study of women who had a history-indicated (HIC) or ultrasound-indicated cerclage (UIC) placed between 1994 and 2011. Based on pre-pregnancy BMI (World Health Organization criteria), three cohorts were defined: normal/overweight (BMI: 20.0-29.9 kg/m(2)), obese class I/II (BMI: 30.0-39.9 kg/m(2)) and obese class III (BMI ≥ 40.0 kg/m(2)). The primary outcome was spontaneous preterm birth (sPTB) <35 weeks. The secondary outcomes included but were not limited to gestational age of delivery, sPTB <37, <32 and <28 weeks, preterm premature rupture of membranes and birth weight.
  
  
  RESULTS
  375 women were included for analysis. Demographics were similar in the three BMI categories, except black race (p = 0.01). The rates of sPTB <35 weeks were similar between each cohort: 24.3%, 23.0% and 27.7%, respectively (p = 0.81). BMI was not a predictor of any of the secondary outcomes. A HIC was placed in 47.2% and an UIC was placed in 52.8% women. Both unadjusted and adjusted analysis showed no significant difference in sPTB <35 weeks between BMI categories overall or by cerclage type (HIC or UIC).
  
  
  CONCLUSIONS
  Pre-pregnancy BMI is not a significant predictor of sPTB <35 weeks in women with HIC or UIC.
authors: a Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Jefferson Medical College of Thomas Jefferson University , Philadelphia , PA , USA .
authors: Anju
authors: A
authors: Suhag
authors: b Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , University of Rochester Medical Center , Rochester , NY , USA , and.
authors: Neil
authors: N
authors: Seligman
authors: c Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Albert Einstein Medical Center , Philadelphia , PA , USA.
authors: Maria
authors: M
authors: Giraldo-Isaza
authors: a Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Jefferson Medical College of Thomas Jefferson University , Philadelphia , PA , USA .
authors: Vincenzo
authors: V
authors: Berghella
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D023802:Cerclage, Cervical / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Body mass index; cervical cerclage; history-indicated cerclage; preterm birth; ultrasound-indicated cerclage