title: Cervical Pessary for Prevention of Preterm Birth: A Meta-Analysis.
abstract: To investigate the efficacy of cervical pessary placement in preventing preterm birth and perinatal morbidity and mortality in asymptomatic women with a singleton pregnancy and a short cervix, we searched literature in relevant databases. The meta-analysis of the 3 included trials (1412 women) showed cervical pessary placement did not reduce the risk of spontaneous preterm birth <34 weeks in these women (risk ratio (RR), 0.71; 95% confidence interval (CI), 0.21-2.43, P = 0.59; I2= 90%). The sensitivity analyses by excluding one trial at one time showed the same results. This meta-analysis also showed that cervical pessary did not prevent preterm birth <34, 30, 28 weeks and was not associated with respiratory distress syndrome, necrotising enterocolitis, intraventricular haemorrhage, neonatal sepsis, retinopathy of prematurity, fetal death, neonatal death, perinatal death, birth weight <1500 g, birth weight <2500 g, premature preterm rupture of membranes, corticosteroid treatment for fetal maturation, and admission to neonatal intensive care unit. Although this meta-analysis showed cervical pessary placement did not reduce the risk of preterm birth in women with a singleton pregnancy and a short cervix, we could not confirm or refute this conclusion, and large-scale randomised controlled trials are urgently needed.
authors.affiliation: Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Xin-Hang
authors.initials: XH
authors.lastname: Jin
authors.affiliation: Wenzhou People's Hospital, Wenzhou, Zhejiang, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Li
authors.affiliation: Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Huang
mesh_terms: D002584:Cervix Uteri / Q000601:surgery*; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D016017:Odds Ratio; D010570:Pessaries; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control*; D016896:Treatment Outcome