Harville E W, Miller K S, Knoepp L R
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Department of Biomedical Engineering, Tulane University School of Science and Engineering, New Orleans, LA, USA.
J Perinatol. 2017 Apr;37(4):335-339. doi: 10.1038/jp.2016.240. Epub 2017 Jan 12.
To evaluate whether the racial and socioeconomic disparities are present in adverse cervical parameters, and, if so, when such disparities develop.
A prospective cohort study was conducted. 175 women with a prior preterm birth had up to four endovaginal ultrasounds between gestational weeks 16 and 24 (Cervical Ultrasound Trial of the MFMU). Each sociodemographic factor (race/ethnicity, marital status, insurance funding and education) was examined as a predictor of short cervix or U/funnel shape, using multiple logistic and linear regression. Changes in the cervical length and shape across pregnancy and after pressure were also examined.
The strongest associations were seen between race and government-funded insurance and short cervix and U shape per funneling (race and length <25 mm per funnel: adjusted odds ratio (OR) 5.52, 2.24 to 13.63; government-funded insurance and length <30 mm per funnel: adjusted OR 3.10, 1.34 to 7.15). Changes in cervical length were not associated with sociodemographics.
African-American race and, to a lesser extent, insurance funder, are associated with cervical length and shapes that have been associated with preterm birth, and those properties are present largely early in pregnancy.
评估不良宫颈参数中是否存在种族和社会经济差异，若存在，这些差异何时出现。
进行了一项前瞻性队列研究。175名有早产史的女性在妊娠16至24周期间接受了多达四次经阴道超声检查（母胎医学单位宫颈超声试验）。使用多元逻辑回归和线性回归，将每个社会人口学因素（种族/族裔、婚姻状况、保险资金和教育程度）作为宫颈短或呈U形/漏斗形的预测因素进行研究。还研究了整个孕期及施压后宫颈长度和形状的变化。
种族与政府资助保险和宫颈短及每漏斗呈U形之间的关联最强（种族与每漏斗长度<25mm：校正比值比（OR）5.52，2.24至13.63；政府资助保险与每漏斗长度<30mm：校正OR 3.10，1.34至7.15）。宫颈长度的变化与社会人口学因素无关。
非裔美国人种族以及在较小程度上的保险资助者，与已被证明与早产相关的宫颈长度和形状有关，且这些特征在妊娠早期就基本存在。
