Markfeld-Erol Filiz, Riedling Aaron, Juhasz-Böss Ingolf, Kunze Mirjam, Meschede Julia
Klinik für Frauenheilkunde, Medizinische Universitätsklinik, Universitätsklinikum Freiburg, Freiburg im Breisgau, Germany.
Quantitative Biology Center (QBIC), Universität Tübingen, Tübingen, Germany.
Geburtshilfe Frauenheilkd. 2025 Aug 29;85(11):1195-1202. doi: 10.1055/a-2651-4971. eCollection 2025 Nov.
Patients with a history of late miscarriage or preterm birth in a previous pregnancy may have a cerclage with total cervical closure (TCC) in a subsequent pregnancy to increase the likelihood of term delivery. This analysis investigates whether the interpregnancy interval influences the outcome of the subsequent pregnancy.
In a retrospective cohort of 131 women who received a prophylactic cerclage with TCC following late miscarriage or preterm birth, the impact of the interpregnancy interval on pregnancy outcome was evaluated. Women were divided into three interpregnancy interval groups (0-6, 6-12, and > 12 months). Outcomes assessed included late miscarriage, preterm birth (stratified by gestational age), term birth (≥ 37+0 weeks of gestation), and neonatal parameters (Apgar scores, umbilical cord pH, birth weight, and admission to the neonatal intensive care unit [NICU]).
An interpregnancy interval of more than 12 months was associated with the highest rate of term deliveries (85.4%) and the best neonatal outcomes overall. This group had the lowest NICU admission rates, the highest birth weights, and the best Apgar scores. Very early preterm births (< 28+0 weeks) were observed more frequently in the shorter interval groups. Umbilical artery pH showed no correlation with the interpregnancy interval.
A longer interpregnancy interval of more than 12 months was associated with a higher rate of deliveries ≥ 37+0 weeks and improved fetal outcomes in women with prophylactic cerclage and TCC after prior preterm birth or late miscarriage. In contrast, very early preterm births (< 28+0 weeks) occurred more often with shorter intervals.
既往有晚期流产或早产史的患者，在随后的妊娠中可能会接受宫颈环扎术以实现宫颈完全闭合（TCC），从而增加足月分娩的可能性。本分析旨在研究两次妊娠间隔时间是否会影响随后妊娠的结局。
在一个回顾性队列中，对131例在晚期流产或早产之后接受预防性宫颈环扎术并实现宫颈完全闭合的女性进行研究，评估两次妊娠间隔时间对妊娠结局的影响。将女性分为三个两次妊娠间隔时间组（0 - 6个月、6 - 12个月和>12个月）。评估的结局包括晚期流产、早产（按孕周分层）、足月分娩（≥37 + 0周妊娠）以及新生儿参数（阿氏评分、脐动脉血pH值、出生体重和入住新生儿重症监护病房[NICU]）。
两次妊娠间隔时间超过12个月与最高的足月分娩率（85.4%）以及总体最佳的新生儿结局相关。该组的NICU入住率最低、出生体重最高且阿氏评分最佳。在较短间隔时间组中，极早早产（<28 + 0周）更为常见。脐动脉血pH值与两次妊娠间隔时间无关。
对于既往有早产或晚期流产史且接受预防性宫颈环扎术并实现宫颈完全闭合的女性，两次妊娠间隔时间超过12个月与≥37 + 0周的分娩率较高以及胎儿结局改善相关。相比之下，间隔时间较短时极早早产（<28 + 0周）更常发生。
