Activity restriction among women with a short cervix

William A. Grobman, Sharon A. Gilbert, Jay D. Iams, Catherine Y. Spong, George Saade, Brian M. Mercer, Alan T N Tita, Dwight J. Rouse, Yoram Sorokin, Kenneth J. Leveno, Jorge E. Tolosa, John M. Thorp, Steve N. Caritis, J. Peter Van Dorsten

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

OBJECTIVE: To estimate determinants of and outcomes associated with activity restriction among women with a short cervix. METHODS: This was a secondary analysis of a randomized trial of 17-α hydroxyprogesterone caproate for prevention of preterm birth among nulliparous women with singleton gestations and cervices less than 30 mm by midtrimester ultrasonography. Women were asked weekly whether they had been placed on pelvic, work, or nonwork rest. "Any activity restriction" was defined as being placed on any type of rest. Factors associated with any activity restriction were determined and the association between preterm birth and activity restriction was estimated with multivariable logistic regression. RESULTS: Of the 657 women in the trial, 646 (98%) responded to questions regarding activity restriction. Two hundred fifty-two (39.0%) were placed on any activity restriction at a median of 23.9 weeks (interquartile range 22.6-27.9 weeks). Women on activity restriction were older, more likely to have private insurance, less likely to be Hispanic, had a shorter cervical length, and were more likely to have funneling and intra-amniotic debris. Preterm birth at less than 37 weeks of gestation was more common among women placed on activity restriction (37% compared with 17%, P<.001). After controlling for potential confounding factors, preterm birth remained more common among those placed on activity restriction (adjusted odds ratio 2.37, 95% confidence interval 1.60-3.53). Results were similar for preterm birth at less than 34 weeks of gestation. CONCLUSION: Activity restriction did not reduce the rate of preterm birth in asymptomatic nulliparous women with a short cervix.

Original languageEnglish (US)
Pages (from-to)1181-1186
Number of pages6
JournalObstetrics and Gynecology
Volume121
Issue number6
DOIs
StatePublished - Jun 2013

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Cervix Uteri
Premature Birth
Pregnancy
17-alpha-Hydroxyprogesterone
Second Pregnancy Trimester
Insurance
Hispanic Americans
Ultrasonography
Logistic Models
Odds Ratio
Confidence Intervals

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Grobman, W. A., Gilbert, S. A., Iams, J. D., Spong, C. Y., Saade, G., Mercer, B. M., ... Van Dorsten, J. P. (2013). Activity restriction among women with a short cervix. Obstetrics and Gynecology, 121(6), 1181-1186. https://doi.org/10.1097/AOG.0b013e3182917529

Activity restriction among women with a short cervix. / Grobman, William A.; Gilbert, Sharon A.; Iams, Jay D.; Spong, Catherine Y.; Saade, George; Mercer, Brian M.; Tita, Alan T N; Rouse, Dwight J.; Sorokin, Yoram; Leveno, Kenneth J.; Tolosa, Jorge E.; Thorp, John M.; Caritis, Steve N.; Van Dorsten, J. Peter.

In: Obstetrics and Gynecology, Vol. 121, No. 6, 06.2013, p. 1181-1186.

Research output: Contribution to journalArticle

Grobman, WA, Gilbert, SA, Iams, JD, Spong, CY, Saade, G, Mercer, BM, Tita, ATN, Rouse, DJ, Sorokin, Y, Leveno, KJ, Tolosa, JE, Thorp, JM, Caritis, SN & Van Dorsten, JP 2013, 'Activity restriction among women with a short cervix', Obstetrics and Gynecology, vol. 121, no. 6, pp. 1181-1186. https://doi.org/10.1097/AOG.0b013e3182917529
Grobman WA, Gilbert SA, Iams JD, Spong CY, Saade G, Mercer BM et al. Activity restriction among women with a short cervix. Obstetrics and Gynecology. 2013 Jun;121(6):1181-1186. https://doi.org/10.1097/AOG.0b013e3182917529
Grobman, William A. ; Gilbert, Sharon A. ; Iams, Jay D. ; Spong, Catherine Y. ; Saade, George ; Mercer, Brian M. ; Tita, Alan T N ; Rouse, Dwight J. ; Sorokin, Yoram ; Leveno, Kenneth J. ; Tolosa, Jorge E. ; Thorp, John M. ; Caritis, Steve N. ; Van Dorsten, J. Peter. / Activity restriction among women with a short cervix. In: Obstetrics and Gynecology. 2013 ; Vol. 121, No. 6. pp. 1181-1186.
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abstract = "OBJECTIVE: To estimate determinants of and outcomes associated with activity restriction among women with a short cervix. METHODS: This was a secondary analysis of a randomized trial of 17-α hydroxyprogesterone caproate for prevention of preterm birth among nulliparous women with singleton gestations and cervices less than 30 mm by midtrimester ultrasonography. Women were asked weekly whether they had been placed on pelvic, work, or nonwork rest. {"}Any activity restriction{"} was defined as being placed on any type of rest. Factors associated with any activity restriction were determined and the association between preterm birth and activity restriction was estimated with multivariable logistic regression. RESULTS: Of the 657 women in the trial, 646 (98{\%}) responded to questions regarding activity restriction. Two hundred fifty-two (39.0{\%}) were placed on any activity restriction at a median of 23.9 weeks (interquartile range 22.6-27.9 weeks). Women on activity restriction were older, more likely to have private insurance, less likely to be Hispanic, had a shorter cervical length, and were more likely to have funneling and intra-amniotic debris. Preterm birth at less than 37 weeks of gestation was more common among women placed on activity restriction (37{\%} compared with 17{\%}, P<.001). After controlling for potential confounding factors, preterm birth remained more common among those placed on activity restriction (adjusted odds ratio 2.37, 95{\%} confidence interval 1.60-3.53). Results were similar for preterm birth at less than 34 weeks of gestation. CONCLUSION: Activity restriction did not reduce the rate of preterm birth in asymptomatic nulliparous women with a short cervix.",
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AU - Grobman, William A.

AU - Gilbert, Sharon A.

AU - Iams, Jay D.

AU - Spong, Catherine Y.

AU - Saade, George

AU - Mercer, Brian M.

AU - Tita, Alan T N

AU - Rouse, Dwight J.

AU - Sorokin, Yoram

AU - Leveno, Kenneth J.

AU - Tolosa, Jorge E.

AU - Thorp, John M.

AU - Caritis, Steve N.

AU - Van Dorsten, J. Peter

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N2 - OBJECTIVE: To estimate determinants of and outcomes associated with activity restriction among women with a short cervix. METHODS: This was a secondary analysis of a randomized trial of 17-α hydroxyprogesterone caproate for prevention of preterm birth among nulliparous women with singleton gestations and cervices less than 30 mm by midtrimester ultrasonography. Women were asked weekly whether they had been placed on pelvic, work, or nonwork rest. "Any activity restriction" was defined as being placed on any type of rest. Factors associated with any activity restriction were determined and the association between preterm birth and activity restriction was estimated with multivariable logistic regression. RESULTS: Of the 657 women in the trial, 646 (98%) responded to questions regarding activity restriction. Two hundred fifty-two (39.0%) were placed on any activity restriction at a median of 23.9 weeks (interquartile range 22.6-27.9 weeks). Women on activity restriction were older, more likely to have private insurance, less likely to be Hispanic, had a shorter cervical length, and were more likely to have funneling and intra-amniotic debris. Preterm birth at less than 37 weeks of gestation was more common among women placed on activity restriction (37% compared with 17%, P<.001). After controlling for potential confounding factors, preterm birth remained more common among those placed on activity restriction (adjusted odds ratio 2.37, 95% confidence interval 1.60-3.53). Results were similar for preterm birth at less than 34 weeks of gestation. CONCLUSION: Activity restriction did not reduce the rate of preterm birth in asymptomatic nulliparous women with a short cervix.

AB - OBJECTIVE: To estimate determinants of and outcomes associated with activity restriction among women with a short cervix. METHODS: This was a secondary analysis of a randomized trial of 17-α hydroxyprogesterone caproate for prevention of preterm birth among nulliparous women with singleton gestations and cervices less than 30 mm by midtrimester ultrasonography. Women were asked weekly whether they had been placed on pelvic, work, or nonwork rest. "Any activity restriction" was defined as being placed on any type of rest. Factors associated with any activity restriction were determined and the association between preterm birth and activity restriction was estimated with multivariable logistic regression. RESULTS: Of the 657 women in the trial, 646 (98%) responded to questions regarding activity restriction. Two hundred fifty-two (39.0%) were placed on any activity restriction at a median of 23.9 weeks (interquartile range 22.6-27.9 weeks). Women on activity restriction were older, more likely to have private insurance, less likely to be Hispanic, had a shorter cervical length, and were more likely to have funneling and intra-amniotic debris. Preterm birth at less than 37 weeks of gestation was more common among women placed on activity restriction (37% compared with 17%, P<.001). After controlling for potential confounding factors, preterm birth remained more common among those placed on activity restriction (adjusted odds ratio 2.37, 95% confidence interval 1.60-3.53). Results were similar for preterm birth at less than 34 weeks of gestation. CONCLUSION: Activity restriction did not reduce the rate of preterm birth in asymptomatic nulliparous women with a short cervix.

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