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.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
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,Peter Van Dorsten J,Eunice Kennedy Shriver National Institute of Child Health and Human Developmentdoi
10.1097/AOG.0b013e3182917529subject
Has Abstractpub_date
2013-06-01 00:00:00pages
1181-1186issue
6eissn
0029-7844issn
1873-233Xpii
00006250-201306000-00007journal_volume
121pub_type
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