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Operative Obstetrics

Poster Session 3

(661) Offspring Long-Term Morbidities in Pregnancies with Cervical Cerclage

Wednesday, February 14, 2024

8:30 AM – 10:00 AM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Amir Snir, MD

Soroka University Medical Center
Beer-Sheva, HaDarom, Israel, Israel

Coauthor(s)

PS

Polina Schwarzman, MD

Soroka
Beer-Sheva, HaDarom, Israel
Tamar Wainstock, PhD (she/her/hers)

Ben Gurion University
Beer-Sheva, HaDarom, Israel
Eyal Sheiner, MD, PhD

Head of department of Obstetrics and Gynecology B, Soroka University Medical Center
Soroka University Medical Center
Beer-Sheva, HaDarom, Israel

Objective: Cervical cerclage is a standard procedure used to reinforce the cervix in order to reduce pregnancy loss and preterm birth in patients with cervical insufficiency. Although cerclage is an accepted practice and profoundly investigated procedure, there is limited evidence regarding cerclage consequences on long-term neonatal outcomes. The present study was aimed to investigate the long-term morbidities of offspring following pregnancies with cervical cerclage.

Study Design: A population-based cohort study was performed in a tertiary medical center including all deliveries between the years 1991-2023. Long-term neurological, endocrine, gastrointestinal and cardiac morbidities among offspring following pregnancy with and without cervical cerclage were compared. Diagnoses were pre-defined based on ICD-9 codes, as recorded in the hospital medical files. Multiple gestations and pregnancies with chromosomal abnormalities were excluded. Kaplan-Meier survival curves were used for cumulative long term morbidities over time and Cox proportional hazards models were constructed to control for confounders.

Results: Out of 354,940 offspring included in the analyses, 0.4% (n=1416) were following pregnancies with cervical cerclage. The crude rates of long-term neurological morbidity (OR 1.4, 95% CI 1.3 – 1.6; p = 0.001), endocrine morbidity (OR 1.4, 95% CI 1.1 – 1.7; p = 0.001) and gastrointestinal morbidity (OR 1.3, 95% CI 1.1 – 1.4; p = 0.001) were higher among offspring following pregnancies with cervical cerclage. However, using Kaplan-Meier survival curve analyses, the association between cervical cerclage and all long-term morbidities was not significant (Table). Likewise, using Cox regression models, controlling for confounders such as gestational age, cervical cerclage was not associated with long-term neurological, endocrine, gastrointestinal and cardiac morbidities of the offspring (Table).

Conclusion:

Cervical cerclage placement is not an independent risk factor for long-term neurological, endocrine, gastrointestinal and cardiac morbidities of the offspring.