Skip to main content
SMFM 2024 Pregnancy Meeting Main banner
Final Program


Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Poster Icons
Foundation Awardee
Foundation Awardee
No Social Media
No Social Media
Back
Q&A

Clinical Obstetrics

Poster Session 2

(596) Delivery Outcomes in Triplet and Twin versus Singleton Pregnancies with Short Cervix

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

Short cervix and multi-fetal gestation are independent risk factors for spontaneous preterm delivery (PTD). Our study aims to identify the impact of short cervix on delivery timing in triplet and twin pregnancies vs singleton pregnancies.

Study Design:

This is a retrospective cohort study of pregnant subjects from the National Inpatient Sample Database from 2017-2019 with a delivery encounter diagnosis of short cervix or cervical incompetence. Exclusion criteria were quadruplet or higher order multiple pregnancies and delivery at < 14 weeks. Subjects with singleton, twin, and triplet pregnancies were separated into three groups for comparison. Primary outcome was delivery gestational age (GA)< 22 weeks, < 28 weeks, and < 34 weeks. ANOVA, chi-squared, and logistic and linear regression were used for statistical analysis; p-value < 0.05 was considered statistically significant.

Results:

18,232 singleton, 2,160 twin, and 125 triplet pregnancies with short cervix were identified for analysis. Average GA at delivery for pregnancies with short cervix was lower in triplets (27.3 +/- 4.6 weeks) and twins (28.7 +/- 5.3 weeks) vs singletons (31.7 +/- 6.7 weeks). Rates of PTD < 22 weeks were similar across groups – 11.6% in triplets vs 9.0% in twins vs 9.2% in singleton (p=0.613). At GA < 28 weeks, PTD was higher with triplets (49.6%) and twins (42.5%) vs singleton (30.5%) (p< 0.001). PTD rates at GA < 34 weeks were 89.9% for triplets, 77.7% for twins, and 50.3% for singleton (p< 0.001). These findings persisted when controlling for confounders. PTD was higher in triplets at GA < 28 weeks (aOR 2.16, 95%CI 1.50-3.10) and < 34 weeks (aOR 8.74, 95%CI 4.80-15.93). There remained no association with triplet pregnancy and delivery < 22 weeks in those with short cervix (aOR 1.30, 95%CI 0.76-2.23).

Conclusion:

Triplet and twin pregnancies with short cervix are associated with increased rates of PTD compared to singleton pregnancies. The difference in PTD rates between triplet, twin, and singleton pregnancies with short cervix is insignificant at GA < 22 weeks, however becomes more salient with advancing gestational age.