Racial and social predictors of longitudinal cervical measures: the Cervical Ultrasound Study.

Objective: To evaluate whether the racial and socioeconomic disparities are present in adverse cervical parameters, and, if so, when such disparities develop.

Study Design: A prospective cohort study was conducted. 175 women with a prior preterm birth had up to four endovaginal ultrasounds between gestational weeks 16 and 24 (Cervical Ultrasound Trial of the MFMU). Each sociodemographic factor (race/ethnicity, marital status, insurance funding and education) was examined as a predictor of short cervix or U/funnel shape, using multiple logistic and linear regression. Changes in the cervical length and shape across pregnancy and after pressure were also examined.

Results: The strongest associations were seen between race and government-funded insurance and short cervix and U shape per funneling (race and length <25 mm per funnel: adjusted odds ratio (OR) 5.52, 2.24 to 13.63; government-funded insurance and length <30 mm per funnel: adjusted OR 3.10, 1.34 to 7.15). Changes in cervical length were not associated with sociodemographics.

Conclusion: African-American race and, to a lesser extent, insurance funder, are associated with cervical length and shapes that have been associated with preterm birth, and those properties are present largely early in pregnancy.