Study questions utility of universal cervical length screens

(HealthDay)—Patients with a short cervix who deliver prematurely have a significantly longer interval from antenatal corticosteroid administration, and fewer receive antenatal corticosteroids within seven days of birth, according to a study published in the June issue of Obstetrics & Gynecology.

Nicole Sahasrabudhe, M.D., from the Albert Einstein College of Medicine/Montefiore Medical Center in Bronx, N.Y., and colleagues performed a retrospective cohort study involving 266 patients with nonanomalous singleton gestation and spontaneous preterm birth between 24 and 34 weeks of gestation. Of the participants, 69 had a short cervical length and 197 were without short cervical length.

During the study period, 92.8 and 89.3 percent of those with and without a short cervix, respectively, received at least one steroid injection before delivery (P = 0.411). The researchers found that steroids were given within seven days of delivery in 47.8 and 64.0 percent of patients with and without a short cervix, respectively (adjusted odds ratio, 0.51; 95 percent confidence interval, 0.29 to 0.9; P = 0.015). The median interval between steroid administration and delivery was eight and three days, respectively, for those diagnosed with and without a short cervix (P < 0.001).

"This study highlights the clinical dilemma for physicians caring for patients with an incidentally identified short cervix trying to balance the risk of administering corticosteroids too early with the risk of administering them too late," the authors write. "A policy of universal transvaginal cervical length screening may increase the likelihood that corticosteroids for fetal maturation are administered less than optimally."

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