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

J Perinatol. 2017 Apr;37(4):335-339. doi: 10.1038/jp.2016.240. Epub 2017 Jan 12.


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.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Cervix Uteri / diagnostic imaging*
  • Cervix Uteri / pathology
  • Female
  • Humans
  • Insurance, Health
  • Linear Models
  • Logistic Models
  • Pregnancy
  • Pregnancy Trimester, Second
  • Premature Birth / epidemiology*
  • Premature Birth / ethnology
  • Prospective Studies
  • Racial Groups*
  • Social Class*
  • Ultrasonography
  • United States
  • Uterine Cervical Incompetence / diagnostic imaging*
  • Uterine Cervical Incompetence / ethnology
  • Young Adult