{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:45:31Z","timestamp":1791935131549,"version":"4.3.4"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","funder":[{"name":"Macon & Joan Brock Virginia Health Sciences at Old Dominion University","award":["VHS 241231"],"award-info":[{"award-number":["VHS 241231"]}],"id":[{"id":"https:\/\/ror.org\/04zjtrb98","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"abstract":"<jats:p>Objective: To evaluate the association between the degree of cervical dilation at the time of physical exam\u2013indicated cerclage and delivery before 28 weeks of gestation.\n\nStudy Design: We conducted a retrospective cohort study of singleton pregnancies who underwent physical exam\u2013indicated cerclage (painless cervical dilation \u22651 cm in the second trimester) at a single academic institution, 2014\u20132022. The primary outcome was delivery before 28 weeks. Cervical dilation was categorized as 1, 2, 3, and 4\u20135 cm. Multivariable logistic regression estimated adjusted odds ratios (aOR) with 95% confidence intervals (CI), adjusting for potential confounders. Kaplan-Meier analysis of the cerclage-to-delivery interval was examined as a sensitivity analysis.\n\nResults: Of 107 singleton pregnancies, 31 (29.0%) delivered before 28 weeks. Groups were similar except for BMI, which was higher among those who delivered before 28 weeks (34.6 \u00b1 8.6 vs 30.8 \u00b1 7.3 kg\/m\u00b2; P=.026). Cervical dilation was greater in the early-delivery group (median 1.5 [IQR 1.0\u20133.0] vs 1.0 [IQR 1.0\u20132.0] cm; P=.016). Compared with 1 cm, dilation of 3 cm (aOR, 8.90; 95% CI, 1.75\u201345.30) and 4\u20135 cm (aOR, 12.95; 95% CI, 2.20\u201376.21) were independently associated with delivery before 28 weeks, whereas 2 cm was not (aOR, 0.74; 95% CI, 0.19\u20132.99); these estimates were imprecise because few patients had dilation of 3 cm or more. Median cerclage-to-delivery latency fell from 16.3 and 14.9 weeks at 1 and 2 cm to 2.4 and 1.5 weeks at 3 and 4\u20135 cm (log-rank P=.03).\n\nConclusion: Greater cervical dilation at physical exam\u2013indicated cerclage was associated with delivery before 28 weeks in a dose-dependent manner, with an apparent inflection between 2 and 3 cm. Because the higher-dilation strata contained few patients, these associations should be interpreted with caution.<\/jats:p>","DOI":"10.1055\/a-2979-5822","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:02:31Z","timestamp":1791932551000},"source":"Crossref","is-referenced-by-count":0,"title":["Cervical Dilation and Risk of Delivery before 28 Weeks after Physical Exam\u2013indicated Cerclage"],"prefix":"10.1055","author":[{"given":"Mackenzi","family":"McHugh","sequence":"additional","affiliation":[{"name":"Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Virginia, United States","place":["Norfolk"],"department":["Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Parker","sequence":"additional","affiliation":[{"name":"Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Virginia, United States","place":["Norfolk"],"department":["Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2438-1699","authenticated-orcid":false,"given":"Tetsuya","family":"Kawakita","sequence":"additional","affiliation":[{"name":"Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Virginia, United States","place":["Norfolk"],"department":["Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2979-5822.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:02:32Z","timestamp":1791932552000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2979-5822"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1055\/a-2979-5822","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10,13]]},"published":{"date-parts":[[2026,10,13]]}}}