Risk of preterm birth associated with intra-amniotic debris and shortened cervix

In a study to be presented on February 14 between 8 a.m. and 10 a.m. PST, at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting -, in San Francisco, California, researchers will report findings suggesting an increased risk of early (less than 35 weeks) preterm birth when intra-amniotic debris is present in nulliparous women with a short cervix. The babies born to women with debris had worse outcomes than those born to women without debris, likely due to the earlier delivery.

The multicenter study, presented by Dr. George Saade for the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Bethesda, Md., looked at intra-amniotic debris in 657 nulliparous women (women who have never given viable birth) with slightly short cervix, examined as part of a treatment trial. The study did not look at women with normal cervical length.

The medical community has long been aware of the risk of preterm birth associated with shortened cervix, but not much is known about debris in amniotic fluid during pregnancy, including what the debris is and how it influences preterm birth.

"Some think it could be proteins, or cells floating around, or infections, or inflammation," said Dr. Saade. "We aren't sure, but from the research: when it is present, the risk for preterm birth is higher."

The women, as part of the treatment for the shortened cervix, had transvaginal ultrasounds, by sonographers certified in cervical length measurements, as well as identification of intra-amniotic debris and cervical funneling.

Dr. Saade says more information about the debris is still needed.

"What is it? Why does it cause preterm birth? And how can it be treated? These are our next steps," stated Saade.