Interpregnancy Interval as a Determinant of Outcome in Women with Prophylactic Cerclage Following Preterm Birth or Late Miscarriage

Patients with a history of late miscarriage or preterm birth in a previous pregnancy may have a cerclage with total cervical closure (TCC) in a subsequent pregnancy to increase the likelihood of term delivery. This analysis investigates whether the interpregnancy interval influences the outcome of the subsequent pregnancy. In a retrospective cohort of 131 women who received a prophylactic cerclage with TCC following late miscarriage or preterm birth, the impact of the interpregnancy interval on pregnancy outcome was evaluated. Women were divided into three interpregnancy interval groups (0–6, 6–12, and > 12 months). Outcomes assessed included late miscarriage, preterm birth (stratified by gestational age), term birth (≥ 37+0 weeks of gestation), and neonatal parameters (Apgar scores, umbilical cord pH, birth weight, and admission to the neonatal intensive care unit [NICU]). An interpregnancy interval of more than 12 months was associated with the highest rate of term deliveries (85.4%) and the best neonatal outcomes overall. This group had the lowest NICU admission rates, the highest birth weights, and the best Apgar scores. Very early preterm births (< 28+0 weeks) were observed more frequently in the shorter interval groups. Umbilical artery pH showed no correlation with the interpregnancy interval. A longer interpregnancy interval of more than 12 months was associated with a higher rate of deliveries ≥ 37+0 weeks and improved fetal outcomes in women with prophylactic cerclage and TCC after prior preterm birth or late miscarriage. In contrast, very early preterm births (< 28+0 weeks) occurred more often with shorter intervals.