Open AccessCervical collagen is reduced in non‐pregnant women with a history of cervical insufficiency and a short cervix
Author(s) -
Sundtoft Iben,
LanghoffRoos Jens,
Sandager Puk,
Sommer Steffen,
Uldbjerg Niels
Publication year - 2017
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13143
Subject(s) - cervical insufficiency , medicine , cervix , obstetrics , pregnancy , gynecology , percentile , gestational age , cancer , statistics , mathematics , biology , genetics
Preterm cervical shortening and cervical insufficiency may be caused by a constitutional weakness of the cervix. The aim of this study was to assess the cervical collagen concentration in non‐pregnant women with a history of cervical insufficiency or of a short cervix in the second trimester of pregnancy. Material and methods In this case‐control study we included non‐pregnant women one year or more after pregnancy: 55 controls with a history of normal delivery; 27 women with a history of cervical insufficiency; and 10 women with a history of a short cervix (<5th percentile) and 10 women with a history of a long cervix (>95th percentile) at gestational weeks 18–20. We obtained biopsies (3 × 3–4 mm) from the ectocervix and determined the collagen concentration by measuring the hydroxyproline concentration. Results Women with cervical insufficiency had lower collagen concentrations (63.5 ± 5.1%; mean ± SD ) compared with controls (68.2 ± 5.4%; p = 0.0004); area under the ROC curve 0.73 (95% CI 0.62–0.84). A cut‐off value at 67.6% collagen resulted in a positive likelihood ratio of 3.2, a sensitivity of 60%, and a specificity of 81%. Also, women with a short cervix in the second trimester had lower collagen concentrations in a non‐pregnant state (62.1% ± 4.9%) compared with women with a long cervix (67.8% ± 5.0%; p = 0.02). Conclusions . Both cervical insufficiency and a short cervix in the second trimester of pregnancy are associated with low cervical collagen concentrations in a non‐pregnant state more than one year after pregnancy.