Archives of Gynecology and Obstetrics

, Volume 297, Issue 4, pp 919–926 | Cite as

Independent association between uterine malformations and cervical insufficiency: a retrospective population-based cohort study

  • Salvatore Andrea Mastrolia
  • Yael Baumfeld
  • Reli Hershkovitz
  • David Yohay
  • Giuseppe Trojano
  • Adi Y. Weintraub
Maternal-Fetal Medicine



The purpose of our study was to explore maternal and fetal outcomes in the second and third trimester in women with uterine malformations.

Study design

This was a retrospective population-based cohort study including women with a diagnosis of uterine malformation arised from workup for infertility or recurrent pregnancy loss, was accidental during pregnancy, or was noticed at the time of cesarean delivery.


A total of 280,721 pregnancies met the inclusion criteria and were divided into two study groups: (1) pregnancies in women with uterine malformations (n = 1099); and (2) controls (n = 279,662). The rate of women presenting uterine malformations was 0.39%. The prevalence of cervical os insufficiency was significantly higher in women with a uterine malformation than in the control group (3.6 vs. 0.4%, p < 0.001). A multivariate analysis, performed to evaluate risk factors for cervical insufficiency in women with uterine malformations. Mullerian anomalies (OR 6.19, 95% CI 4.41–8.70, p < 0.001), maternal age (OR 1.05, 95% CI 1.04–1.06, p < 0.001), recurrent abortions (OR 12.93, 95% CI 11.43–14.62, p < 0.001), and ethnicity (OR 2.86, 95% CI 2.454–3.34, p < 0.001) were found to be independently associated with the development of cervical insufficiency.


Uterine anomalies have a strong association with cervical insufficiency. Women with uterine anomalies have an increased risk to develop pregnancy complications that arise from a loss in cervical function during the midtrimester or early third trimester.


Cervical incontinence Preterm labor Recurrent abortion Retrospective study 


Compliance with ethical standards

Conflict of interest

Authors have no conflict of interest to declare.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, School of MedicineBen Gurion University of the NegevBeer ShevaIsrael
  2. 2.Department of Maternal Fetal MedicineFondazione MBBM, San Gerardo Hospital, University of Milano BicoccaMonzaItaly
  3. 3.Department of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria Policlinico di Bari, School of MedicineUniversity of Bari “Aldo Moro”BariItaly

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