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

Background: 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. Methods: 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]). Results: 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. Conclusion: 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.