The effect of maternal obesity on cervical cerclage outcomes: A retrospective cohort study

INTRODUCTION: The objective of the study was to investigate the relationship between body mass index (BMI) and gestational age at delivery in patients who underwent cervical cerclage.
METHODS: The population of this retrospective study comprised the patients aged 18–45 who underwent cervical cerclage procedure in Zeynep Kamil Hospital between 2014 and 2021. Maternal demographic data and clinical characteristics, including BMI at the time of the cervical cerclage, were recorded. Patients were categorized into three groups according to their BMI values: normal (BMI: <25 kg/m2), overweight (BMI: 25–29.9 kg/m2), and obese (BMI: ≥30 kg/m2) groups. The primary and secondary outcomes of this study were gestational age at delivery and the percentage of deliveries that occurred <37 weeks, respectively.
RESULTS: The study sample consisted of 151 patients with a mean age of 30.4±5.6 years. The mean gestational age at cervical cerclage was 18.0±4.0 weeks, and the median gestational age at delivery was 37.0 weeks. Gestational week at delivery was significantly lower, and significantly fewer deliveries at ≥37 weeks occurred in the obese group compared with the other two groups (p<0.001). There was a significant inverse correlation between maternal BMI and gestational age at delivery (r=−0.516, p<0.001).
DISCUSSION AND CONCLUSION: Gestational age at delivery is inversely correlated with BMI in the pregnancies which have undergone cerclage operation. Accordingly, the risk of preterm delivery is significantly associated with BMI values of ≥30 kg/m2 in patients with cervical cerclage. Maternal obesity is shown to decrease the success of cerclage.