Cervical polyps: A risk factor for spontaneous preterm labor?

The risk of spontaneous preterm labor is increased 4-folds in pregnant women diagnosed with cervical polyp in in the first trimester of pregnancy and which are not removed compared to women without polyps, suggests a recent study published in The American Journal of Obstetrics and Gynecology.1

In this study, researchers from the Osaka Women's and Children's Hospital in Osaka, Japan retrospectively analysed medical records of 4172 pregnant women at less than 12 weeks of gestation between January 2015 and December 2019. These participants had been detected to have cervical polyp on routine vaginal speculum examination, which was managed expectantly, except in cases where there was a suspicion of malignancy. None of the study subjects with cervical polyps had abnormal cervical smears during pregnancy. They sought to examine if cervical polyps had an impact on spontaneous preterm birth before 34 weeks of gestation. Women with fetal anomalies, multiple pregnancies, loss of pregnancy before 12 weeks of gestation were not included in the trial.

Out of the 4172 selected participants, 92 (2.2%) were found to have a cervical polyp before 12 weeks of gestation. But polypectomy was not performed. Pregnant women who had cervical polyps were 4 times more likely to have spontaneous preterm births before 34 weeks of gestation compared to women who did not have cervical polyps; 5.4% vs 0.7%, respectively with adjusted odds ratio of 4.09. After adjusting for confounding variables such as smoking, underweight prior to conceiving, the adjusted hazard ratio for spontaneous preterm birth before 34 weeks of gestation among women with polyps compared to those without cervical polyps was 2.95.

Based on these findings, the authors suggest that unremoved cervical polyps diagnosed in early pregnancy are a risk factor for spontaneous preterm birth before 34 weeks of gestation. Clinicians should be aware of the association between cervical polyps and spontaneous preterm birth and encourage their patients to adopt healthy lifestyle habits

Reference

1. Wakimoto T, et al. Relationship between unremoved cervical polyp in pregnancy and spontaneous preterm birth. Am J Obstet Gynecol. 2022 Jul 13;S0002-9378(22)00550-6. doi: 10.1016/j.ajog.2022.06.064.