(1052) Assessment of Disparities in Cerclage Placement Among Individuals with a History of Preterm Birth

Objective: To evaluate the association between rates of cerclage placement and race and ethnicity group, primary language, and insurance type among patients with a history of preterm birth.

Study Design: This was a retrospective cohort study within a large healthcare system in New York. Patients with were included who had screening cervical length measurements between 16 weeks 0 days and 23 weeks 6 days of gestation and a history of preterm birth due to any indication. Multivariate logistic regression was used to compare rates of cerclage placement by race and ethnicity group, English as primary language, Medicaid insurance, and the presence of a very short cervix < 10mm. All statistical analyses were performed in R 4.3.1.

Results: A total of 3,988 pregnancies in patients with a history of preterm birth were included. A cerclage was placed during 1228 (30.8%) of these pregnancies, and not in the remaining 2760 (69.2%). There were no significant differences in the rates of cerclage placement based on race and ethnicity groups, primary language, or insurance type. Very short cervical length ( < 10mm) was associated with a significantly higher rate of cerclage placement (aOR 4.04, 95% CI 2.97-5.51).

Conclusion: Systemic disparities in rates of cerclage placement among patients with a history of preterm birth on the basis of race and ethnicity group, primary language, and insurance type were not identified in this cohort. Patients with a history of preterm birth and a cervical length < 10mm have increased odds of receiving a cerclage.