Email this article Risk factors for preterm birth and miscarriage in patients with cervical insufficiency
- Authors: Koshulko P.A.1, Kuzina Y.A.1, Maltseva M.M.1, Kvinikadze M.Z.1, Kravtsova P.V.1, Romashina V.S.1, Belomyttceva P.A.1, Zelenov A.A.1, Andreytseva O.I.1, Nedopekin A.Y.1, Volodichev G.I.1, Khalipaev M.S.1, Karasev P.V.1, Medvedev K.A.1, Iarichuk T.A.1, Chernomorova D.S.1, Mitroshkin P.P.1, Fomovskiy G.I.1, Nefedova M.V.1
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Affiliations:
- Privolzhsky Research Medical University, Ministry of Health of Russia
- Issue: Vol 22, No 1 (2026)
- Pages: 104-111
- Section: GYNECOLOGY. ORIGINAL REPORTS
- Published: 02.07.2026
- URL: https://ojrs.abvpress.ru/ojrs/article/view/1477
- DOI: https://doi.org/10.17650/1994-4098-2026-22-1-104-111
- ID: 1477
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Abstract
Aim. To identify risk factors for preterm birth and spontaneous miscarriage in pregnant patients with cervical insufficiency (CI).
Materials and methods. The study included 300 patients (aged 20–30 years) with a confirmed diagnosis of CI, who were subsequently divided into three groups: group 1 – patients with spontaneous miscarriage due to CI; group 2 – patients with preterm birth due to CI; group 3 – patients with term delivery and CI. The control group consisted of 100 patients (aged 20–30 years) with term delivery without CI.
Results. Women with CI demonstrated a markedly higher burden of obstetric and gynecological risk factors. A history of CI (up to 29 %), significant cervical shortening by 16 weeks (22.7 ± 2.2 mm vs. 45.7 ± 3.6 mm in controls; p <0.05), a high prevalence of connective tissue dysplasia (up to 48 %), and chronic cervical inflammation (up to 51 %) were strongly associated with spontaneous miscarriage and preterm birth. Obstetric complications, including premature rupture of membranes (up to 12 %), acute fetal hypoxia (up to 7 %), perineal tears (15 %), and macrosomia (12 %), occurred significantly more often. Correlation analysis confirmed strong associations between adverse outcomes and a history of CI (r = 0.85), connective tissue dysplasia (r = 0.78), multiparity (r = 0.80), and cervical length ≤25 mm in the second trimester (r up to 0.70).
Conclusion. CI is a multifactorial condition in which the combination of anatomical, connective tissue, and inflammatory alterations substantially increases the risk of pregnancy loss and preterm birth. The findings highlight the importance of early cervical length monitoring, detailed reproductive history assessment, and individualized preventive strategies for women at high risk.
About the authors
Pavel A. Koshulko
Privolzhsky Research Medical University, Ministry of Health of Russia
Author for correspondence.
Email: nikolconnik@gmail.com
ORCID iD: 0000-0003-2806-4017
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
Yu. A. Kuzina
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0000-7809-3655
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
M. M. Maltseva
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0000-9834-0852
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
M. Z. Kvinikadze
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0002-0754-9568
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
P. V. Kravtsova
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0008-9584-7859
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
V. S. Romashina
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0007-3588-2815
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
P. A. Belomyttceva
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0008-3863-6916
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
A. A. Zelenov
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0007-4338-8761
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
O. I. Andreytseva
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0006-5017-0560
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
A. Yu. Nedopekin
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0005-4329-1308
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
G. I. Volodichev
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0006-4033-3901
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
M. S. Khalipaev
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0003-6128-1870
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
Ph. V. Karasev
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0000-6190-858X
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
K. A. Medvedev
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0008-4842-591X
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
T. A. Iarichuk
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0009-5621-858X
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
D. S. Chernomorova
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0003-7785-0599
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
P. P. Mitroshkin
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0008-1975-0887
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
G. I. Fomovskiy
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0007-2615-4189
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
M. V. Nefedova
Privolzhsky Research Medical University, Ministry of Health of Russia
Email: nikolconnik@gmail.com
ORCID iD: 0009-0007-1684-2893
Russian Federation, 10 / 1 Ploshchad Minina and Pozharskogo, Nizhny Novgorod 603005
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