Abstract：
OBJECTIVE: Earlier studies have indicated a potential link between dilatation and curettage (D&C) and subsequent preterm delivery, possibly attributed to cervical damage. This study examines outcomes in pregnancies subsequent to first-trimester curettage with and without cervical dilatation.
METHODS: A retrospective cohort study was conducted on women who conceived after undergoing curettage due to a first trimester pregnancy loss. Maternal and neonatal outcomes of the subsequent pregnancy were compared between two groups: women who underwent cervical dilatation before their curettage and those who had curettage without dilatation. The primary outcome assessed was the rate of preterm delivery at the subsequent pregnancy, and secondary outcomes included other adverse maternal and neonatal outcomes. Univariate analysis was performed, followed by multiple logistic regression models to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
RESULTS: Among the 1087 women meeting the inclusion criteria during the study period, 852 (78.4 %) underwent first-trimester curettage with cervical dilatation, while 235 (21.6 %) opted for curettage only. No significant maternal or neonatal different outcomes were noted between the study groups, including preterm delivery (5.5 % vs. 3.5 %, p = 0.16), fertility treatments, placental complications, and mode of delivery. However, deliveries following D&C were associated with higher rates of small for gestational age neonates (7.6 % vs. 3.8 %, p = 0.04). Multivariate analysis revealed that cervical dilation before curettage was not significantly linked to preterm delivery [adjusted odds ratio 0.64 (0.33-1.26), p = 0.20].
CONCLUSIONS: The use of cervical dilatation during a curettage procedure for first trimester pregnancy loss, does not confer additional risk of preterm delivery. Further studies are needed to reinforce and validate these results.
METHODS: A retrospective cohort study was conducted on women who conceived after undergoing curettage due to a first trimester pregnancy loss. Maternal and neonatal outcomes of the subsequent pregnancy were compared between two groups: women who underwent cervical dilatation before their curettage and those who had curettage without dilatation. The primary outcome assessed was the rate of preterm delivery at the subsequent pregnancy, and secondary outcomes included other adverse maternal and neonatal outcomes. Univariate analysis was performed, followed by multiple logistic regression models to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
RESULTS: Among the 1087 women meeting the inclusion criteria during the study period, 852 (78.4 %) underwent first-trimester curettage with cervical dilatation, while 235 (21.6 %) opted for curettage only. No significant maternal or neonatal different outcomes were noted between the study groups, including preterm delivery (5.5 % vs. 3.5 %, p = 0.16), fertility treatments, placental complications, and mode of delivery. However, deliveries following D&C were associated with higher rates of small for gestational age neonates (7.6 % vs. 3.8 %, p = 0.04). Multivariate analysis revealed that cervical dilation before curettage was not significantly linked to preterm delivery [adjusted odds ratio 0.64 (0.33-1.26), p = 0.20].
CONCLUSIONS: The use of cervical dilatation during a curettage procedure for first trimester pregnancy loss, does not confer additional risk of preterm delivery. Further studies are needed to reinforce and validate these results.
摘要：
目的：早期的研究表明，扩张和刮治（D&C）与随后的早产之间存在潜在的联系，可能归因于宫颈损伤。这项研究检查了妊娠早期刮宫后有无宫颈扩张的妊娠结局。
方法：对因早孕流产而接受刮宫后受孕的妇女进行了一项回顾性队列研究。比较了两组随后妊娠的孕产妇和新生儿结局：在刮宫前进行宫颈扩张的妇女和在没有扩张的情况下进行刮宫的妇女。评估的主要结局是随后妊娠的早产率，次要结局包括其他不良母婴结局.进行了单变量分析，其次是多逻辑回归模型，以计算调整比值比（aOR）和95％置信区间（CIs）。
结果：在研究期间符合纳入标准的1087名女性中，852（78.4％）接受了宫颈扩张的早孕期刮宫术，而235(21.6%)只选择刮宫。研究组之间没有显著的孕产妇或新生儿不同的结局。包括早产(5.5%与3.5%,p=0.16),生育治疗,胎盘并发症,和交付方式。然而,D&C后分娩与较高的小于胎龄新生儿比率相关(7.6%vs.3.8%,p=0.04)。多因素分析显示，刮宫前宫颈扩张与早产无显著关联[校正比值比0.64(0.33-1.26)，p=0.20]。
结论：刮宫术中使用宫颈扩张治疗妊娠早期流产，不会带来额外的早产风险。需要进一步的研究来加强和验证这些结果。
方法：对因早孕流产而接受刮宫后受孕的妇女进行了一项回顾性队列研究。比较了两组随后妊娠的孕产妇和新生儿结局：在刮宫前进行宫颈扩张的妇女和在没有扩张的情况下进行刮宫的妇女。评估的主要结局是随后妊娠的早产率，次要结局包括其他不良母婴结局.进行了单变量分析，其次是多逻辑回归模型，以计算调整比值比（aOR）和95％置信区间（CIs）。
结果：在研究期间符合纳入标准的1087名女性中，852（78.4％）接受了宫颈扩张的早孕期刮宫术，而235(21.6%)只选择刮宫。研究组之间没有显著的孕产妇或新生儿不同的结局。包括早产(5.5%与3.5%,p=0.16),生育治疗,胎盘并发症,和交付方式。然而,D&C后分娩与较高的小于胎龄新生儿比率相关(7.6%vs.3.8%,p=0.04)。多因素分析显示，刮宫前宫颈扩张与早产无显著关联[校正比值比0.64(0.33-1.26)，p=0.20]。
结论：刮宫术中使用宫颈扩张治疗妊娠早期流产，不会带来额外的早产风险。需要进一步的研究来加强和验证这些结果。
