Nav: Home

Surgical stitch linked to stillbirth and preterm birth

August 03, 2016

In a study of almost 700 pregnant women who received a cervical stitch designed to prevent preterm labor, the use of one type of suture over another was associated with three times higher risk of stillbirth and almost twice the risk of preterm birth. The findings suggest that the suture may disrupt the vaginal microbiome and spur inflammation, one of the major risk factors for preterm birth. The results have helped launch a clinical trial in the UK reassessing the safety of the suture in women who undergo the procedure, known as cervical cerclage, which is performed about two million times annually. With common childhood diseases like diarrhea and measles now kept in check, preterm birth has emerged as the leading cause of death in children under five years old, claiming more than one million lives worldwide each year. Women with a weak or short cervix, often due to previous preterm labor or surgery for cervical cancer, are at risk of premature birth. A common preventative treatment is cervical cerclage, which sews the cervix closed to keep the baby inside longer during pregnancy. Two types of suture material--monofilament and multifilament braided--are used for the procedure. Evidence for one stitch being better than the other is lacking, but most surgeons prefer the braided suture because it's stronger and easier to work with. The suture material used may be critical because cervical cerclage can raise risk of vaginal infection, which is thought to cause preterm births. Previous studies have linked disruptions in the vaginal microbiome, the bacterial community residing in the vagina that plays a key role in reproductive health, to poor pregnancy outcomes, but until now have been limited to animal models or associative studies, according to David MacIntyre.

MacIntyre and colleagues now find that in 678 women in the UK, those who received cervical cerclage using the braided suture, compared to the monofilament suture, were three times more likely to experience nonviable births and almost two times more likely to undergo preterm labor. Further study revealed that the braided suture, perhaps because of its larger size or mesh-like structure, spurred the growth of diverse bacteria and stunted that of Lactobacillus species, which are important to maintaining a healthy vaginal microbiome. These perturbations were accompanied by an inflammatory response in women receiving the braided cerclage. In contrast, the monofilament cerclage had little impact on the vaginal microbiome or inflammation. Of the two million cervical cerclages performed each year, about 80% use the braided suture. The authors estimate that a switch from the braided to the monofilament suture used in cervical cerclages would prevent about 170,000 preterm births and 172,000 fetal losses each year worldwide. For further insights from MacIntyre and co-author Phillip Bennett, listen to the three related audio files at

American Association for the Advancement of Science

Related Preterm Birth Articles:

Researchers develop app to determine risk of preterm birth
An improved mobile phone app will help identify women who need special treatments at the right time and reduce emotional and financial burden on families and the NHS.
Point-of-care diagnostic for detecting preterm birth on horizon
A new study provides a first step toward the development of an inexpensive point-of-care diagnostic test to assess the presence of known risk factors for preterm birth in resource-poor areas.
WVU biostatistician studies link between microbiome and preterm birth
Pregnant African American women are more likely than white women to give birth prematurely, but they're underrepresented in studies of preterm birth rates.
3D-printed device detects biomarkers of preterm birth
Preterm birth (PTB) -- defined as birth before the 37th week of gestation -- is the leading complication of pregnancy.
Association of quitting smoking during pregnancy, risk of preterm birth
This study of more than 25 million pregnant women reports on rates of smoking cessation at the start of and during pregnancy and also examines the association of quitting cigarette smoking and the risk of preterm birth.
Blood test developed to predict spontaneous preterm birth
Results from a multicenter study show that five circulating microparticle proteins found in first-trimester blood samples may provide important clues about risk of spontaneous preterm birth.
Scientists gain new insight on triggers for preterm birth
A group of scientists led by Ramkumar Menon at The University of Texas Medical Branch at Galveston have gained new insight on a poorly-understood key player in the timing of labor and delivery.
Medically assisted reproduction does not raise risk of preterm birth and low birth weight
Study shows that couples can decide about using medically assisted reproduction free from concerns about increasing the health risks to their baby.
Risk of preterm birth reliably predicted by new test
Scientists at UC San Francisco have developed a test to predict a woman's risk of preterm birth when she is between 15 and 20 weeks pregnant, which may enable doctors to treat them early and thereby prevent severe complications later in the pregnancy.
Preterm birth leaves its mark in the functional networks of the brain
Researchers at the University of Helsinki and the Helsinki University Hospital, Finland, have proven that premature birth has a significant and, at the same time, a very selective effect on the functional networks of a child's brain.
More Preterm Birth News and Preterm Birth Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Reinvention
Change is hard, but it's also an opportunity to discover and reimagine what you thought you knew. From our economy, to music, to even ourselves–this hour TED speakers explore the power of reinvention. Guests include OK Go lead singer Damian Kulash Jr., former college gymnastics coach Valorie Kondos Field, Stockton Mayor Michael Tubbs, and entrepreneur Nick Hanauer.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at