Cervical polyps are often associated with localized inflammatory foci, which may be detected during pregnancy. In symptomatic cases, polypectomy currently represents the primary therapeutic intervention. However, the impact of cervical polyps on pregnancy outcomes and the clinical significance of cervical polypectomy remain subjects of ongoing debate. This study aimed to investigate the relationship between cervical polyps and pregnancy outcomes, focusing on spontaneous preterm birth (SPTB) and late miscarriage, and to evaluate the association of polypectomy with these outcomes. This retrospective study was conducted at a tertiary university-affiliated women’s hospital.

The study included 9990 consecutive women who underwent vaginal delivery, with or without cervical polyps, over a 12-month period from January to December 2021. All patients had undergone gynecological examination and transvaginal ultrasonography during early pregnancy. The diagnosis of cervical polyps in early pregnancy (4–12 gestational weeks) was determined through gross clinical inspection and confirmed by transvaginal ultrasound. Polypectomy should be considered in cases of heavy vaginal bleeding, secondary infection, excessively long polyps or prolapse of the vaginal orifice, and when cervical malignancy is strongly suspected. The associations of cervical polyps or polypectomy with late miscarriage and SPTB were evaluated using comparative analysis, as well as univariate and multivariate logistic regression.

A comparative analysis of pregnancy outcomes was performed between two groups: 94 (0.94%) cases with cervical polyps detected in the first trimester and 9896 cases without cervical polyps. The incidence of late miscarriage and SPTB was significantly higher in the polyp group than in the non-polyp group. Multivariate analysis revealed that cervical polyps in first trimester pregnancy was a significant independent risk factor for both late miscarriage (odds ratio [OR]: 96.94, 95% CI: 34.88–269.49, p < 0.001) and SPTB before 28 (OR: 31.48, 95% CI: 11.48–86.32, p < 0.001), 34 (OR: 26.13, 95% CI: 11.58–58.94, p < 0.001), or 37 (OR: 5.13, 95% CI: 2.59–10.17, p < 0.001) weeks of gestation. Our analysis demonstrated comparable pregnancy outcomes between the polypectomy and non-polypectomy groups, with no statistically significant association observed between cervical polypectomy and pregnancy outcomes in this cohort. Vaginal bleeding was identified as an independent protective factor for SPTB before 34 weeks of pregnancy in these patients (OR: 0.27, 95% CI: 0.09–0.83, p = 0.023).

Cervical polyps detected during the first trimester were associated with a significantly increased risk of both late miscarriage and SPTB; however, polypectomy did not significantly improve in pregnancy outcomes.