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In normal pregnancy, the cervix maintains its shape during a period of substantial fetal and uterine growth. Hence, maintenance of biomechanical integrity is an important aspect of cervical function. It is known that cervical mechanical properties arise from the extracellular matrix. The most important constituent of the cervical extracellular matrix is fibrillar collagen -it is from collagen protein that the cervix derives its "strength." Other matrix molecules known to affect the collagen network include water, proteoglycans, hyaluronan and elastin. The objective of this review is to discuss relationships between biochemical constituents and macroscopic mechanical properties. The individual constituents of the extracellular matrix will be discussed, especially in regard to collagen remodeling during pregnancy. In addition, the macroscopic mechanical properties of cervical tissue will be reviewed. An improved understanding of the biochemistry of cervical "strength" will shed light into how the cervix maintains its shape in normal pregnancy and shortens in preterm birth.

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