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. 2007 Feb;109(2 Pt 1):309-13.
doi: 10.1097/01.AOG.0000253239.87040.23.

Preterm delivery after surgical treatment for cervical intraepithelial neoplasia

Maija Jakobsson  1 , Mika Gissler, Susanna Sainio, Jorma Paavonen, Anna-Maija Tapper
Affiliations

Preterm delivery after surgical treatment for cervical intraepithelial neoplasia

Maija Jakobsson et al. Obstet Gynecol. 2007 Feb.

Erratum in

  • Obstet Gynecol. 2008 Oct;112(4):945

Abstract

Objective: To study whether a treatment of cervical intraepithelial neoplasia (CIN) is associated with an adverse outcome in the subsequent pregnancies.

Methods: This study is a register-based retrospective cohort study from Finland. National data of 25,827 women having a surgical treatment of the cervix for CIN in 1986-2003 and their 8,210 subsequent singleton births in 1987-2004 were studied. Main outcome measures were preterm birth rate, low birth weight rate, and perinatal mortality rate.

Results: The risk of any preterm delivery (less than 37 weeks of gestation), especially the risk of very preterm delivery (28-31 weeks of gestation), and extremely preterm delivery (less than 28 weeks of gestation) was increased after cervical conization (relative risk [RR] 1.99, 95% confidence interval [CI] 1.81-2.20; RR 2.86, 95% CI 2.22-3.70; and RR 2.10, 95% CI 1.47-2.99, respectively). After cervical ablation, the risk of preterm delivery was also increased. The risk of low birth weight and perinatal death was increased after conization (RR 2.06, 95% CI 1.83-2.31 and RR 1.74, 95% CI 1.30-2.32, respectively). Adjusting for maternal age, parity, and maternal smoking did not affect our results.

Conclusion: Any treatment for CIN, including loop electrosurgical excision procedure, increases the risk of preterm delivery. It is important to emphasize this when treating young women with CIN.

Level of evidence: II.

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