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. 2015 Feb 11;10(2):e0117525.
doi: 10.1371/journal.pone.0117525. eCollection 2015.

Pregnancy after treatment for cervical cancer precursor lesions in a retrospective matched cohort

Allison L Naleway  1 , Sheila Weinmann  1 , Girishanthy Krishnarajah  2 , Bhakti Arondekar  2 , Jovelle Fernandez  2 , Geeta Swamy  3 , Evan Myers  3
Affiliations

Pregnancy after treatment for cervical cancer precursor lesions in a retrospective matched cohort

Allison L Naleway et al. PLoS One. .

Abstract

Objective: To determine whether treatments for precancerous cervical lesions were associated with lower pregnancy rates compared to rates in unexposed women and women who had a diagnostic cervical biopsy or colposcopy.

Design: Matched, retrospective cohort study.

Setting: Kaiser Permanente Northwest (KPNW), an integrated healthcare delivery system in Oregon and Washington.

Patients: Women 14 to 53 years old with KPNW enrollment during the period 1998 through 2009.

Main outcome measure: Pregnancy after exposure or index date. Pregnancy was defined using a validated algorithm and electronic medical records data.

Results: We observed 570 pregnancies following cervical treatment in 4,137 women, 1,533 pregnancies following a diagnostic procedure in 13,767 women, and 7,436 pregnancies in a frequency-matched sample of 81,435 women unexposed to treatment or diagnostic procedures. After adjusting for age and contraceptive use, we observed a higher rate of pregnancies in the treatment group compared to unexposed women (hazard ratio (HR) = 1.42, 95% confidence interval (CI): 1.30-1.55), but no difference in pregnancy rates between the treatment and diagnostic procedure groups (HR = 1.03, 95% CI: 0.93-1.13).

Conclusions: No adverse effects of cervical procedures on subsequent rates of pregnancy were observed in this cohort with up to twelve years of follow-up time.

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Conflict of interest statement

Competing Interests: GK, BA, and JF are employees of the GlaxoSmithKline group of companies. GK, BA, and JF own restricted shares in the GlaxoSmithKline group of companies. EM has received grants and consulting fees from GlaxoSmithKline during the conduct of the study; consulting fees from Merck, Inc. for work on HPV vaccines; and grants from Gen-Probe/Hologic for work on HPV RNA testing. EM is a consultant for cervical cancer screening guidelines for the American Cancer Society Federal Advisory Panel, National Breast and Cervical Cancer Early Detection Program, and Centers for Disease Control and Prevention. GS has received consulting and lecturing fees as well as grant support for vaccine-related studies from GlaxoSmithKline, as well as for advisory boards, lectures, and the development of educational presentations. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Inclusion and Exclusion Criteria to Establish a Cohort of Women Exposed to Cervical Treatment or Diagnostic Procedures and a Matched Sample of Unexposed Women, Kaiser Permanente Northwest, 1998–2009.
Fig 2
Fig 2. Time to Pregnancy among Women Exposed or Unexposed to Cervical Treatment Procedures over 12 Years of Follow-Up.
Fig 3
Fig 3. Time to Pregnancy among Women Exposed to Cervical Treatment Procedures or Diagnostic Procedures over 12 Years of Follow-Up.
See this image and copyright information in PMC

Comment in

References

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