Preterm delivery after surgical treatment for cervical intraepithelial neoplasia

被引:132
作者
Jakobsson, Maija [1 ]
Gissler, Mika [1 ]
Sainio, Susanna [1 ]
Paavonen, Jorma [1 ]
Tapper, Anna-Maija [1 ]
机构
[1] Univ Helsinki Hosp, Dept Obstet & Gynaecol, FIN-00029 Helsinki, Finland
关键词
D O I
10.1097/01.AOG.0000253239.87040.23
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
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.
引用
收藏
页码:309 / 313
页数:5
相关论文
共 24 条
[1]   Loop electrosurgical excision procedure of the cervix and time of delivery in subsequent pregnancy [J].
Althuisius, SM ;
Schornagel, IJ ;
Dekker, GA ;
van Geijn, HP ;
Hummel, P .
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, 2001, 72 (01) :31-34
[2]   High prevalence of HPV among female students in Finland [J].
Auvinen, E ;
Niemi, M ;
Malm, C ;
Zilliacus, R ;
Trontti, A ;
Fingerroos, R ;
Lehtinen, M ;
Paavonen, J .
SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES, 2005, 37 (11-12) :873-876
[3]   PREGNANCY OUTCOME AFTER LARGE LOOP EXCISION OF THE CERVICAL TRANSFORMATION ZONE [J].
BLOMFIELD, PI ;
BUXTON, J ;
DUNN, J ;
LUESLEY, DM .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1993, 169 (03) :620-625
[4]   THE EFFECT OF CERVICAL LOOP ELECTROSURGICAL EXCISION ON SUBSEQUENT PREGNANCY OUTCOME - NORTH-AMERICAN EXPERIENCE [J].
FERENCZY, A ;
CHOUKROUN, D ;
FALCONE, T ;
FRANCO, E .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1995, 172 (04) :1246-1250
[5]   Quality of data on subsequent events in a routine Medical Birth Register [J].
Gissler, M ;
Shelley, J .
MEDICAL INFORMATICS AND THE INTERNET IN MEDICINE, 2002, 27 (01) :33-38
[6]  
GISSLER M, 2004, NORSK EPIDEMIOLOGI, V14, P1
[7]   LARGE LOOP EXCISION OF THE TRANSFORMATION ZONE (LLETZ) COMPARED TO CARBON-DIOXIDE LASER IN THE TREATMENT OF CIN - A SUPERIOR MODE OF TREATMENT [J].
GUNASEKERA, PC ;
PHIPPS, JH ;
LEWIS, BV .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1990, 97 (11) :995-998
[8]   THE OUTCOME OF PREGNANCY AFTER CO2-LASER CONIZATION OF THE CERVIX [J].
HAGEN, B ;
SKJELDESTAD, FE .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1993, 100 (08) :717-720
[9]   Smoking during pregnancy in Finland: Determinants and trends, 1987-1997 [J].
Jaakkola, N ;
Jaakkola, MS ;
Gissler, M ;
Jaakkola, JJK .
AMERICAN JOURNAL OF PUBLIC HEALTH, 2001, 91 (02) :284-286
[10]  
JONES CJ, 1990, CANCER RES, V50, P3657