Interval From Loop Electrosurgical Excision Procedure to Pregnancy and Pregnancy Outcomes

被引:42
作者
Conner, Shayna N. [1 ]
Cahill, Alison G. [1 ]
Tuuli, Methodius G. [1 ]
Stamilio, David M. [1 ]
Odibo, Anthony O. [1 ]
Roehl, Kimberly A. [1 ]
Macones, George A. [1 ]
机构
[1] Washington Univ, Dept Obstet & Gynecol, St Louis, MO 63110 USA
基金
美国国家卫生研究院;
关键词
CERVICAL INTRAEPITHELIAL NEOPLASIA; TRANSFORMATION ZONE; PRETERM DELIVERY; UTERINE CERVIX; COLD-KNIFE; CONIZATION; MANAGEMENT; BIRTH; LASER; RISK;
D O I
10.1097/01.AOG.0000435454.31850.79
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE; Previous studies have shown mixed results for pregnancy outcomes after loop electrosurgical excision procedure (LEEP); however, evidence is lacking regarding the pregnancy outcome of spontaneous abortion with respect to time elapsed from LEEP to pregnancy. We investigated risks of spontaneous abortion and preterm birth as they relate to time elapsed from LEEP to pregnancy METHODS; A 10-year, multicenter cohort study of women who underwent LEEP was performed between 1996 and 2006. Trained research nurses conducted telephone interviews with all patients to complete data extraction unavailable in charts. Median time from LEEP to pregnancy for spontaneous abortion compared with no spontaneous abortion and preterm birth before 34 and before 37 weeks of gestation compared with term birth were estimated. Patients with time intervals less than 12 months compared with 12 months or more from LEEP to pregnancy were then compared with identify adjusted odds ratios for spontaneous abortion and preterm birth. RESULTS; Five hundred ninety-six patients met inclusion criteria. Median time from LEEP to pregnancy was significantly shorter for women with a spontaneous abortion (20 months [interquartile range 11.2-40.9] compared with 31 months [interquartile range 18.7-51.2]; P=.01) but did not differ for women with a term birth compared with preterm birth. Women with a time interval less than 12 months compared with 12 months or more were at significantly increased risk for spontaneous abortion (17.9% compared with 4.6%; adjusted odds ratio 5.6; 95% confidence interval 2.5-12.7). No increased risk was identified for preterm birth before 34 weeks of gestation or before 37 weeks of gestation. CONCLUSION; Women with a shorter time interval from LEEP to pregnancy are at increased risk for spontaneous abortion but not preterm birth.
引用
收藏
页码:1154 / 1159
页数:6
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