Loop electrosurgical excision of the cervix and subsequent risk for spontaneous preterm delivery: a population-based study of singleton deliveries during a 9-year period
Presented at the 24th International Papillomavirus Conference and Clinical Workshop, Beijing, China, Nov. 3-9, 2007.
Received 2 October 2008; received in revised form 8 December 2008; accepted 11 February 2009. published online 06 April 2009.
Objective
Our aim was to assess the association between loop electrosurgical excision procedure (LEEP) and the subsequent risk for spontaneous preterm delivery, with the use of population-based data from various nationwide registries.
Study Design
The study population consisted of all singleton deliveries in Denmark during a 9-year period, 1997-2005. Information on the deliveries that included different cervical procedures was obtained from various national registries. In all, 552,678 deliveries were eligible for analyses.
Results
Of the deliveries in which the mother had no previous LEEP, 18,519 deliveries (3.5%) were preterm; when this data were applied to 530 preterm deliveries (6.9%) that were subsequent to LEEP, the yield was a significantly increased risk of preterm delivery, with an odds ratio of 2.07 (95% CI, 1.88-2.27; LEEP vs no LEEP).
Conclusion
Our study showed an overall 2-fold increase in the risk of spontaneous preterm delivery in singleton deliveries subsequent to LEEP treatment, even after adjustment for various potential risk factors.
aInstitute of Cancer Epidemiology, Danish Cancer Society, Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
bDepartment of Fetal Medicine and Ultrasound, Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
cDepartment of Gynecology and Obstetrics, Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
Reprints: Susanne Krüger Kjaer, MD, DMSc, Danish Cancer Society / Rigshospitalet, Strandboulevarden 49, DK-2100 Copenhagen, Denmark
Authorship and contribution to the manuscript is limited to the 5 authors indicated. There was no outside funding or technical assistance with the production of this article.
Cite this article as: Noehr B, Jensen A, Frederiksen K, et al. Loop electrosurgical excision of the cervix and subsequent risk for spontaneous preterm delivery: a population-based study of singleton deliveries during a 9-year period. Am J Obstet Gynecol 2009;201:33.e1-6.
ABSTRACT