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Pregnancy Outcomes After Treatment for Cervical Intraepithelial Neoplasia in a Single NHS Hospital
  1. Rekha Wuntakal, MD, MRCOG*,,
  2. Alejandra Castanon, MD, MSc,
  3. Peter D. Sasieni, BA, MA, PhD and
  4. Antony Hollingworth, MBCHB, PhD, MBA, FRCS (ED), FRCOG*
  1. *Whipps Cross University Hospital;
  2. Barking Havering and Redbridge University Hospital NHS Trust; and
  3. Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, London, United Kingdom.
  1. Address correspondence and reprint requests to Alejandra Castanon, MSc, Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Charterhouse Square, London, United Kingdom EC1M 6BQ. E-mail: a.castanon@qmul.ac.uk.

Abstract

Objective The objective of this study was to assess the adverse pregnancy outcomes in women who had treatment for cervical intraepithelial neoplasia.

Methods This was a retrospective cohort using data linkage. Pathology databases from Whipps Cross University Hospital were used to identify women with a histological sample taken at colposcopy between 1995 and 2009. Births for these women were identified through the hospitals’ obstetric database. A total of 876 births (from 721 women) were identified. Logistic regression was used to assess the relationship between adverse pregnancy outcomes and treatment for cervical intraepithelial neoplasia before delivery. Results were adjusted by ethnicity, deprivation, and parity.

Results After taking into account parity, socioeconomic status, and ethnicity, receiving any type of excisional treatment (single or multiple) before birth increased the risk of preterm labor compared with having a punch biopsy only (adjusted relative risk, 1.61; 95% confidence interval, 1.11–2.32). Preterm deliveries that occurred after a spontaneous onset of labor were found to be more likely after treatment for cervical disease (adjusted relative risk, 1.68; 95% confidence interval, 1.11–2.52).

Conclusions Women receiving any type of excisional treatment before delivery are at increased risk of preterm delivery when compared with women attending colposcopy but not treated. Although we took into account the effects of parity, socioeconomic status, and ethnicity, residual confounding factors may be unidentified.

  • Cervical intraepithelial neoplasia
  • Cone biopsy
  • Laser cone biopsy
  • LLETZ
  • Preterm delivery

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Footnotes

  • This was service evaluation and therefore did not need ethical approval. However, the authors had R&D approval. All the data were anonymized and then analyzed.

  • R.W. received funding as an Educational/Research fellow from SIFT fund (Queen Mary University, London) and the Whipps Cross University Hospital NHS Trust. A.C and P.D.S. are funded by Cancer Research UK (C8162/10406 and C8162/12537).

  • The authors declare no conflicts of interest.

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