TY - JOUR
T1 - Loop electrosurgical excision of the cervix and risk for spontaneous preterm delivery in twin pregnancies
AU - Noehr, Bugge
AU - Jensen, Allan
AU - Frederiksen, Kirsten
AU - Tabor, Ann
AU - Kjaer, Susanne K
N1 - Keywords: Ablation Techniques; Adolescent; Adult; Cervical Intraepithelial Neoplasia; Cohort Studies; Conization; Electrosurgery; Female; Humans; Pregnancy; Pregnancy Complications, Neoplastic; Pregnancy, Multiple; Premature Birth; Retrospective Studies; Risk Factors; Twins; Uterine Cervical Neoplasms; Young Adult
PY - 2009
Y1 - 2009
N2 - OBJECTIVE: To investigate the association between three cervical procedures (biopsy with no treatment, ablation, and loop electrosurgical excision procedure [LEEP]) and subsequent spontaneous preterm delivery in twin pregnancies using population-based data from various nationwide registries. METHODS:: The study population consisted of all twin deliveries in Denmark during a 9-year period, 1997-2005. Information on the deliveries, including cervical procedures, was obtained from various national registries. In all, 9,868 deliveries were eligible for analyses, of which 3,228 were delivered spontaneously preterm (32.7%). Preterm delivery was defined as gestational age between 21 weeks and 37 weeks. Logistic regression analyses were used to evaluate the association between cervical procedures and preterm delivery. RESULTS: Twin pregnancies subsequent to LEEP had a significantly increased risk of overall subsequent spontaneous preterm delivery (43.4%) with an adjusted odds ratio of 1.58 (95% confidence interval 1.16-2.14) compared with pregnancies with no prior LEEP (32.5%). The association was consistent in various secondary analyses and especially strong for the very preterm and extremely preterm groups. We found no increase in risk of preterm delivery subsequent to biopsy without treatment or ablation. CONCLUSION: Our study showed an overall significant increase in risk of preterm delivery in twin pregnancies subsequent to LEEP treatment, even after adjustment for several potential risk factors. LEVEL OF EVIDENCE: II.
AB - OBJECTIVE: To investigate the association between three cervical procedures (biopsy with no treatment, ablation, and loop electrosurgical excision procedure [LEEP]) and subsequent spontaneous preterm delivery in twin pregnancies using population-based data from various nationwide registries. METHODS:: The study population consisted of all twin deliveries in Denmark during a 9-year period, 1997-2005. Information on the deliveries, including cervical procedures, was obtained from various national registries. In all, 9,868 deliveries were eligible for analyses, of which 3,228 were delivered spontaneously preterm (32.7%). Preterm delivery was defined as gestational age between 21 weeks and 37 weeks. Logistic regression analyses were used to evaluate the association between cervical procedures and preterm delivery. RESULTS: Twin pregnancies subsequent to LEEP had a significantly increased risk of overall subsequent spontaneous preterm delivery (43.4%) with an adjusted odds ratio of 1.58 (95% confidence interval 1.16-2.14) compared with pregnancies with no prior LEEP (32.5%). The association was consistent in various secondary analyses and especially strong for the very preterm and extremely preterm groups. We found no increase in risk of preterm delivery subsequent to biopsy without treatment or ablation. CONCLUSION: Our study showed an overall significant increase in risk of preterm delivery in twin pregnancies subsequent to LEEP treatment, even after adjustment for several potential risk factors. LEVEL OF EVIDENCE: II.
U2 - 10.1097/AOG.0b013e3181b1377b
DO - 10.1097/AOG.0b013e3181b1377b
M3 - Journal article
C2 - 19701028
SN - 0029-7844
VL - 114
SP - 511
EP - 515
JO - Obstetrics and Gynecology
JF - Obstetrics and Gynecology
IS - 3
ER -