Cervical surgery for cervical intraepithelial neoplasia and prolonged time to conception of a live birth: a case–control study. Issue 8 (14th March 2013)

• Record Type: Journal Article
• Authors: Spracklen, CN; Harland, KK; Stegmann, BJ; Saftlas, AF
• Is Part Of: BJOG. Volume 120:Issue 8(2013:Aug.)
• Page Start: 960
• Page End: 965
• Publication Date: 2013-03-14
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.12209
• Languages: English
• ISSNs: 1470-0328

Abstract

<abstract abstract-type="main" id="bjo12209-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjo12209-sec-0001" sec-type="section"> <title>Objective</title> <p>To determine whether women with a history of surgery for cervical intraepithelial neoplasia (CIN) are at an increased risk of subfertility, measured as a time to pregnancy of more than 12 months.</p> </sec> <sec id="bjo12209-sec-0002" sec-type="section"> <title>Design</title> <p>Case–control study.</p> </sec> <sec id="bjo12209-sec-0003" sec-type="section"> <title>Setting</title> <p>Iowa Health in Pregnancy Study (IHIPS), a population‐based case–control study of preterm and small‐for‐gestational‐age (SGA) live birth outcomes (from May 2002 through June 2005) in the USA.</p> </sec> <sec id="bjo12209-sec-0004" sec-type="section"> <title>Sample</title> <p>Women with an intended pregnancy and a history of either one prior cervical surgery (<italic>n</italic> = 152), colposcopy only (<italic>n</italic> = 151), or no prior cervical surgery or colposcopy (<italic>n</italic> = 1021).</p> </sec> <sec id="bjo12209-sec-0005" sec-type="section"> <title>Methods</title> <p>Cervical treatment history, pregnancy intention, time to pregnancy, and other variables were self‐reported by computer‐assisted telephone interviews. Odds ratios were calculated using logistic regression to estimate the risk of prolonged time to pregnancy among women with a history of cervical surgery or colposcopy alone, compared with untreated women (control group).</p> </sec> <sec id="bjo12209-sec-0006" sec-type="section"> <title>Main outcome measure</title> <p>Prolonged time to pregnancy (i.e. >1 year).</p> </sec> <sec id="bjo12209-sec-0007" sec-type="section"> <title>Results</title> <p>Prolonged time to pregnancy was most prevalent among treated women (16.4%), compared with untreated women (8.4%) and women with colposcopy only (8.6%) (<italic>P </italic>= 0.039). After adjusting for covariates, women with prior cervical surgery had a more than two‐fold higher risk of prolonged time to pregnancy compared with untreated women (aOR 2.09, 95% CI 1.26–3.46). In contrast, women with a history of colposcopy only had a risk equivalent to that found among untreated women (aOR 1.02, 95% CI 0.56–1.89).</p> </sec> <sec id="bjo12209-sec-0008" sec-type="section"> <title>Conclusions</title> <p>Women with a history of cervical treatment for CIN are at increased risk of subfertility, measured as a time to pregnancy of more than 12 months.</p> </sec> </abstract>