Association between loop electrosurgical excision procedure and adverse pregnancy outcomes: a meta-analysis. (31st December 2023)

• Record Type: Journal Article
• Authors: Liu, Ruian; Liu, Chunyan; Ding, Xing
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 36:Number 1(2023)
• Publication Date: 2023-12-31
• Subjects: Loop electrosurgical excision procedure -- adverse pregnancy outcomes -- meta-analysis; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2023.2183769
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective: To assess the association between loop electrosurgical excision procedure (LEEP) and adverse pregnancy outcomes. Methods: The databases including PubMed, Embase, Cochrane Library and Web of science were searched from inception to December 27th, 2020. Odds ratio (OR) and 95% confidence interval (CI) were utilized to calculate the association between LEEP and adverse pregnancy outcomes. Heterogeneity test was performed for each outcome effect amount. If I 2 ≥ 50%, the random-effects model was conducted, otherwise, fixed-effects model was performed. Sensitivity analysis was performed on all outcomes. Publication bias was performed by Begg's test. Results: A total of 30 studies containing 2, 475, 421 patients were included in this study. The results showed that patients who received the LEEP before pregnancy had a higher risk of preterm delivery (OR: 2.100, 95%CI: 1.762–2.503, p < .001), premature rupture of fetal membranes (OR: 1.989, 95%CI: 1.630–2.428, p < .001) and low birth weight infants (OR: 1.939, 95%CI: 1.617–2.324, p < .001) in comparison with controls. Subgroup analysis further found that prenatal LEEP treatment was associated with the risk of preterm birth subsequently. Conclusion: LEEP treatment before pregnancy may increase the risk of preterm delivery, premature rupture of fetal membranes and low birth weight infants. It is necessary to do a regular prenatal examination and early intervention in a timely manner to reduce the risk of adverse pregnancy outcomes after LEEP.