Perinatal mortality and other severe adverse pregnancy outcomes associated with treatment of cervical intraepithelial neoplasia: meta-analysis
2008

Risks of Pregnancy Complications After Cervical Cancer Treatment

Sample size: 15 publication 10 minutes Evidence: moderate

Author Information

Author(s): Arbyn M, Kyrgiou M, Simoens C, Raifu A O, Koliopoulos G, Martin-Hirsch P, Prendiville W, Paraskevaidis E

Primary Institution: Scientific Institute of Public Health, Brussels, Belgium

Hypothesis

What is the relative risk of perinatal mortality and other severe pregnancy outcomes associated with treatment for cervical intraepithelial neoplasia?

Conclusion

Cold knife conisation and possibly laser conisation and radical diathermy are linked to higher risks of perinatal mortality and severe pregnancy outcomes, while large loop excision does not significantly increase these risks.

Supporting Evidence

  • Cold knife conisation was associated with a relative risk of 2.87 for perinatal mortality.
  • Severe preterm delivery risk was 2.78 times higher after cold knife conisation.
  • Laser conisation showed increased risk for low birth weight.
  • Large loop excision did not significantly increase risks of severe pregnancy outcomes.
  • Diathermy was linked to higher rates of perinatal mortality and low birth weight.

Takeaway

Women who have had certain treatments for cervical cancer may have a higher chance of problems during pregnancy, like losing the baby or having a very early delivery.

Methodology

Meta-analysis of studies comparing pregnancy outcomes in women treated for cervical intraepithelial neoplasia versus untreated women.

Potential Biases

Selection bias may exist due to non-randomized control groups.

Limitations

The studies included were mostly retrospective, which may introduce bias.

Participant Demographics

Women treated for cervical intraepithelial neoplasia, primarily aged around 30.

Statistical Information

P-Value

p<0.05

Confidence Interval

95% CI 1.42 to 5.81

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1136/bmj.a1284

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