TORONTO — Women who undergo cervical conization for the treatment of cervical intraepithelial neoplasia may benefit from delaying conception for about 1 year to reduce their risk of preterm birth. And African American women may need to delay conception even longer, although the ideal time interval is not clear, Dr. Katherine P. Himes said at the annual meeting of the Society for Gynecologic Investigation.
“Cones are common, and most women do fine—which is why when you look overall you tend not to find obstetrical risks associated with the procedure,” she said in an interview. “This study may identify a population where significant risk exists, so this may hopefully help us in terms of our counseling and surveillance.”
In the retrospective study she presented, Dr. Himes, of the department of obstetrics and gynecology, Magee-Womens Hospital, Pittsburgh, identified 1,080 women who had become pregnant after undergoing a colposcopic biopsy, a loop electrosurgical excision procedure, or a cold knife cone biopsy. Overall, cervical conization was not associated with an increased rate of preterm birth, which occurred in 12.7% of the cohort.
However, when the time from conization to conception was analyzed, women who experienced preterm birth had a significantly shorter interval (mean 3.5 months), compared with women who did not have preterm birth (mean 11 months). This difference remained statistically significant even after controlling for the confounders of race, tobacco use, prior preterm birth, and cone dimensions, she said.
Kate Johnson