Pregnancy incidence and outcome before and after cervical intraepithelial neoplasia: a retrospective cohort study
Author(s)
Kalliala, I
Anttila, A
Nieminen, P
Halttunen, M
Dyba, T
Type
Journal Article
Abstract
We performed a retrospective cohort study of 3530 women treated for cervical intraepithelial neoplasia (CIN) in Helsinki University Central Hospital, Finland, to investigate whether CIN treatment itself affects pregnancy incidence and outcome. We estimated the incidence of live births, miscarriages, extrauterine pregnancies, molar pregnancies, and termination of pregnancies (TOPs) before and after CIN treatment using nationwide registers. Women were followed up until death, emigration, sterilization, or the end of 2004. The comparison of incidence of pregnancy outcomes before and after the treatment was estimated by calculating hazard ratios (HRs) with conditional Poisson regression. After 76,162 woman-years of follow-up, the incidence of any pregnancy remained constant over CIN-treatment, HR 1.02 and 95% confidence interval (CI) 0.97-1.08, but the incidence of the first pregnancy was significantly elevated after treatment, HR 1.13, and 95% CI 1.03-1.23. The incidence of live births was significantly elevated after treatment, HR 1.08 and 95% CI 1.01-1.15. Incidence of miscarriages, TOPs, extrauterine pregnancies, and molar pregnancies was not elevated. TOPs was significantly increased in the first pregnancy, HR 1.40, 95% CI 1.15-1.72 and after treatment by the loop electrosurgical excision procedure (LEEP), HR 1.36, 95% CI 1.15-1.60. CIN treatment did not reduce pregnancy incidence and women had more live births after than before CIN treatment. TOPs was more common in the first pregnancy or after treatment by LEEP. We encourage research on the psychosocial consequences of CIN treatment also in other countries and settings.
Date Issued
2014-08-21
Date Acceptance
2014-06-23
Citation
Cancer Medicine, 2014, 3 (6), pp.1512-1516
ISSN
2045-7634
Publisher
Wiley
Start Page
1512
End Page
1516
Journal / Book Title
Cancer Medicine
Volume
3
Issue
6
Copyright Statement
© 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Subjects
CIN
Cervical intraepithelial neoplasia
conization
fecundity
pregnancy outcome
Adult
Cervical Intraepithelial Neoplasia
Cohort Studies
Female
Finland
Humans
Incidence
Pregnancy
Pregnancy Outcome
Registries
Retrospective Studies
Treatment Outcome
Uterine Cervical Neoplasms
Young Adult
Publication Status
Published