The relationship between previous treatment for cervical dysplasia and preterm delivery in twin gestations

Robert M. Ehsanipoor, Jennifer A. Jolley, Mathew A. Goldshore, Linda M. Szymanski, Michael L. Haydon, Cecilia Lyons Gaffaney, David C. Lagrew

Research output: Contribution to journalArticle

Abstract

Objective: To describe the impact of previous cervical surgery on preterm birth prior to 34 weeks in twins. Methods: A retrospective review of twin pregnancies delivered between January 1998 and December 2005 at two institutions was performed. Women with a prior cold knife cone (CKC), loop electrosurgical excision procedure (LEEP), or ablative procedure were compared to a control group of women who had not undergone a previous treatment for cervical dysplasia. The primary outcome was delivery before 34 weeks of gestation. Results: A total of 876 women met inclusion criteria. Of these, 110 (12.6%) had previous surgical procedures for cervical dysplasia, including CKC (n=10), LEEP (n=36), cryotherapy (n=59) and CO2 laser treatment (n=5). Delivery prior to 34 weeks was more common in women with a previous CKC compared to women with no prior treatment (4% versus 11.3%; odds ratio [OR], 3.6; 95% confidence interval [CI], 1.7-8.0). Delivery prior to 34 weeks was not more common in women with a previous LEEP (8.3%; OR, 0.8; 95% CI, 0.3-2.3) or ablative procedure (9.4%; OR, 0.9; 95% CI, 0.4-1.9) in comparison to the untreated group. Adjusting for the potential confounders of age, tobacco use, infertility treatments and previous preterm birth did not change the results. Conclusions: Previous CKC is associated with delivery prior to 34 weeks while LEEP and ablative procedures are not. CKC should be carefully considered and avoided when possible in reproductive age women.

Original languageEnglish (US)
Pages (from-to)821-824
Number of pages4
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume27
Issue number8
DOIs
StatePublished - May 2014

Keywords

  • Cervical ablation
  • Cervical intraepithelial neoplasia
  • Cold knife cone
  • LEEP
  • Multiple gestation
  • Preterm birth

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Fingerprint Dive into the research topics of 'The relationship between previous treatment for cervical dysplasia and preterm delivery in twin gestations'. Together they form a unique fingerprint.

  • Cite this

    Ehsanipoor, R. M., Jolley, J. A., Goldshore, M. A., Szymanski, L. M., Haydon, M. L., Gaffaney, C. L., & Lagrew, D. C. (2014). The relationship between previous treatment for cervical dysplasia and preterm delivery in twin gestations. Journal of Maternal-Fetal and Neonatal Medicine, 27(8), 821-824. https://doi.org/10.3109/14767058.2013.836178