Loop electrosurgical excision of the cervix and subsequent risk for spontaneous preterm delivery: a population-based study of singleton deliveries during a 9-year period

Am J Obstet Gynecol. 2009 Jul;201(1):33.e1-6. doi: 10.1016/j.ajog.2009.02.004. Epub 2009 Apr 5.

Abstract

Objective: Our aim was to assess the association between loop electrosurgical excision procedure (LEEP) and the subsequent risk for spontaneous preterm delivery, with the use of population-based data from various nationwide registries.

Study design: The study population consisted of all singleton deliveries in Denmark during a 9-year period, 1997-2005. Information on the deliveries that included different cervical procedures was obtained from various national registries. In all, 552,678 deliveries were eligible for analyses.

Results: Of the deliveries in which the mother had no previous LEEP, 18,519 deliveries (3.5%) were preterm; when this data were applied to 530 preterm deliveries (6.9%) that were subsequent to LEEP, the yield was a significantly increased risk of preterm delivery, with an odds ratio of 2.07 (95% CI, 1.88-2.27; LEEP vs no LEEP).

Conclusion: Our study showed an overall 2-fold increase in the risk of spontaneous preterm delivery in singleton deliveries subsequent to LEEP treatment, even after adjustment for various potential risk factors.

MeSH terms

  • Adult
  • Cervix Uteri / surgery*
  • Electrosurgery*
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Obstetric Labor, Premature / epidemiology*
  • Obstetric Surgical Procedures / adverse effects*
  • Pregnancy
  • Registries
  • Risk Assessment
  • Risk Factors