Risk of preterm birth following treatment for cervical dysplasia

January 01, 0001

Risk of preterm birth following treatment for cervical dysplasia

These Australian authors investigated whether treatment for precancerous changes in the cervix is associated with preterm birth at less than 37 weeks gestation and examined the impact of the type of comparison group on estimates of risk. Eligible studies were those that reported preterm birth outcomes for excisional and ablative treatments separately and included a comparison group.

They found: "Thirty eligible studies were located. Excisional treatment was associated with an increased odds of preterm birth, when compared with an external (RR 2.19) or internal (RR 1.96) comparison group. In comparison with women who were assessed but not treated, the risk estimate was smaller (RR 1.25). Ablative treatment was associated with an increased risk of preterm birth when an external comparison group (RR 1.47) but not an internal comparison group (RR 1.24) or untreated comparison group (RR 1.03) was used."

The authors concluded: "Excisional treatment was associated with a significantly increased risk of preterm birth. It provides new evidence that some types of ablative treatment may also be associated with a small increased risk. The type of comparison group used is an important consideration when comparing the outcomes of studies."

Excisional treatment of the uterine cervix in young women should be avoided if possible unless they have completed their families.

For the full abstract, click here.

BJOG 118(9):1031-1041, August 2011 © 2011 to the Royal College of Obstetricians and Gynaecologists
The risk of preterm birth following treatment for precancerous changes in the cervix: a systematic review and meta-analysis. F. Bruinsma, and M. Quinn. Correspondence to Dr. Bruinsma: [email protected]

Category: X. Female Genital System, Breast, W. Pregnancy, Family Planning. Keywords: precancerous changes, cervix, preterm birth, meta-analysis of comparative studies, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 2 August 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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