Is the increased risk of preterm birth following excision for cervical intraepithelial neoplasia restricted to the first birth post treatment?

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Is the increased risk of preterm birth following excision for cervical intraepithelial neoplasia restricted to the first birth post treatment? / Castañon, A; Landy, R; Brocklehurst, Peter; Evans, H; Peebles, D; Singh, N; Walker, P; Patnick, J; Sasieni, P; PaCT Study Group.

In: BJOG: An International Journal of Obstetrics & Gynaecology, Vol. 122, No. 9, 08.2015, p. 1191-1199.

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Castañon, A ; Landy, R ; Brocklehurst, Peter ; Evans, H ; Peebles, D ; Singh, N ; Walker, P ; Patnick, J ; Sasieni, P ; PaCT Study Group. / Is the increased risk of preterm birth following excision for cervical intraepithelial neoplasia restricted to the first birth post treatment?. In: BJOG: An International Journal of Obstetrics & Gynaecology. 2015 ; Vol. 122, No. 9. pp. 1191-1199.

Bibtex

@article{eaa178ef5417435b9b0bed45bdb85b05,
title = "Is the increased risk of preterm birth following excision for cervical intraepithelial neoplasia restricted to the first birth post treatment?",
abstract = "OBJECTIVE: To explore whether the increased risk of preterm birth following treatment for cervical disease is limited to the first birth following colposcopy.DESIGN: Nested case-control study.SETTING: Twelve NHS hospitals in England.POPULATION: All nonmultiple births from women selected as cases or controls from a cohort of women with both colposcopy and a hospital birth. Cases had a preterm (20-36 weeks of gestation) birth. Controls had a term birth (38-42 weeks) and no preterm.METHODS: Obstetric, colposcopy and pathology details were obtained.MAIN OUTCOME MEASURES: Adjusted odds ratio of preterm birth in first and second or subsequent births following treatment for cervical disease.RESULTS: A total of 2798 births (1021 preterm) from 2001 women were included in the analysis. The risk of preterm birth increased with increasing depth of treatment among first births post treatment [trend per category increase in depth, categories <10 mm, 10-14 mm, 15-19 mm, ≥20 mm: odds ratio (OR) 1.23, 95% confidence interval (95% CI) 1.12-1.36, P < 0.001] and among second and subsequent births post treatment (trend OR 1.34, 95% CI 1.15-1.56, P < 0.001). No trend was observed among births before colposcopy (OR 0.98, 95% CI 0.83-1.16, P = 0.855). The absolute risk of a preterm birth following deep treatments (≥15 mm) was 6.5% among births before colposcopy, 18.9% among first births and 17.2% among second and subsequent births post treatment. Risk of preterm birth (once depth was accounted for) did not differ when comparing first births post colposcopy with second and subsequent births post colposcopy (adjusted OR 1.15, 95% CI 0.89-1.49).CONCLUSIONS: The increased risk of preterm birth following treatment for cervical disease is not restricted to the first birth post colposcopy; it remains for second and subsequent births. These results suggest that once a woman has a deep treatment she remains at higher risk of a preterm birth throughout her reproductive life.",
keywords = "Adult, Case-Control Studies, Cervical Intraepithelial Neoplasia, Colposcopy, England, Female, Humans, Infant, Newborn, Odds Ratio, Pregnancy, Premature Birth, Risk Factors, Uterine Cervical Neoplasms, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't",
author = "A Casta{\~n}on and R Landy and Peter Brocklehurst and H Evans and D Peebles and N Singh and P Walker and J Patnick and P Sasieni and {PaCT Study Group}",
note = "{\textcopyright} 2015 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.",
year = "2015",
month = aug,
doi = "10.1111/1471-0528.13398",
language = "English",
volume = "122",
pages = "1191--1199",
journal = "BJOG: An International Journal of Obstetrics & Gynaecology",
issn = "1470-0328",
publisher = "Wiley",
number = "9",

}

RIS

TY - JOUR

T1 - Is the increased risk of preterm birth following excision for cervical intraepithelial neoplasia restricted to the first birth post treatment?

AU - Castañon, A

AU - Landy, R

AU - Brocklehurst, Peter

AU - Evans, H

AU - Peebles, D

AU - Singh, N

AU - Walker, P

AU - Patnick, J

AU - Sasieni, P

AU - PaCT Study Group

N1 - © 2015 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

PY - 2015/8

Y1 - 2015/8

N2 - OBJECTIVE: To explore whether the increased risk of preterm birth following treatment for cervical disease is limited to the first birth following colposcopy.DESIGN: Nested case-control study.SETTING: Twelve NHS hospitals in England.POPULATION: All nonmultiple births from women selected as cases or controls from a cohort of women with both colposcopy and a hospital birth. Cases had a preterm (20-36 weeks of gestation) birth. Controls had a term birth (38-42 weeks) and no preterm.METHODS: Obstetric, colposcopy and pathology details were obtained.MAIN OUTCOME MEASURES: Adjusted odds ratio of preterm birth in first and second or subsequent births following treatment for cervical disease.RESULTS: A total of 2798 births (1021 preterm) from 2001 women were included in the analysis. The risk of preterm birth increased with increasing depth of treatment among first births post treatment [trend per category increase in depth, categories <10 mm, 10-14 mm, 15-19 mm, ≥20 mm: odds ratio (OR) 1.23, 95% confidence interval (95% CI) 1.12-1.36, P < 0.001] and among second and subsequent births post treatment (trend OR 1.34, 95% CI 1.15-1.56, P < 0.001). No trend was observed among births before colposcopy (OR 0.98, 95% CI 0.83-1.16, P = 0.855). The absolute risk of a preterm birth following deep treatments (≥15 mm) was 6.5% among births before colposcopy, 18.9% among first births and 17.2% among second and subsequent births post treatment. Risk of preterm birth (once depth was accounted for) did not differ when comparing first births post colposcopy with second and subsequent births post colposcopy (adjusted OR 1.15, 95% CI 0.89-1.49).CONCLUSIONS: The increased risk of preterm birth following treatment for cervical disease is not restricted to the first birth post colposcopy; it remains for second and subsequent births. These results suggest that once a woman has a deep treatment she remains at higher risk of a preterm birth throughout her reproductive life.

AB - OBJECTIVE: To explore whether the increased risk of preterm birth following treatment for cervical disease is limited to the first birth following colposcopy.DESIGN: Nested case-control study.SETTING: Twelve NHS hospitals in England.POPULATION: All nonmultiple births from women selected as cases or controls from a cohort of women with both colposcopy and a hospital birth. Cases had a preterm (20-36 weeks of gestation) birth. Controls had a term birth (38-42 weeks) and no preterm.METHODS: Obstetric, colposcopy and pathology details were obtained.MAIN OUTCOME MEASURES: Adjusted odds ratio of preterm birth in first and second or subsequent births following treatment for cervical disease.RESULTS: A total of 2798 births (1021 preterm) from 2001 women were included in the analysis. The risk of preterm birth increased with increasing depth of treatment among first births post treatment [trend per category increase in depth, categories <10 mm, 10-14 mm, 15-19 mm, ≥20 mm: odds ratio (OR) 1.23, 95% confidence interval (95% CI) 1.12-1.36, P < 0.001] and among second and subsequent births post treatment (trend OR 1.34, 95% CI 1.15-1.56, P < 0.001). No trend was observed among births before colposcopy (OR 0.98, 95% CI 0.83-1.16, P = 0.855). The absolute risk of a preterm birth following deep treatments (≥15 mm) was 6.5% among births before colposcopy, 18.9% among first births and 17.2% among second and subsequent births post treatment. Risk of preterm birth (once depth was accounted for) did not differ when comparing first births post colposcopy with second and subsequent births post colposcopy (adjusted OR 1.15, 95% CI 0.89-1.49).CONCLUSIONS: The increased risk of preterm birth following treatment for cervical disease is not restricted to the first birth post colposcopy; it remains for second and subsequent births. These results suggest that once a woman has a deep treatment she remains at higher risk of a preterm birth throughout her reproductive life.

KW - Adult

KW - Case-Control Studies

KW - Cervical Intraepithelial Neoplasia

KW - Colposcopy

KW - England

KW - Female

KW - Humans

KW - Infant, Newborn

KW - Odds Ratio

KW - Pregnancy

KW - Premature Birth

KW - Risk Factors

KW - Uterine Cervical Neoplasms

KW - Journal Article

KW - Multicenter Study

KW - Research Support, Non-U.S. Gov't

U2 - 10.1111/1471-0528.13398

DO - 10.1111/1471-0528.13398

M3 - Article

C2 - 25854594

VL - 122

SP - 1191

EP - 1199

JO - BJOG: An International Journal of Obstetrics & Gynaecology

JF - BJOG: An International Journal of Obstetrics & Gynaecology

SN - 1470-0328

IS - 9

ER -