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Systematic review and meta-analysis
Review: excisional, and perhaps ablative treatments for precancerous cervical changes increase the risk for preterm birth
  1. Joan Crane
  1. Department of Obstetrics and Gynecology, Memorial University, Eastern Health, St.John's, Canada
  1. Correspondence to Joan Crane
    Department of Obstetrics and Gynecology, Memorial University, Eastern Health, 300 Prince Phillip Drive, St. John's, Newfoundland A1B 3V6, Canada; joan.crane{at}easternhealth.ca

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Context

Cervical intraepithelial neoplasia (CIN) is a common complication in women of reproductive age. Treatment options include excisional treatments, such as cold knife conisation, loop electrosurgical excision procedure, large loop excision of the transformation zone (LLETZ) and laser conisation; and ablative treatments, including cryotherapy, laser ablation, cold coagulation and diathermy. These treatments may have an impact on subsequent pregnancy outcomes. The meta-analysis by Bruinsma and Quinn evaluates the effect of the type of comparison group on the association between treatment for CIN and subsequent preterm birth <37 weeks gestation.

Methods

The authors performed a meta-analysis of cohort studies published between 1950 and 2009, evaluating subsequent pregnancy outcome of women who had singleton gestations and who had undergone treatment for CIN. They included both ablative and excisional treatments, but …

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