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Pregnancy outcome after loop electrosurgical excision procedure: a systematic review
1Department of Obstetrics and Gynecology, Memorial University of Newfoundland, Health Care Corporation of St. John's, St. John's, Newfoundland, Canada. hcc.cranj@hccsj.nf.ca
Obstetrics and Gynecology
|December 16, 2003
Summary
Loop electrosurgical excision procedure (LEEP) is linked to a higher risk of preterm birth in subsequent pregnancies. Further research is needed to understand this association and other pregnancy outcomes.
Area of Science:
- Reproductive Health
- Gynecologic Oncology
- Perinatal Medicine
Background:
- Cervical cancer screening frequently involves loop electrosurgical excision procedure (LEEP).
- The impact of LEEP on subsequent pregnancy outcomes requires further investigation.
Purpose of the Study:
- To evaluate the association between loop electrosurgical excision procedure (LEEP) and pregnancy outcomes.
- To determine if LEEP influences rates of preterm birth, low birth weight, and other adverse pregnancy events.
Main Methods:
- A systematic review and meta-analysis of studies comparing women with and without a history of LEEP.
- Searches of MEDLINE and PubMed were conducted using relevant keywords.
- Five studies met the inclusion criteria, comparing pregnancy outcomes between women who underwent LEEP and controls.
Main Results:
- Women with a history of LEEP had a significantly higher likelihood of preterm birth (OR 1.81) and low birth weight infants (OR 1.60).
- Subgroup analysis controlling for smoking status confirmed an increased risk of preterm birth (OR 2.53) in women who had undergone LEEP.
- No significant differences were observed in cesarean delivery, labor induction, or NICU admission rates.
Conclusions:
- Loop electrosurgical excision procedure (LEEP) is associated with an increased risk of subsequent preterm birth.
- Further large-scale studies are necessary to elucidate the relationship between LEEP and preterm birth, considering confounders like excision depth.