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Loop electrosurgical excision procedure and risk of preterm birth
Claudia L Werner1, Julie Y Lo, Thomas Heffernan
1From the University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, Dallas, Texas.
Obstetrics and Gynecology
|February 24, 2010
Summary
Loop electrosurgical excision procedure (LEEP) does not increase preterm birth risk. This study found no association between LEEP and adverse birth outcomes, regardless of procedure timing relative to pregnancy.
Area of Science:
- Obstetrics and Gynecology
- Reproductive Health
- Perinatal Medicine
Background:
- Loop electrosurgical excision procedure (LEEP) is a common gynecological intervention.
- Concerns exist regarding potential adverse pregnancy outcomes, such as preterm birth, following LEEP.
- It remains unclear whether LEEP itself or patient-specific factors contribute to any observed risks.
Purpose of the Study:
- To investigate the association between LEEP and preterm birth.
- To determine if LEEP increases the risk of delivering before 37 weeks of gestation.
- To differentiate between procedural effects and intrinsic patient factors related to LEEP and preterm birth.
Main Methods:
- Retrospective analysis of singleton births at Parkland Hospital (January 1992 - May 2008).
- Comparison of preterm birth rates (before 37 weeks) in women who underwent LEEP before or after an index pregnancy versus the general obstetric population.
- Analysis of causes and timing of preterm birth, including delivery before 34 weeks and between 34-36 weeks.
Main Results:
- A total of 241,701 deliveries were analyzed.
- 511 women had undergone LEEP prior to pregnancy, and 842 underwent LEEP after pregnancy.
- No statistically significant increased risk of preterm birth was observed for women who had undergone LEEP compared to the general obstetric population, irrespective of the reason for preterm birth or gestational age at delivery.
Conclusions:
- The study found no association between undergoing a loop electrosurgical excision procedure (LEEP) and an increased risk of preterm birth.
- This finding applies to women who had LEEP performed either before or after an index pregnancy.
- The results suggest that LEEP is not an independent risk factor for preterm birth.
