Effect of cervical carcinoma in situ and its management on pregnancy outcome

Objective: To assess the effect of cervical carcinoma in situ (CIS) and its management on subsequent pregnancy outcome. Methods: We used a population-based retrospective cohort design that includ ed record linkage between cancer data and birth records. The Cancer Surveil lance System records of women with CIS (n = 1851, 312 diagnosed during preg nancy) diagnosed between 1984 and 1992, were linked to birth certificates o f their first subsequent deliveries after CIS diagnosis. The comparison gro up (n = 9201) was a random sample of women without CIS who gave birth durin g the same years. The outcome measures were preterm and low birth weight in fants subsequent to CIS diagnosis and treatment. Treatments included no the rapy, dilation and curettage or endocervical curettage, cryosurgery or lase r vaporization, and conization. Results: Women with CIS who were not treated with conization had a small in creased risk of preterm delivery (odds ratio [OR] 1.4, 95% confidence inter val [CI] 1.0, 2.0) and no increased risk of low birth weight infant (OR 1.0 , 95% CI 0.7, 1.6), compared with women without CIS, after adjusting for ma ternal smoking, race, parity, marital status, and history of induced pregna ncy termination. Women with CIS who had conization were more likely to deli ver premature infants (OR 1.6, 95% CI 1.2, 2.0) than women without CIS, aft er adjusting for the same confounding factors. The apparently increased ris k of low birth weight (OR 1.8, 95% CI 1.4, 2.4) seemed to be a reflection o f premature delivery. Conclusion: The risk of prematurity increased after conization for CIS and did not increase when women with CIS had other procedures. (Obstet Gynecol 1999;93:207-12. (C) 1999 by The American College of Obstetricians and Gynec ologists.).