Sjøborg Katrine Donvold, Vistad Ingvild, Myhr Siv S, Svenningsen Rune, Herzog Christine, Kloster-Jensen Arild, Nygård Gunhild, Hole Sølvi, Tanbo Tom
Department of Obstetrics and Gynecology, Oestfold Hospital Trust, Fredrikstad, Norway.
Acta Obstet Gynecol Scand. 2007;86(4):423-8. doi: 10.1080/11038120701208158.
To investigate the effect of cervical laser conisation (CLC) or loop electrosurgical excision procedure (LEEP) on the outcome of subsequent pregnancies. Methods. Multi-centre, retrospective, case-control study, which included a cohort of 742 women, who, after treatment with LEEP or CLC, gave birth or suffered second trimester miscarriage. Control women (n=742) were extracted from the respective hospital birth registries and matched by age and parity. Outcome measures were perinatal mortality, length of gestation, birth weight and preterm premature rupture of membranes (pPROM).
There was no significant difference in perinatal mortality among women treated with LCL or LEEP compared to controls, 6/742 versus 2/742: odds ratio (OR)=3.1 (95% CI: 0.6-15.2). Excluding second trimester miscarriages, ORs for giving birth before week 37, 32 and 28 after conisation compared to the controls were 3.4 (95% CI: 2.3-5.1), 4.6 (95% CI: 1.7-12.5), and 12.4 (95% CI: 1.6-96.1), respectively, after adjusting for smoking habits during pregnancy, marital status and educational level. Adjusted ORs of birth weight <2,500, <1,500 and <1,000 g after conisation compared to controls were 3.9 (95% CI: 2.4-6.3), 4.4 (95% CI: 1.5-13.6), and 10.4 (95% CI: 1.3-82.2), respectively. The adjusted OR for pPROM was 10.5 (95% CI: 3.7-29.5).
Treatment by CLC and LEEP increases the risk of preterm delivery, low birth weight and pPROM in subsequent pregnancies.
探讨宫颈激光锥切术（CLC）或环形电切术（LEEP）对后续妊娠结局的影响。方法：多中心、回顾性、病例对照研究，纳入742名在接受LEEP或CLC治疗后分娩或发生孕中期流产的女性。对照女性（n = 742）从各自医院的出生登记册中抽取，并按年龄和产次进行匹配。观察指标为围产期死亡率、妊娠时长、出生体重和胎膜早破（pPROM）。
与对照组相比，接受LCL或LEEP治疗的女性围产期死亡率无显著差异，分别为6/742和2/742：比值比（OR）= 3.1（95%可信区间：0.6 - 15.2）。排除孕中期流产后，锥切术后在37周、32周和28周前分娩的OR值与对照组相比，在调整孕期吸烟习惯、婚姻状况和教育水平后，分别为3.4（95%可信区间：2.3 - 5.1）、4.6（95%可信区间：1.7 - 12.5）和12.4（95%可信区间：1.6 - 96.1）。锥切术后出生体重<2500g、<1500g和<1000g的调整后OR值与对照组相比，分别为3.9（95%可信区间：2.4 - 6.
