Xavier-Júnior José Cândido C, Dufloth Rozany M, do Vale Diama B, Tavares Thalita A, Zeferino Luiz C
UNESP - Universidade Estadual Paulista, Pathology Department, Botucatu, SP, Brazil.
UNESP - Universidade Estadual Paulista, Pathology Department, Botucatu, SP, Brazil.
Eur J Obstet Gynecol Reprod Biol. 2014 Apr;175:103-6. doi: 10.1016/j.ejogrb.2014.01.018. Epub 2014 Jan 20.
To evaluate if the prevalence of cervical smear results varies between pregnant and non-pregnant women stratified by age group.
Observational analytical study with a total sample of 1,336,180 pregnant and non-pregnant women, aged between 20 and 34 years, who underwent cervical cancer screening in the Primary Health Care of the national health system in the area of Campinas in Brazil during the period of 2005-2009. The source is the information system for cervical cancer screening. Data collected on abnormal cervical smears were analyzed using the Chi-square test and Fisher's exact test and the magnitude of the association between pregnancy and high-grade squamous epithelial lesions was analyzed by odds ratio (OR) and estimated values with confidence intervals (CI) of 95%.
15,190 pregnant women and 395,961 non-pregnant women were analyzed and fulfilled the inclusion criteria. Regardless of age, no statistical differences were observed for high-grade squamous intraepithelial lesion prevalence (OR 0.90; CI 0.66-1.23). Taking into account the five-year age groups, however, low-grade squamous intraepithelial lesion was less prevalent in pregnant women aged 20-24 (OR 0.71; 0.54-0.95) and 25-29 years (OR 0.56; 0.35-0.89); also, atypical squamous cells of undetermined significance was more prevalent in non-pregnant women aged 25-29 years (OR 0.72; 0.54-0.97).
The study showed that the cytological prevalence of high-grade squamous intraepithelial lesion was similar in pregnant and non-pregnant women, regardless of age. The results indicate that there are no reasons for specific approaches to cervical cancer screening for pregnant women. The examination should be carried out only on pregnant women who have not been tested according to current recommendations.
评估按年龄组分层的孕妇和非孕妇宫颈涂片结果的患病率是否存在差异。
观察性分析研究，总样本为1336180名年龄在20至34岁之间的孕妇和非孕妇，她们于2005年至2009年期间在巴西坎皮纳斯地区国家卫生系统的初级卫生保健机构接受了宫颈癌筛查。数据来源是宫颈癌筛查信息系统。对收集到的异常宫颈涂片数据进行卡方检验和费舍尔精确检验，并通过比值比（OR）和95%置信区间（CI）的估计值分析妊娠与高级别鳞状上皮病变之间的关联强度。
分析了15190名孕妇和395961名非孕妇，她们均符合纳入标准。无论年龄如何，高级别鳞状上皮内病变患病率均无统计学差异（OR 0.90；CI 0.66 - 1.23）。然而，考虑到五年年龄组，20 - 24岁（OR 0.71；0.54 - 0.95）和25 - 29岁（OR 0.56；0.35 - 0.89）的孕妇中低级别鳞状上皮内病变的患病率较低；此外，意义不明确的非典型鳞状细胞在25 - 29岁的非孕妇中更为普遍（OR 0.72；0.54 - 0.97）。
该研究表明，无论年龄大小，孕妇和非孕妇高级别鳞状上皮内病变的细胞学患病率相似。结果表明，没有理由对孕妇采取特殊的宫颈癌筛查方法。仅应对未按照当前建议进行检测的孕妇进行检查。
