Raio L, Ghezzi F, Di Naro E, Gomez R, Lüscher K P
Department of Obstetrics and Gynecology, Kantonsspital, Münsterlingen, Switzerland.
Obstet Gynecol. 1997 Dec;90(6):978-82. doi: 10.1016/s0029-7844(97)00489-4.
To determine if carbon dioxide laser conization of the cervix is a risk factor for preterm delivery in subsequent gestations and to evaluate whether there is any relationship between cone height and duration of pregnancy.
Patients of fertile age who had carbon dioxide laser conization were followed for reproductive events. Cases were matched one-to-one with controls for known risk factors for preterm delivery. Pregnancy duration, rate of preterm birth, and mode of delivery were studied. Parametric and nonparametric tests were used for statistical analysis. Logistic regression analysis and Cox proportional hazard modeling were used to investigate the relationship between cone height and subsequent preterm delivery.
Sixty-four women with singleton pregnancies after carbon dioxide laser conization and 64 controls were included in the study. Overall, no difference was found in the rate of preterm delivery and duration of pregnancy. However, women with cone height of at least 10 mm had a higher rate of preterm delivery than either those with cone height less than 10 mm (five of 23 versus one of 41, P = .01) or the controls (five of 23 versus three of 64, P < .05). Cone height of at least 10 mm remained significant in predicting the occurrence of preterm delivery and the duration of pregnancy after adjusting for known risk factors (odds ratio 11.1, P < .05).
Cone height of at least 10 mm is an independent risk factor for the duration of pregnancy and for the occurrence of preterm delivery in the subsequent gestation.
确定宫颈二氧化碳激光锥切术是否为后续妊娠早产的危险因素，并评估锥高与妊娠持续时间之间是否存在关联。
对接受二氧化碳激光锥切术的育龄患者进行生殖事件随访。病例与早产已知危险因素的对照组进行一对一匹配。研究妊娠持续时间、早产率和分娩方式。采用参数检验和非参数检验进行统计分析。使用逻辑回归分析和Cox比例风险模型研究锥高与后续早产之间的关系。
本研究纳入了64例二氧化碳激光锥切术后单胎妊娠的女性和64例对照。总体而言，早产率和妊娠持续时间未发现差异。然而，锥高至少10 mm的女性早产率高于锥高小于10 mm的女性（23例中有5例，41例中有1例，P = 0.01）或对照组（23例中有5例，64例中有3例，P < 0.05）。在调整已知危险因素后，锥高至少10 mm在预测早产发生和妊娠持续时间方面仍具有显著意义（优势比11.1，P < 0.05）。
锥高至少10 mm是后续妊娠持续时间和早产发生的独立危险因素。
