Cervical excisional treatment, HPV infection and risk of preterm delivery - a Swedish population-based study
Artikel i vetenskaplig tidskrift, 2020

Objective Excisional treatment for cervical intraepithelial neoplasia (CIN) is associated with preterm delivery (PTD). It has been shown that even untreated CIN is associated with PTD. We aimed to explore the magnitude of the associations of CIN with PTD and adverse obstetrical outcome.

Methods Retrospective register-based study comprising all women with singleton deliveries in Sweden 1999-2016. Data were retrieved from the Medical Birth Registry and the Swedish National Cervical Screening Registry. Women with normal cytology all life (n = 340,290) were compared to a) women with sign of HPV-infection close to pregnancy (abnormal cytology (n = 11,936) or positive HPV-test (n = 2,587)), b) women treated for CIN before delivery (n = 25,123) and c) women with CIN/carcinoma diagnosed after delivery (n = 34,251) by logistic regression adjusted for socioeconomic and health-related confounders.

Results PTD was increased in all groups compared to women with normal cytology all life (4.7 %), with greatest risk for the treated group (9,0 %, OR 1.80 (1.71-1.89)), but also for women with HPV-infection close to pregnancy (5,9 %, OR 1.19 (1.10-1.29)) and CIN/carcinoma after delivery (6,1 %, OR 1.10 (1.04-1.16)). Paired analysis in 5,547 women with deliveries both before and after treatment showed increased risk of PTD after treatment (OR 1.27 (1.07-1.50)). The treated group had increased risk also for preterm prelabour rupture of the membranes (pPROM, OR 2.25 (2.08-2.44)) and chorioamnionitis (2.44 (2.05-2.90)). HPV-infection close to pregnancy was associated with pPROM (OR 1.22 (1.06-1.40)).

Conclusions Women with HPV infection close to pregnancy have a small increased risk for PTD and pPROM while excisional treatment increases risks further.


J. Wiik

Göteborgs universitet

Staffan Nilsson

Chalmers, Matematiska vetenskaper, Tillämpad matematik och statistik

Göteborgs universitet

C. Kaerrberg

Göteborgs universitet

B. Strander

Göteborgs universitet

B. Jacobsson

Göteborgs universitet

V Sengpiel

Göteborgs universitet

Geburtshilfe und Frauenheilkunde

0016-5751 (ISSN) 1438-8804 (eISSN)

Vol. 80 10 e81


Reproduktionsmedicin och gynekologi



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