Cervical excisional treatment, HPV infection and risk of preterm delivery - a Swedish population-based study
Artikel i vetenskaplig tidskrift, 2020
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.
Chalmers, Matematiska vetenskaper, Tillämpad matematik och statistik
Geburtshilfe und Frauenheilkunde
0016-5751 (ISSN) 1438-8804 (eISSN)Vol. 80 10 e81
Reproduktionsmedicin och gynekologi