| Abstrakt: |
Objective To determine whether women with a history of surgery for cervical intraepithelial neoplasia ( CIN) are at an increased risk of subfertility, measured as a time to pregnancy of more than 12 months. Design Case-control study. Setting Iowa Health in Pregnancy Study ( IHIPS), a population-based case-control study of preterm and small-for-gestational-age ( SGA) live birth outcomes (from May 2002 through June 2005) in the USA. Sample Women with an intended pregnancy and a history of either one prior cervical surgery ( n = 152), colposcopy only ( n = 151), or no prior cervical surgery or colposcopy ( n = 1021). Methods Cervical treatment history, pregnancy intention, time to pregnancy, and other variables were self-reported by computer-assisted telephone interviews. Odds ratios were calculated using logistic regression to estimate the risk of prolonged time to pregnancy among women with a history of cervical surgery or colposcopy alone, compared with untreated women (control group). Main outcome measure Prolonged time to pregnancy (i.e. >1 year). Results Prolonged time to pregnancy was most prevalent among treated women (16.4%), compared with untreated women (8.4%) and women with colposcopy only (8.6%) ( P = 0.039). After adjusting for covariates, women with prior cervical surgery had a more than two-fold higher risk of prolonged time to pregnancy compared with untreated women ( aOR 2.09, 95% CI 1.26-3.46). In contrast, women with a history of colposcopy only had a risk equivalent to that found among untreated women ( aOR 1.02, 95% CI 0.56-1.89). Conclusions Women with a history of cervical treatment for CIN are at increased risk of subfertility, measured as a time to pregnancy of more than 12 months. [ABSTRACT FROM AUTHOR] |
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