Loop electrosurgical excision procedure and perinatal outcomes post-human papillomavirus cervical screening: A longitudinal cohort study.

OBJECTIVE

This study examines the associations between the loop electrosurgical excision procedure (LEEP) and the risk of adverse perinatal outcomes among women who have undergone primary human papillomavirus (HPV) screening.

METHODS

In this longitudinal cohort study, women who received HPV screening and were followed up in a randomized trial in British Columbia (BC), Canada, were linked to a province-wide perinatal registry; those with a singleton live birth after screening (index birth) were included (N = 1765). Adjusted odds ratios (aORs) were calculated to compare the risk of preterm birth (PTB, gestational week <37) and low birthweight (LBW, birthweight <2500 g) by LEEP status prior to index birth. Crude rates of LEEP, PTB, and LBW in the HPV-screened cohort (HPV group) and the provincial cytology-screened population (cytology group) were reported.

RESULTS

Risks of PTB and LBW were not significantly higher in LEEP-treated women (PTB: aOR 1.32, 95% confidence interval [CI], 0.63-2.80); LBW: (aOR 1.33, 95% CI, 0.50-3.55). In the HPV and cytology groups, 1.5% and 0.6% were referred for LEEP, respectively. Rates of PTB were 9.1% and 10.5% and LBW were 4.8% and 6.1% in the HPV and cytology groups, respectively.

CONCLUSION

Among HPV-screened women, the risks of PTB and LBW were not statistically significantly associated with LEEP. HPV-based screening might lead to more treatments than cytology-based screening, yet the overall risks of PTB and LBW remained similar across groups.