Loop electrosurgical excision of the cervix and subsequent risk for spontaneous preterm delivery: a population-based study of singleton deliveries during a 9-year period.

Abstract

Our aim was to assess the association between loop electrosurgical excision procedure (LEEP) and the subsequent risk for spontaneous preterm delivery, with the use of population-based data from various nationwide registries. The study population consisted of all singleton deliveries in Denmark during a 9-year period, 1997-2005. Information on the deliveries that included different cervical procedures was obtained from various national registries. In all, 552,678 deliveries were eligible for analyses. Of the deliveries in which the mother had no previous LEEP, 18,519 deliveries (3.5%) were preterm; when this data were applied to 530 preterm deliveries (6.9%) that were subsequent to LEEP, the yield was a significantly increased risk of preterm delivery, with an odds ratio of 2.07 (95% CI, 1.88-2.27; LEEP vs no LEEP). Our study showed an overall 2-fold increase in the risk of spontaneous preterm delivery in singleton deliveries subsequent to LEEP treatment, even after adjustment for various potential risk factors.