What Contributes to Pregnancy Complications Among Women With Cervical Intraepithelial Neoplasia Grade 3?
Authors: Rebecca B. Perkins, Claudia Werner, Nicolas Wentzensen
Journal: Annals of Internal Medicine (2022)

EditorialsFebruary 2022What Contributes to Pregnancy Complications Among Women With Cervical Intraepithelial Neoplasia Grade 3?Rebecca B. Perkins, MD, MSc, Claudia Werner, MD, Nicolas Wentzensen, MD, PhDRebecca B. Perkins, MD, MScDepartment of Obstetrics and Gynecology, Boston University School of Medicine and Boston Medical Center, Boston, MassachusettsSearch for more papers by this author, Claudia Werner, MDDepartment of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TexasSearch for more papers by this author, Nicolas Wentzensen, MD, PhDDepartment of Clinical Epidemiology and Genetics, National Cancer Institute, Bethesda, MarylandSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-4666 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Infections with human papillomaviruses (HPVs) are a necessary cause of cervical cancer, which affects over 500 000 women worldwide every year. Beyond that, HPV infections may be associated with negative reproductive outcomes like preterm birth (1). The causal relationship of cervical HPV infections and their sequelae with obstetric outcomes is not well understood. Potential underlying causes include genetic predisposition, direct effects of HPV on obstetric outcomes, and factors related to treatment of cervical precancers. Effects of treatment have been most widely studied, and data suggest that treatment can lead to cervical insufficiency and obstetric complications with a documented dose–response relationship between ...References1. Niyibizi J, Zanré N, Mayrand MH, et al. Association between maternal human papillomavirus infection and adverse pregnancy outcomes: systematic review and meta-analysis. J Infect Dis. 2020;221:1925-1937. [PMID: 32022858] doi:10.1093/infdis/jiaa054 CrossrefMedlineGoogle Scholar2. He W, Sparén P, Fang F, et al. Pregnancy outcomes in women with a prior cervical intraepithelial neoplasia grade 3 diagnosis. A nationwide population-based cohort study with sibling comparison design. Ann Intern Med. 2022;175:210-218. doi:10.7326/M21-2793. Google Scholar3. Kyrgiou M, Athanasiou A, Kalliala IEJ, et al. Obstetric outcomes after conservative treatment for cervical intraepithelial lesions and early invasive disease. Cochrane Database Syst Rev. 2017;11:CD012847. [PMID: 29095502] doi:10.1002/14651858.CD012847 CrossrefMedlineGoogle Scholar4. Bruinsma FJ, Quinn MA. The risk of preterm birth following treatment for precancerous changes in the cervix: a systematic review and meta-analysis. BJOG. 2011;118:1031-41. [PMID: 21449928] doi:10.1111/j.1471-0528.2011.02944.x CrossrefMedlineGoogle Scholar5. Bjørge T, Skare GB, Bjørge L, et al. Adverse pregnancy outcomes after treatment for cervical intraepithelial neoplasia. Obstet Gynecol. 2016;128:1265-1273. [PMID: 27824756] doi:10.1097/AOG.0000000000001777 CrossrefMedlineGoogle Scholar6. Shanbhag S, Clark H, Timmaraju V, et al. Pregnancy outcome after treatment for cervical intraepithelial neoplasia. Obstet Gynecol. 2009;114:727-735. [PMID: 19888028] doi:10.1097/AOG.0b013e3181b5cba3 CrossrefMedlineGoogle Scholar7. Castanon A, Brocklehurst P, Evans H, et al; PaCT Study Group. Risk of preterm birth after treatment for cervical intraepithelial neoplasia among women attending colposcopy in England: retrospective-prospective cohort study. BMJ. 2012;345:e5174. [PMID: 22899563] doi:10.1136/bmj.e5174 CrossrefMedlineGoogle Scholar8. Werner CL, Lo JY, Heffernan T, et al. Loop electrosurgical excision procedure and risk of preterm birth. Obstet Gynecol. 2010;115:605-608. [PMID: 20177293] doi:10.1097/AOG.0b013e3181d068a3 CrossrefMedlineGoogle Scholar9. Perkins RB, Guido RS, Castle PE, et al; 2019 ASCCP Risk-Based Management Consensus Guidelines Committee. 2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis. 2020;24:102-131. [PMID: 32243307] doi:10.1097/LGT.0000000000000525 CrossrefMedlineGoogle Scholar10. Yuill S, Egger S, Smith M, et al. Has human papillomavirus (HPV) vaccination prevented adverse pregnancy outcomes? Population-level analysis after 8 years of a national HPV vaccination program in Australia. J Infect Dis. 2020;222:499-508. [PMID: 32386228] doi:10.1093/infdis/jiaa106 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Rebecca B. Perkins, MD, MSc; Claudia Werner, MD; Nicolas Wentzensen, MD, PhDAffiliations: Department of Obstetrics and Gynecology, Boston University School of Medicine and Boston Medical Center, Boston, MassachusettsDepartment of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TexasDepartment of Clinical Epidemiology and Genetics, National Cancer Institute, Bethesda, MarylandDisclosures: Authors have reported no disclosures of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-4666.Corresponding Author: Rebecca B. Perkins, MD, MSc, 85 East Concord Street, Boston, MA 02118; e-mail, [email protected]edu.This article was published at Annals.org on 8 February 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPregnancy Outcomes in Women With a Prior Cervical Intraepithelial Neoplasia Grade 3 Diagnosis Wei He , Pär Sparén , Fang Fang , Verena Sengpiel , Björn Strander , and Kamila Czene Metrics February 2022Volume 175, Issue 2Page: 293-294KeywordsCervical intraepithelial neoplasiaHuman papillomavirusObstetrics and gynecologyPregnancyPregnancy complicationsPreterm birth ePublished: 8 February 2022 Issue Published: February 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...