Risk of preterm delivery in gestations following the treatment of Cervical Intraepithelial Neoplasia (CIN) according to cone dimensions: systematic review
Background: There is evidence of increased risk of adverse events in subsequent pregnancies to CIN treatment. However, it is unclear what risk factors are associated with preterm delivery. Objective: To provide evidence for the association between excised uterine cervix dimensions and preterm delivery. Methodology: Systematic review about the association between the excised dimensions of the cervix and the occurrence of preterm birth in subsequent pregnancies after CIN treatment. The survey was conducted in the PUBMED database from 2004 to 2015, in the English language. It was excluded articles that, although they assessed complications in subsequent pregnancies after CIN treatment, did not evaluate association between cone dimensions and preterm birth occurrence. Results: It was included eight retrospective cohorts, one prospective cohort and one case-control study. The number of participants in ten studies was 8.185. The association between preterm birth and cone depth was evidenced in eight studies and not shown in two. Four studies evaluated the relationship between excised volume and preterm birth, with discordant results. The number of conizations was evaluated in six studies, with results also discordant. Conclusion: It is unclear whether the excised tissue dimensions would be isolated risk factors for preterm delivery.
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