1. Women who became pregnant within 12 months of LEEP were more likely to experience spontaneous abortion.
2. The likelihood of spontaneous abortion was highest in the first 6 months after LEEP.
Evidence Rating Level: 2 (Good)
Study Rundown: This study found that women who became pregnant within 12 months of loop electrosurgical excision procedures (LEEP) were more likely to experience spontaneous abortion. Prior studies have yielded mixed results regarding the relationship between LEEP and risk of preterm birth and a positive association has been observed between LEEP and spontaneous abortion. The present work is the first to evaluate how risk for spontaneous abortion differs by time interval between LEEP and ongoing pregnancy.
Limitations of the study include retrospective design, low incidence of spontaneous abortion in the study population and recall bias in telephone interviews. Future work should include a larger, multi-center prospective cohort study to increase power, confirm the associations identified here and evaluate trends in different populations.
In-Depth [retrospective cohort study]: This study used medical records and structured telephone interviews of women who had undergone LEEP and had a subsequent pregnancy (n=596) from 1996 to 2006 to evaluate how length of time between LEEP and pregnancy affected likelihood of spontaneous abortion or preterm birth. Outcomes evaluated were spontaneous abortion <20 weeks gestation and preterm birth <37 and <34 weeks gestation.
Spontaneous abortion was associated with a shorter median length of time from LEEP to pregnancy (20.3 months vs. 31.3 months). Women with a time interval of <12 months were more likely to experience spontaneous abortion (OR 5.6, CI 2.5-12.7). Notably, women with a time interval <6 months were most likely to experience this outcome (OR 16.8, CI 3.5-81.6)
By Denise Pong, MPH and Leah Hawkins, MD, MPH
More from this author: Spontaneous early term delivery associated with subsequent preterm birth, Donor oocyte IVF making strides, Shortage of evidence assessing teratogenic drugs, HPV infection associated with preeclampsia, Conservative treatment of recurrent ovarian tumors may preserve fertility
©2012-2013 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT.