Pregnancies within 1 year of LEEP more likely to end in spontaneous abortion

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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.

Click to read the study in Obstetrics & Gynecology

Relevant Reading: Pregnancy outcome after loop electrosurgical excision procedure for cervical intraepithelial neoplasia

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

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