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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

The risk of preterm birth following treatment for precancerous changes in the cervix: a systematic review and meta-analysis

Review published: 2011.

Bibliographic details: Bruinsma FJ, Quinn MA.  The risk of preterm birth following treatment for precancerous changes in the cervix: a systematic review and meta-analysis. BJOG. An International Journal of Obstetrics and Gynaecology 2011; 118(9): 1031-1041. [PubMed: 21449928]

Abstract

BACKGROUND: Studies investigating the association between treatment for precancerous changes in the cervix and risk of preterm birth have used a variety of comparison groups.

OBJECTIVES: To investigate whether treatment for precancerous changes in the cervix is associated with preterm birth (<37 weeks) and to examine the impact of the type of comparison group on estimates of risk.

SEARCH STRATEGY: PubMed, Embase and CENTRAL were searched for studies pubished between 1950 and 2009.

SELECTION CRITERIA: Eligible studies were those that reported preterm birth outcomes for excisional and ablative treatments separately and included a comparison group.

DATA COLLECTION AND ANALYSIS: Pooled relative risks (RR) and 95% confidence intervals were computed using a random effects model.

MAIN RESULTS: Thirty eligible studies were located. Excisional treatment was associated with an increased odds of preterm birth, when compared with an external (RR 2.19, 95% CI 1.93-2.49) or internal (RR 1.96, 95% CI 1.46-2.64) comparison group. In comparison with women who were assessed but not treated, the risk estimate was smaller (RR 1.25, 95% CI 0.98-1.58). Ablative treatment was associated with an increased risk of preterm birth when an external comparison group (RR 1.47, 95% CI 1.24-1.74) but not an internal comparison group (RR 1.24, 95% CI 0.73-2.10) or untreated comparison group (RR 1.03, 95% CI 0.90-1.18) was used.

AUTHORS' CONCLUSIONS: Excisional treatment was associated with a significantly increased risk of preterm birth. It provides new evidence that some types of ablative treatment may also be associated with a small increased risk. The type of comparison group used is an important consideration when comparing the outcomes of studies.

© 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

PMID: 21449928

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