Incidence and obstetrical outcomes of cervical intraepithelial neoplasia and cervical cancer in pregnancy: a population-based study on 8.8 million births

Abstract

Objective: To estimate the incidence and outcomes of cervical intraepithelial neoplasia (CIN) and cervical cancer in pregnancy.

Methods: We conducted a population-based cohort study using the United States Healthcare Cost and Utilization Project-Nationwide Inpatient Sample from 1999 to 2008. The incidence of CIN and cervical cancer was measured and logistic regression analysis used to estimate the adjusted effect of CIN and cervical cancer on obstetrical outcomes.

Results: There were 8,826,137 births over a 10-year period of which 11,755 were among women with CIN and 294 among women with cervical cancer. Compared with controls, women with CIN were younger, had lower annual incomes, and more likely to be on Medicaid while women with cancer were more likely to be older. Women with CIN had lower rates of cesarean delivery but higher rates of transfusions and cesarean hysterectomies, while women with cancer had higher rates of cesarean deliveries, transfusions and cesarean hysterectomies. There were no significant increase of thrombosis; maternal death, instrumental delivery, IUGR, PPROM or intrauterine death was found.

Conclusion: CIN and cervical cancer are rare in pregnancy. Although there is a greater risk of transfusion/hysterectomy, overall major maternal and neonatal morbidity does not appear to be increased.