CIN in pregnancy: antepartum and postpartum cytology and histology.
OBJECTIVE
To determine the rates of antepartum and postpartum cervical intraepithelial neoplasia (CIN) 2 or worse in pregnant women with abnormal cervical cytology.


METHODS
A prospective, cohort study of 283 pregnant women referred for colposcopy between 1992 and 1999 for the evaluation of abnormal Pap smears. In this analysis, the population was stratified by severity of referral cytology (atypical squamous cells of undetermined significance [ASCUS] or low grade squamous intraepithelial lesion [LSIL] versus high grade squamous intraepithelial lesion [HSIL] and atypical glandular cells of undetermined significance [AGUS]).


RESULTS
Sixty-seven women (24%) had ASCUS, 147 (52%) LSIL, 67 (24%) HSIL and 2 (0.7%) AGUS. As compared to women with HSIL or AGUS, women with ASCUS or LSIL were less likely to undergo antepartum biopsy (relative risk [RR] .34, 95% CI .23-.51) and if biopsied, less likely to have CIN 2 or worse (OR .49, 95% CI .24-.99). Women with antepartum ASCUS or LSIL were less likely to have postpartum HSIL (OR .29, 95% CI, .17-.52) and tended to have fewer histologically severe biopsies as compared to women with antepartum HSIL (OR .55, 95% CI .31-1.05).


CONCLUSIONS
Among those biopsied, pregnant women with mildly abnormal cytology (ASCUS or LSIL), as compared to pregnant women with HSIL, were less likely to have either antepartum or postpartum CIN 2 or worse.
Boardman
Lori A
LA
Department of Obstetrics and Gynecology, Women and Infants' Hospital of Rhode Island, 101 Dudley Street, Providence, RI 02905, USA. lboardma@wihri.org
Goldman
Debra L
DL
Cooper
Amy S
AS
Heber
Walter W
WW
Weitzen
Sherry
S
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003127:Colposcopy; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D016017:Odds Ratio; D065006:Papanicolaou Test; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000453:epidemiology*; D011446:Prospective Studies; D012237:Rhode Island / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000145:classification / Q000453:epidemiology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000145:classification / Q000453:epidemiology*