title: Vaginal delivery and low immunity are strongly associated with high-grade cervical intraepithelial neoplasia in a high-risk population.
abstract: OBJECTIVE
  To test the association between high-grade cervical intraepithelial neoplasia (CIN), including CIN 2 and CIN 3, and the main risk factors established in the literature, such as age, early onset of sexual activity, use of hormonal contraception, smoking, sexually transmitted diseases, immunosuppression, the number of deliveries, and abortions.
  
  
  METHODS
  A cross-sectional study using medical records of 531 women examined for a period of 2 years in a referral center in southern Brazil.
  
  
  RESULTS
  Multivariate logistic regression analysis confirmed the following risk factors for high-grade CIN: smoking (odds ratio [OR] = 1.92, with 95% confidence interval [CI] = 1.13-3.27), immunosuppression (OR = 3.45, 95% CI = 1.61-7.43), abortion (OR = 2.15, 95% CI = 1.07-4.35) and 2 or more abdominal deliveries (OR = 3.46, 95% CI = 1.90-6.27).
  
  
  CONCLUSIONS
  Cervical cancer screening should give special attention to the women with the above profile of risk factors by shortening the time interval between the screens.
authors: Department of Obstetrics and Gynecology, Federal University of Santa Catarina, Florianópolis-SC, Brazil. evandrorusso.mg@gmail.com
authors: Evandro
authors: E
authors: Russo
authors: Emil
authors: E
authors: Kupek
authors: Rita Maria
authors: RM
authors: Zanine
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D016015:Logistic Models; D008875:Middle Aged; D011247:Pregnancy; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology*