title: Loop electrosurgical excision procedure and risk of miscarriage.
abstract: OBJECTIVE
  To evaluate the risk of miscarriage in the subsequent pregnancy after a loop electrosurgical excision procedure (LEEP), also considering time elapsed from LEEP to pregnancy.
  
  
  METHODS
  Multicenter, retrospective cohort study.
  
  
  METHODS
  Tertiary care university hospitals.
  
  
  METHODS
  Women who had undergone LEEP from January 2000 to December 2011. Women with histologic assessment of low-grade cervical dysplasia, not requiring subsequent surgical treatment, constituted the control group.
  
  
  METHODS
  None.
  
  
  METHODS
  The first pregnancy after the procedure was evaluated, and only women with singleton spontaneous pregnancies were considered. Women with time intervals of <12 months and women with intervals of ≥12 months or more from LEEP to pregnancy were then compared, to identify adjusted odds ratios for miscarriage.
  
  
  RESULTS
  In women previously treated with LEEP, a total of 116 cases of miscarriage (18.1%) was reported. The mean time interval from LEEP to pregnancy for women with miscarriage compared with women without miscarriage was significantly shorter (25.1 ± 11.7 months vs. 30.1 ± 13.3 months). A higher rate of miscarriage in women with a LEEP-to-pregnancy interval of <12 months compared with controls emerged (28.2% vs. 13.4%; adjusted odds ratio 2.60, 95% confidence interval 1.57-4.3). No significant difference in the rate of miscarriage in women with a LEEP-to-pregnancy interval of ≥12 months compared with controls emerged.
  
  
  CONCLUSIONS
  Women with a time interval from LEEP to pregnancy of <12 months are at increased risk for miscarriage.
authors.affiliation: Gynecologic Section, Woman's Health Sciences Department, Polytechnic University of Marche, Ancona, Italy. Electronic address: ciavattini.a@libero.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ciavattini
authors.affiliation: Gynecologic Section, Woman's Health Sciences Department, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Clemente
authors.affiliation: Gynecologic Section, Woman's Health Sciences Department, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Delli Carpini
authors.affiliation: Gynecologic Section, Woman's Health Sciences Department, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Gentili
authors.affiliation: Gynecologic Section, Woman's Health Sciences Department, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Di Giuseppe
authors.affiliation: Department of Biomedical Science and Public Health, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Pamela
authors.initials: P
authors.lastname: Barbadoro
authors.affiliation: Department of Biomedical Science and Public Health, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Prospero
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
authors.forename: Carlo Antonio
authors.initials: CA
authors.lastname: Liverani
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D003127:Colposcopy / Q000009:adverse effects* / Q000379:methods; D004598:Electrosurgery / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D061685:Time-to-Pregnancy / Q000502:physiology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000601:surgery*
keywords: LEEP; Loop electrosurgical excision procedure; miscarriage