title: Pregnancy after treatment for cervical cancer precursor lesions in a retrospective matched cohort.
abstract: OBJECTIVE
  To determine whether treatments for precancerous cervical lesions were associated with lower pregnancy rates compared to rates in unexposed women and women who had a diagnostic cervical biopsy or colposcopy.
  
  
  METHODS
  Matched, retrospective cohort study.
  
  
  METHODS
  Kaiser Permanente Northwest (KPNW), an integrated healthcare delivery system in Oregon and Washington.
  
  
  METHODS
  Women 14 to 53 years old with KPNW enrollment during the period 1998 through 2009.
  
  
  METHODS
  Pregnancy after exposure or index date. Pregnancy was defined using a validated algorithm and electronic medical records data.
  
  
  RESULTS
  We observed 570 pregnancies following cervical treatment in 4,137 women, 1,533 pregnancies following a diagnostic procedure in 13,767 women, and 7,436 pregnancies in a frequency-matched sample of 81,435 women unexposed to treatment or diagnostic procedures. After adjusting for age and contraceptive use, we observed a higher rate of pregnancies in the treatment group compared to unexposed women (hazard ratio (HR) = 1.42, 95% confidence interval (CI): 1.30-1.55), but no difference in pregnancy rates between the treatment and diagnostic procedure groups (HR = 1.03, 95% CI: 0.93-1.13).
  
  
  CONCLUSIONS
  No adverse effects of cervical procedures on subsequent rates of pregnancy were observed in this cohort with up to twelve years of follow-up time.
authors: The Center for Health Research, Kaiser Permanente Northwest, Portland, OR, United States of America.
authors: Allison L
authors: AL
authors: Naleway
authors: The Center for Health Research, Kaiser Permanente Northwest, Portland, OR, United States of America.
authors: Sheila
authors: S
authors: Weinmann
authors: GlaxoSmithKline, North American Vaccine Development, Philadelphia and King of Prussia, PA, United States of America.
authors: Girishanthy
authors: G
authors: Krishnarajah
authors: GlaxoSmithKline, North American Vaccine Development, Philadelphia and King of Prussia, PA, United States of America.
authors: Bhakti
authors: B
authors: Arondekar
authors: GlaxoSmithKline, North American Vaccine Development, Philadelphia and King of Prussia, PA, United States of America.
authors: Jovelle
authors: J
authors: Fernandez
authors: Duke University Medical Center, Department of Obstetrics and Gynecology, Durham, NC, United States of America.
authors: Geeta
authors: G
authors: Swamy
authors: Duke University Medical Center, Department of Obstetrics and Gynecology, Durham, NC, United States of America.
authors: Evan
authors: E
authors: Myers
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D055815:Young Adult