FC 03-09PRETERM DELIVERY AND PERINATAL OUTCOME AFTER CONIZATION: A RETROSPECTIVE ANALYSIS OF THE NATIONAL INPATIENT QUALITY SURVEY DATA IN GERMANY; 2009-2014.

22. Cervical neoplasia
C. Dannecker 1, J. Gallwas 1, T. Eggersmann 1, S. Mahner 1, C. Hübener 1, M. Rottmann 2, S. Wetzka 1.
1Department of Gynecology and Obstetrics, University Hospital Munich, Ludwig-Maximilians-University, Munich (Germany), 2Munich Cancer Registry (MCR), Munich Tumour Centre (TZM), Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich (Germany)

Background / Objectives

Infants born preterm are at increased risk of morbidity and mortality. Conization for the treatment of cervical dysplasia has been associated with an increased risk of preterm delivery. However, valid comparable data for Germany are still missing. Our study aimed to investigate the association between conization and perinatal outcomes in subsequent pregnancies, using data from a German population database.


Methods

A retrospective cohort study was performed on data from the German nationwide performance measurement program in healthcare quality. The survey routinely collects parameters of women who give birth in a German hospital. Approximately 98,5% of all births in Germany are covered within the data collection, comprising a total of 4.002.503 births between 2009 and 2014. 
Women with history of conization prior to pregnancy were compared to a control group of women without. To control for multiple pregnancies the cohort was limited to singleton deliveries and to avoid double-counting, only primipara were included. Main outcome measures are gestational age at birth, birth weight, neonatal morbidity and perinatal mortality. Data were analyzed using univariate and multivariate statistical methods.

 


Results

A total of 1.573.200 cases were eligible for inclusion. There were 14.337 women with history of conization and 1.328.057 women without. Women with history of conization were more likely to be single, (self-) employed, older, had a lower body mass index and delivered infants with lower birth weight [mean (SD), 3.240g (± 603g) vs. 3.307g (±545g), p < 0.0001]. The preterm birth rate was significantly higher in the conization cohort compared to the non-exposed cohort (12,2% vs. 7,5%; Chi2<0,0001). Conization was a significant risk factor for preterm birth (odds ratio, OR 1,7; 95% CI: 1,65-1,83). There was no significant difference in stillbirth and death after 7 days of birth between both groups (OR 0,9, 95 % CI: 0.66-1.25; OR 1,6, 95 % CI: 0,92-2.65).


Conclusion

Pregnancies complicated by conization are at a greater risk of preterm delivery. There was no increase in perinatal mortality. Further research of the data set will investigate whether preterm delivery after conization affects the perinatal morbidity.


References