Cervical cancer and risk for delivery of small-for-gestational age neonates

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JOURNAL OF WOMEN’S HEALTH Volume 19, Number 5, 2010 ª Mary Ann Liebert, Inc. DOI: 10.1089=jwh.2009.1574

Cervical Cancer and Risk for Delivery of Small-for-Gestational Age Neonates
Gina M. MantiaSmaldone, M.D.,* Marijane A. Krohn, Ph.D., and Elizabeth A. McGee, M.D.{

Abstract

Objective: To determine if cervical intraepithelial neoplasia grade 3 (CIN-3) and cervical cancer are associatedwith adverse obstetrical outcomes. Methods: Women with diagnoses of CIN-3 and cervical cancer were first identified from the University of Pittsburgh Medical Center (UPMC) Network Cancer Registry byusing respective ICD-3 codes. Identified records were then linked to the Magee Obstetrical Maternal and Infant (MOMI) database to identify women who subsequently delivered pregnancies at Magee-WomensHospital. Women with cervical disease were compared with women without known disease to determine the impact of cervical disease on various maternal and neonatal outcomes. The latter group consisted ofthose women who delivered singleton pregnancies at our institution, as determined by the MOMI database, but who did not have any matching records in the UPMC Cancer Registry. Statistical significancewas defined by a p value 40% of cases are diagnosed in women 44 years of age.3 Up to 48% of reproductive-age women may seek fertilitysparing treatment for cervical cancer.4 However, candidates aregenerally limited to those with early stage disease (IA1 to nonbulky IB1) and to those from developed nations.5 Excisional treatment modalities, including cervical conization and

radical trachelectomy,are feasible options for the treatment of IA1 and IA2–IB1 nonbulky cancers, respectively.6–9 Ablative treatment modalities, such as cryoablation, may be used in the treatment of cervicalintraepithelial neoplasia (CIN).10 Several retrospective studies have examined the impact of treatment for cervical disease, including CIN and cervical cancer, on reproductive outcomes.11–19 Kyrgiou et al.20...
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