Uterine cervical conisation and chorioamnionitis: A nationwide observational study

Objective To investigate whether conisation increases chorioamnionitis (CAM) and assess whether this risk differs between preterm and term periods. Furthermore, we estimated mediation effects of CAM between conisation and preterm birth (PTB). Design A nationwide observational study. Setting Japan. P...

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Published in:BJOG : an international journal of obstetrics and gynaecology 2024-06, Vol.131 (7), p.977-984
Main Authors: Wada, Yoshimitsu, Takahashi, Hironori, Ogoyama, Manabu, Horie, Kenji, Suzuki, Hirotada, Usui, Rie, Jwa, Seung Chik, Ohkuchi, Akihide, Fujiwara, Hiroyuki
Format: Article
Language:English
Subjects:
Adult
cervical conisation
cervical intraepithelial neoplasia
Cervix
Cervix Uteri
Chorioamnionitis
Chorioamnionitis - epidemiology
Conization - adverse effects
Female
Humans
Japan - epidemiology
Observational studies
Obstetrics
Population studies
Pregnancy
Premature birth
Premature Birth - epidemiology
Premature Birth - etiology
preterm birth
preterm premature rupture of membrane
Registries
Risk Factors
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Summary:Objective To investigate whether conisation increases chorioamnionitis (CAM) and assess whether this risk differs between preterm and term periods. Furthermore, we estimated mediation effects of CAM between conisation and preterm birth (PTB). Design A nationwide observational study. Setting Japan. Population Singleton pregnant women derived from the perinatal registry database of the Japan Society of Obstetrics and Gynaecology between 2013 and 2019. Methods The association between a history of conisation and clinical CAM was examined using a multivariable logistic regression model with multiple imputation. We conducted mediation analysis to estimate effects of CAM on PTB following conisation. Main Outcome Measures Clinical CAM. Results Of 1 500 206 singleton pregnant women, 6961 (0.46%) underwent conisation and 1 493 245 (99.5%) did not. Clinical CAM occurred in 150 (2.2%) and 11 484 (0.8%) women with and without conisation, respectively. Conisation was associated with clinical CAM (odds ratio [OR] 3.09; 95% confidence interval (CI) 2.63–3.64; p 
ISSN:1470-0328
1471-0528
DOI:10.1111/1471-0528.17718