BACKGROUND It currently remains unknown whether the resection of cervical polyps during pregnancy leads to miscarriage and/or preterm birth. This study evaluated the risk of spontaneous PTB below 34 or 37 weeks and miscarriage above 12 weeks in patients undergoing cervical polypectomy during pregnancy. METHODS This was a retrospective monocentric cohort study of patients undergoing cervical polypectomy for clinical indication. Seventy-three pregnant women who underwent polypectomy were selected, and risk factors associated with miscarriage above 12 weeks or premature delivery below 34 or 37 weeks were investigated. A multivariable regression looking for predictors of spontaneous miscarriage > 12 weeks and PTB < 34 or 37 weeks were performed. RESULTS Sixteen patients (21.9%, 16/73) had spontaneous delivery at < 34 weeks or miscarriage above 12 weeks. A univariate analysis showed that bleeding before polypectomy [odds ratio (OR) 7.7, 95% confidence interval (CI) 1.6-37.3, p = 0.004], polyp width ≥ 12 mm (OR 4.0, 95% CI 1.2-13.1, p = 0.005), the proportion of decidual polyps (OR 8.1, 95% CI 1.00-65.9, p = 0.024), and polypectomy at ≤10 weeks (OR 5.2, 95% CI 1.3-20.3, p = 0.01) were significantly higher in delivery at < 34 weeks than at ≥34 weeks. A logistic regression analysis identified polyp width ≥ 12 mm (OR 11.8, 95% CI 2.8-77.5, p = 0.001), genital bleeding before polypectomy (OR 6.5, 95% CI 1.2-55.7, p = 0.025), and polypectomy at ≤10 weeks (OR 5.9, 95% CI 1.2-45.0, p = 0.028) as independent risk factors for predicting delivery at < 34 weeks. Polyp width ≥ 12 mm and bleeding before polypectomy are risk factors for PTB < 37 wks. CONCLUSIONS Our cohort of patients undergoing polypectomy in pregnancy have high risks of miscarriage or spontaneous premature delivery. It is unclear whether these risks are given by the underlying disease, by surgical treatment or both. This study establishes clinically relevant predictors of PTB are polyp size> 12 mm, bleeding and first trimester polypectomy. PTB risks should be exposed to patients and extensively discussed with balancing against the benefits of intervention in pregnancy.

中文翻译：

---

妊娠期间接受宫颈息肉切除术的患者发生12周以上自然流产或早产的危险因素。

背景技术目前尚不清楚怀孕期间宫颈息肉的切除是否会导致流产和/或早产。这项研究评估了妊娠期接受宫颈息肉切除术的患者在34或37周以下自发性PTB和在12周以上流产的风险。方法这是一项回顾性单中心队列研究，对接受宫颈息肉切除术的患者进行临床指征。选择73例行息肉切除术的孕妇，并调查与12周以上流产或34或37周以下早产相关的危险因素。进行多元回归分析，寻找自发流产> 12周且PTB <34或37周的预测因素。结果16例患者（21.9％，16/73）在< 34周或流产12周以上。单因素分析显示息肉切除术前出血[比值比（OR）7.7，95％置信区间（CI）1.6-37.3，p = 0.004]，息肉宽度≥12 mm（OR 4.0，95％CI 1.2-13.1，p = 0.005），蜕膜蜕膜的比例（OR 8.1，95％CI 1.00-65.9，p = 0.024）和息肉切除术在≤10周时（OR 5.2，95％CI 1.3-20.3，p = 0.01）明显更高<34周时≥34周时。逻辑回归分析确定息肉宽度≥12 mm（OR 11.8，95％CI 2.8-77.5，p = 0.001），息肉切除前的生殖器出血（OR 6.5，95％CI 1.2-55.7，p = 0.025），息肉切除≤ 10周（OR 5.9，95％CI 1.2-45.0，p = 0.028）作为预测<34周分娩的独立危险因素。息肉宽度≥12 mm和息肉切除术前出血是PTB <37 wks的危险因素。结论我们队列中的孕妇在接受息肉切除术后有很高的流产或自然早产风险。目前尚不清楚这些风险是由潜在疾病，通过手术治疗还是由两者共同引起。这项研究确定了PTB的临床相关预测指标是息肉大小> 12 mm，出血和妊娠早期息肉切除术。PTB风险应暴露给患者，并在平衡妊娠干预带来的益处之间进行广泛讨论。