(879) Obstetric Outcomes After Cervical Conization: A Retrospective Cohort from a Large Tertiary Center

To evaluate the association between prior cervical conization and obstetric outcomes, particularly preterm birth, compared to the general obstetric population.

Study Design:

This retrospective cohort study was conducted at a large tertiary center between 2011 and May 2025. Women who delivered following cervical conization (n=61) were compared to all other deliveries during the same period (n=150,276). The primary outcome was preterm birth < 37 weeks. Secondary outcomes included preterm birth < 34 weeks, mode of delivery, and neonatal outcomes. Multivariable logistic regression adjusted for maternal age, BMI, nulliparity, multifetal gestation, history of preterm labor, and smoking.

Results:

Preterm birth < 37 weeks occurred more frequently in the conization group (14.8% vs. 2.9%, aOR 5.54, 95% CI 2.69–11.39, p< 0.001). However, the median gestational age remained within term (38.4 vs. 39.1 weeks, p=0.026), and birth < 34 weeks was comparable. There was no significant association between time from conization to delivery and risk of preterm birth (p=0.656). Cesarean delivery was more common after conization (42.6% vs. 28.3%, p=0.013), with a trend toward unplanned CD. Rates of placental abruption (3.3% vs. 0.5%, p=0.037) and NICU admission (5.0% vs. 0.6%, p=0.005) were higher. No differences were observed in birthweight, Apgar scores, or neonatal mortality.

Conclusion:

Cervical conization is associated with increased risk of preterm birth and selected maternal and neonatal complications. Still, most women deliver at term with reassuring neonatal outcomes. These findings support individualized prenatal counseling and enhanced monitoring in pregnancies following cervical excisional procedures.