{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T17:13:13Z","timestamp":1779297193479,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,12,17]],"date-time":"2014-12-17T00:00:00Z","timestamp":1418774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["5 T32 HD055172-02"],"award-info":[{"award-number":["5 T32 HD055172-02"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["5R01CA10918604"],"award-info":[{"award-number":["5R01CA10918604"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007268","name":"Washington University in St. Louis CTSA","doi-asserted-by":"crossref","award":["UL1 TR000448"],"award-info":[{"award-number":["UL1 TR000448"]}],"id":[{"id":"10.13039\/100007268","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the risk for preterm birth associated with vaginal infections in pregnancies after a loop electrosurgical excision procedure (<jats:styled-content style=\"fixed-case\">LEEP<\/jats:styled-content>), compared with women with no prior <jats:styled-content style=\"fixed-case\">LEEP<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Multicentre retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">USA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women with <jats:styled-content style=\"fixed-case\">LEEP<\/jats:styled-content> between 1996 and 2006 were compared with two unexposed groups who had cervical biopsy or Pap test, without any other cervical procedure, in the same calendar year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The first pregnancy progressing beyond 20\u00a0weeks of gestation in women with prior <jats:styled-content style=\"fixed-case\">LEEP<\/jats:styled-content> was compared with pregnancy in women without <jats:styled-content style=\"fixed-case\">LEEP<\/jats:styled-content>. Stratified analysis according to the presence or the absence of vaginal infection during pregnancy was used to investigate whether the risk for preterm birth differed according to the presence or the absence of infection. The interaction between <jats:styled-content style=\"fixed-case\">LEEP<\/jats:styled-content> and vaginal infection was investigated using multivariable logistic regression with interaction terms, as well as the Mantel\u2013Haenszel test for homogeneity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Spontaneous preterm birth (&lt;37 and &lt;34\u00a0weeks of gestation).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1727 patients who met the inclusion criteria, 34.4% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0598) underwent <jats:styled-content style=\"fixed-case\">LEEP<\/jats:styled-content> prior to an index pregnancy. There was no increased risk for vaginal infections among women with <jats:styled-content style=\"fixed-case\">LEEP<\/jats:styled-content> compared with women without <jats:styled-content style=\"fixed-case\">LEEP<\/jats:styled-content>. Chlamydia infection and <jats:styled-content style=\"fixed-case\">LEEP<\/jats:styled-content> demonstrated significant interaction, suggesting that the presence of chlamydia infection in women with a history of <jats:styled-content style=\"fixed-case\">LEEP<\/jats:styled-content> augments the risk for preterm birth, compared with women with no history of <jats:styled-content style=\"fixed-case\">LEEP<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Vaginal infections during pregnancy in women with a history of <jats:styled-content style=\"fixed-case\">LEEP<\/jats:styled-content> may be associated with an increased risk for preterm birth, compared with women with no history of <jats:styled-content style=\"fixed-case\">LEEP<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13252","type":"journal-article","created":{"date-parts":[[2014,12,17]],"date-time":"2014-12-17T06:55:06Z","timestamp":1418799306000},"page":"545-551","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Loop electrosurgical excision procedure and risk of vaginal infections during pregnancy: an observational study"],"prefix":"10.1111","volume":"122","author":[{"given":"MJ","family":"Stout","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Washington University in St\u00a0Louis St\u00a0Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"HA","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Washington University in St\u00a0Louis St\u00a0Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MG","family":"Tuuli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Washington University in St\u00a0Louis St\u00a0Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AG","family":"Cahill","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Washington University in St\u00a0Louis St\u00a0Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AO","family":"Odibo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of South Florida Tampa FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KA","family":"Roehl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Washington University in St\u00a0Louis St\u00a0Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"GA","family":"Macones","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Washington University in St\u00a0Louis St\u00a0Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,12,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.07.050"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e3181ac05e9"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(03)00741-5"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000151991.09124.bb"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.02.004"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181b052de"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181bf1ef2"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7682"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-011-1848-3"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.02944.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68181-6"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7827-8-113"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.123034"},{"key":"e_1_2_6_15_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/AOG.0000000000000174","article-title":"Loop electrosurgical excision procedure and risk of preterm birth: a systematic review and meta\u2010analysis","volume":"123","author":"Conner SN","year":"2014","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/15.4.778"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.17.2100"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181d068a3"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a1284"},{"key":"e_1_2_6_20_1","unstructured":"Sexually Transmitted Disease In the City of St. Louis MO: Five year summary 2005\u20102009. 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