META-ANALYSIS OF THE IMPACT OF LOOP ELECTROSURGICAL EXCISION PROCEDURE FOR CERVICAL INTRAEPITHELIAL NEOPLASIA ON PREGNANCY OUTCOMES IN ATHLETES

Abstract

To assess the influence of cervical intraepithelial neoplasia treated with loop electrosurgical excision procedure (LEEP) on the pregnancy outcomes of female athletes. This study compiles data from various studies cataloged within the Embase database. Methods: A comprehensive review of Embase database was conducted, focusing on studies from its inception until December 2021 that examined pregnancy outcomes post-LEEP in athletes. The quality of included studies was assessed using the Newcastle Ottawa Scale (NOS), and risk of bias was evaluated using Cochrane’s risk of bias tool. Meta-analysis was performed using RevMan software. Results: Six high-quality studies were included, published between 2006 and 2021, with NOS scores ≥6 points. Significant disparities were noted in pregnancy outcomes between athletes who underwent LEEP and those who did not. Notably, the risk of preterm birth was slightly increased [RR = 1.10, 95% CI (0.87-1.68), P < 0.05]. Moreover, perinatal neonatal mortality and low birth weight incidences were higher in the post-LEEP group, with RRs of 1.22 and 1.45 respectively. Conclusion: LEEP for cervical intraepithelial neoplasia in female athletes may be associated with a higher risk of adverse pregnancy outcomes, including preterm birth and neonatal complications. Given the physical demands on athlete populations, these findings underscore the importance of tailored preoperative counseling and postoperative monitoring to manage and mitigate potential risks effectively.