Clinical and medical history characteristics of pregnant women with different cervical cytology results

Objective: To determine the clinical and medical history characteristics of pregnant women with different cervical cytology results.

Materials and methods: This retrospective study included 349 patients aged 18–44 years (median=32, Q25–Q75: 29–36). Group 1 included pregnant women without a history of cervical surgery and NILM cytology reports (n=136); group 2 included pregnant women with a history of cervical conization (before pregnancy) for obligate precancer and NILM cytology reports at the time of inclusion in the study (n=67); group 3 included pregnant patients with mild dysplasia (LSIL by cytology, n=63), and group 4 included pregnant patients with severe dysplasia (HSIL according to cytology, n=83). Statistical analysis and data visualization were performed using R version 4.4.0 (build 2024-04-24). The statistical significance of differences between categorical variables was assessed using two-tailed Fisher's exact test, and differences between continuous variables were assessed using the Kruskal-Wallis test. Differences were considered statistically significant at p<0.05.

Results: Pregnant women with HSIL cytology had a nicotine addiction rate of 44.6% (p<0.001), initiated sexual activity at ages 16–18 (p<0.001), a high abortion rate of 59% (p=0.005), and a high birth rate of 83.1% (p=0.016). They also had a high rate of gynecological diseases in general (65.1%, p=0.018) as well as sexually transmitted infections, HIV infections, and viral hepatitis C. Patients with NILM cytology had a higher rate of endometriosis (p=0.018) and ovarian lesions (p=0.037) than those with abnormal cytology. Women with a history of cervical conization were distinguished by the absence of allergic reactions compared to those in the other groups (p<0.001). There were no differences in the rates of extragenital diseases.

Conclusion: Distinct medical history characteristics were observed in patients, depending on the results of the cytological examination. All pregnant women exhibited low adherence to the use of contraceptive methods, a significant number of pregnancy terminations, and high parity.