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February 19, 2026PLoS ONE0 citationsOpen Access

Association between cervical conization and pregnancy outcomes: A nationwide population-based cohort study

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WKWoo Jeng KimYKYong Oock Kim

Key Points

  • This research aims to investigate how cervical conization affects pregnancy outcomes in women.
  • Conducted a population-based retrospective cohort study using data from the Korean National Health Insurance System.
  • Included 199,826 singleton primiparous women aged 19 and older, with 18,602 having undergone conization.
  • Estimated adjusted odds ratios for obstetric complications using multivariable logistic regression.
  • Cervical conization is associated with increased risks of cervical incompetence (aOR 3.15) and preterm labor (aOR 1.44).
  • Significantly higher risks of preterm labor and preterm premature rupture of membranes were observed in women who had both conization and cerclage.
  • Other complications linked to conization include placenta previa, gestational diabetes, and intrauterine growth restriction.

Abstract

Cervical conization is the standard treatment for cervical intraepithelial neoplasia. However, its effects on pregnancy outcomes remain controversial. Using data from the Korean National Health Insurance System, this population-based retrospective cohort study evaluated the relationship between cervical conization and adverse pregnancy outcomes between 2006 and 2022. Altogether, 199,826 singleton primiparous women aged 19 years or older were included, of whom 18,602 had undergone conization prior to pregnancy. The adjusted odds ratios for obstetric complications were estimated using multivariable logistic regression. Conization was associated with an elevated risk of cervical incompetence (adjusted odds ratios aOR 3.15; 95% confidence interval CI 3.01–3.30), preterm labor (aOR 1.44), preterm premature rupture of membranes (aOR 1.67), placenta previa, gestational diabetes, and intrauterine growth restriction. The subgroup analysis revealed that women who underwent both conization and cerclage had substantially higher risks of preterm labor and preterm premature rupture of membranes than did those who did not receive cerclage. The results point to a heightened obstetric risk following cervical conization, emphasizing the need for tailored prenatal care and continued prospective investigation.

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Cite This Study

Kim et al. (2026) studied this question.

synapsesocial.com/papers/6996a869ecb39a600b3ef0e3https://doi.org/10.1371/journal.pone.0341660
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