Biological Samples From Pregnant Women: Insights -Into Cervical Intraepithelial Neoplasia

Cervical cancer has remained a major threat to women’s health, with pregnant women considered a particularly vulnerable population. This study was designed to evaluate the impact of cervical intraepithelial neoplasia (CIN) on pregnancy outcomes using longitudinal biological sample analysis.

A retrospective review was carried out on 125 pregnant women who underwent vaginal examination after presenting with abnormal cervical cytology or a positive human papillomavirus (HPV) test. Suspected cases were examined with colposcopy-guided cervical biopsy performed by experienced clinicians with over ten years of practice. Postpartum assessment included repeat cervical cytology, HPV testing, and colposcopic biopsy when clinically indicated.

Of the 125 patients, 34 underwent colposcopic biopsy during pregnancy. Histopathological outcomes showed strong concordance with colposcopic impressions (kappa = 0.82, p < 0.001). Postpartum follow-up was completed in 98 patients within one year of delivery, including repeat colposcopy and biopsy when needed. Multivariate logistic regression revealed that persistent cervical cytological abnormalities (OR 9.838; 95% CI 3.851–25.135; p < 0.001) were significantly associated with abnormal colposcopic findings, while persistent HPV infection did not show a significant association.

Findings suggested that for pregnant women who declined cervical biopsy, colposcopy alone served as a safe and clinically valuable diagnostic approach. Conservative management was considered appropriate for high-grade CIN during pregnancy once invasive carcinoma was excluded through thorough evaluation. Ongoing monitoring with cytology and HPV testing was recommended in such cases.

The study concluded that persistent cytological abnormalities were strongly predictive of CIN progression, while HPV persistence did not correlate with disease outcomes. These results underscored the importance of cytological surveillance in managing CIN during pregnancy.

References:

1. Xue M, Maharjan R, Zangyu P, Di W, Jinwei M. The significance of biological samples from pregnant women in cervical intraepithelial neoplasia. Front Med. 2025;12:1645567. https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1645567/full