Pregnancy Outcome in Women with Inflammatory Cervical Smear

Background: Cervical cytology is a routine tool for screening premalignant and malignant cervical lesions and can incidentally detect inflammation and infections. In pregnancy, Pap smears often reveal inflammatory changes, with reported rates ranging from 40.8% to 98.33%. While inflammation in nonpregnant women is often linked to infections such as Candida , bacterial vaginosis, and Trichomonas , the significance of inflammatory smears in pregnancy remains unclear. Some studies have suggested an association between cervical inflammation and adverse outcomes such as preterm delivery (PTD), but findings are inconsistent. Limited data exist on this correlation, and no Indian studies have been published. This study aims to explore the impact of inflammatory cervical smears on pregnancy outcomes. Aim: This study aimed to study the pregnancy outcome in women with an inflammatory cervical smear. Materials and Methods: This prospective observational study was conducted over 18 months at a tertiary care hospital in New Delhi. A total of 150 antenatal women at <20 weeks of gestation were screened using liquid-based cytology. Women with epithelial cell abnormalities or infections were excluded from outcome analysis. Inflammation was graded as mild, moderate, or dense. Maternal and neonatal outcomes, including gestational age at delivery and neonatal intensive care unit admissions, were recorded. Statistical analyses were performed using SPSS version 21.0, with significance set at P < 0.05. Results: All 150 women had smears reported as negative for intraepithelial lesion or malignancy with inflammation (mild: 68.0%, moderate: 28.0%, dense: 4.0%). After excluding 7 cases with infections, 143 women were followed. The mean gestational age at delivery was 38.56 weeks. Preterm birth (<37 weeks) occurred in 5.6% of cases. There was no statistically significant correlation between inflammation on Pap smear and pregnancy outcome according to our study. A statistically significant association was found between higher grades of inflammation and PTD ( P = 0.005). None of the mother or baby showed signs of infection postdelivery. Conclusion: Inflammation on a Pap smear is highly prevalent among pregnant women. While most women delivered at term, only higher grades of inflammation showed a statistically significant association with PTD. Pap smear during antenatal visits offers a valuable opportunity for cervical screening and early infection detection, potentially aiding in the prevention of adverse outcomes.