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Conservative methods to treat cervical intraepithelial neoplasia and microinvasive cervical cancer are commonly used in young women because of the advent of effective screening programmes. In a meta-analysis, we investigated the effect of these procedures on subsequent fertility and pregnancy outcomes.

We searched for studies in MEDLINE and EMBASE and classified them by the conservative method used and the outcome measure studied regarding both fertility and pregnancy. Pooled relative risks and 95% CIs were calculated with a random-effects model and interstudy heterogeneity was assessed with Cochrane's Q test.

We identified 27 studies. Cold knife conisation was significantly associated with preterm delivery (<37 weeks; relative risk 2·59, 95% CI 1·80–3·72, 100/704 [14%] vs 1494/27 674 [5%]), low birthweight (<2500 g; 2·53, 1·19–5·36, 32/261 [12%] vs 905/13 229 …