Association of subjective health and abnormal cervical cytology in Japanese pregnant women: An adjunct study of the Japan Environment and Children's Study

Satomi Sasaki; Hirohito Metoki; Michihiro Satoh; Takahisa Murakami; Kaou Tanoue; Kosuke Tanaka; Noriyuki Iwama; Zen Watanabe; Satoshi Okamoto; Masatoshi Saito; Junichi Sugawara; Kiyoshi Ito; Nobuo Yaegashi

doi:10.1016/j.pmedr.2021.101525

Association of subjective health and abnormal cervical cytology in Japanese pregnant women: An adjunct study of the Japan Environment and Children's Study

Prev Med Rep. 2021 Aug 18:24:101525. doi: 10.1016/j.pmedr.2021.101525. eCollection 2021 Dec.

Authors

Satomi Sasaki¹, Hirohito Metoki^{2

3}, Michihiro Satoh², Takahisa Murakami², Kaou Tanoue⁴, Kosuke Tanaka⁵, Noriyuki Iwama⁴, Zen Watanabe⁴, Satoshi Okamoto⁶, Masatoshi Saito^{1

4}, Junichi Sugawara^{1

3}, Kiyoshi Ito^{3

4

7}, Nobuo Yaegashi^{1

3

4}

Affiliations

¹ Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
² Division of Public Health, Hygiene and Epidemiology, Tohoku Medical Pharmaceutical University, 1-15-1 Fukumuro, Sendai, Miyagi 983-8536, Japan.
³ Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan.
⁴ Department of Obstetrics and Gynecology, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
⁵ Department of Obstetrics and Gynecology, Hachinohe City Hospital, 3-1-1, Tamukai, Hachinohe, Aomori 031-8555, Japan.
⁶ Department of Clinical Laboratory, Tohoku Kosai Hospital, 2-3-11, Kokubun-machi, Aoba-ku, Sendai, Miyagi 980-0803, Japan.
⁷ Department of Disaster Obstetrics and Gynecology, International Research Institute of Disaster Science (IRIDeS), Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8573, Japan.

Abstract

This study examines the association between abnormal cervical cytology and subjective health in pregnant women, as an adjunct to the Japan Environment and Children's Study, which cross-sectionally analyzed a subset of the prospective cohort. A total of 3024 pregnant women at a childbirth facility whose medical records of cervical cytology in the first trimester of pregnancy were transcribed and who responded to the subjective health questionnaire were included herein. They were classified into excellent, good, fair, and poor groups based on their subjective health. Cervical cytology results obtained from perinatal medical records were classified into normal and abnormal cytology based on the Bethesda classification. Logistic regression analysis adjusted for baseline characteristics, including age, pre-pregnancy body mass index, parity, and other possible confounding factors, was used. Of 3024 pregnant women, 106 (3.5%) had abnormal cytology, with the prevalence being 1.3%, 3.7%, 3.9%, and 4.0%, respectively (p = 0.055) in the poor, fair, good, and excellent groups. The baseline characteristics, namely age, history of gynecological diseases, Kessler 6-item psychological distress scale score, and history of mental illness, were significantly different between groups. Compared to the poor group, the other three groups had a significantly higher abnormal cytology risk after adjusting for confounding factors (Fair: adjusted OR [aOR] = 3.6, 95% CI [1.0-12.1]; Good: aOR = 4.6 [1.3-15.5]; Excellent: aOR = 4.6 [1.2-17.8]). This study encourages young women to undergo cervical cancer screening because they are at risk for cervical cancer even if they think that they are healthy, and preventive activities like regular screening are essential.

Keywords: Cervical cancer; HPV; Pregnancy; Screening; Subjective health.