Cervical intraepithelial neoplasia (CIN) is a premalignant squamous lesion of the uterine cervix, caused by human papilloma virus (HPV) infection, the most common sexually transmitted infection in women. A rise in the incidence of abnormal Pap smear in pregnant women has been reported lately, estimated at approximately 5%. This may be attributed to HPV's predilection for women of reproductive age or to the fact that cancer screening has become a crucial part of prenatal care [1]. Cervical cancer is the most common gynecological malignancy diagnosed during pregnancy with an estimated incidence of between 1.5 and 12 cases per 100,000 pregnancies [2]. Nearly 1–3% of cervical cancer cases are diagnosed during pregnancy or during the postpartum period [3].

Over the last few decades, the management of cervical intraepithelial lesions has changed from an aggressive diagnostic and treatment approach to a more conservative surveillance strategy. Given that preinvasive lesions usually present during the third decade of life, it is expected that a significant proportion of patients will be diagnosed at their first pregnancy, rendering their management problematic for the average physician. According to the American Society of Colposcopy and Cervical Pathology (ASCCP) guidelines, when HSIL is diagnosed during pregnancy, surveillance colposcopy with cytology and/or HPV DNA testing every 12–24 weeks is recommended. In the case of suspected invasion or lesion progression, punch biopsies should be repeated [4].

Numerous studies have evaluated the progress of CIN during pregnancy. However, the results of these studies are quite heterogeneous and therefore safe conclusions cannot be extracted about the evolution of preinvasive cervical lesions in this particular subcategory of the population. Current recommendations suggest that women should be screened only to rule out invasive disease, whereas preinvasive lesions, even high grade, should be treated conservatively until delivery [5]. However, a correlation between the mode of delivery and the regression rate has yet to be determined.

The purpose of the present meta-analysis is to accumulate current literature in the field, to evaluate the impact of delivery mode on the course of CIN and provide robust effect estimates of regression, persistence or progression rates that will help physicians create a plan during their clinical practice.