Uterine fibroids increase risk for preterm labor and cesarean delivery

  • BMJ Open

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Diagnosis of uterine fibroids prior to or during pregnancy increases risk for preterm birth and cesarean delivery (CD).

Why this matters

  • 10% of pregnant women have uterine fibroids.

Study design

  • Retrospective historical cohort study.
  • Cohort obtained from the Danish National Patient Registry and the Danish National Birth Registry (n=92,696 pregnancies).
  • Women with fibroids identified through diagnosis and operation codes.
  • Cohort divided into 4 groups:
    • Group 1: no fibroid codes (n=91,292);
    • Group 2: fibroid diagnosis code before, during, or up to 1 year after delivery and with no operation codes before pregnancy (n=124);
    • Group 3: fibroid diagnosis code given >1 year after delivery (n=963); and
    • Group 4: fibroid operation code before pregnancy (n=317).
  • Funding: No funding for study; 1 author cited Danish university and government funding.

Key results

  • Risk for preterm birth increased in group 2: OR, 2.3 (95% CI, 1.30-3.96).
  • Risk for CD increased in group 2: OR, 2.2 (95% CI, 1.50-3.21).
  • The risk for postpartum hemorrhage (PPH), placental abruption, and fetal growth restriction was not increased in women with a fibroid diagnosis code.

Limitations

  • Retrospective data.
  • Coding errors possible.