Obstetric characteristics and perinatal outcome of pregnancies with uterine leiomyomas.

The Journal of reproductive medicine Pub Date : 2004-03-01 DOI:10.1097/01.OGX.0000137615.96233.53

E. Sheiner, A. Bashiri, A. Levy, R. Hershkovitz, M. Katz, M. Mazor

{"title":"Obstetric characteristics and perinatal outcome of pregnancies with uterine leiomyomas.","authors":"E. Sheiner, A. Bashiri, A. Levy, R. Hershkovitz, M. Katz, M. Mazor","doi":"10.1097/01.OGX.0000137615.96233.53","DOIUrl":null,"url":null,"abstract":"OBJECTIVE\nTo determine the rate, obstetric characteristics and perinatal outcome of pregnancies with uterine leiomyomas.\n\n\nSTUDY DESIGN\nA population-based study comparing all singleton deliveries between the years 1988 and 1999 in women with and without uterine leiomyomas was performed. Patients lacking prenatal care were excluded from the analysis. Multivariable analysis, adjusting for possible confounders, such as maternal age, parity and gestational age, was performed to investigate associations between uterine leiomyomas and selected outcomes.\n\n\nRESULTS\nThere were 105,909 singleton deliveries with 690 (0.65%) complicated by uterine leiomyomas during the study period. Using a multivariable analysis, the following conditions were significantly associated with uterine leiomyomas: nulliparity (odds ratio [OR]=4.0, 95% confidence interval [CI] 3.3-4.7, P<.001), chronic hypertension (OR=1.9, 95% CI 1.6-2.4, P<.001), hydramnios (OR=1.5, 95% CI 1.2-2.0, P<.001), diabetes mellitus (OR=1.4, 95% CI 1.1-1.7, P=.001) and advanced maternal age (OR=1.2, 95% CI 1.1-1.2, P<.001). Higher rates of perinatal mortality (2.2% vs. 1.2%, OR=1.8, 95% CI 1.1-3.2, P<.001) were found in the uterine leiomyoma group as compared to the control group. While adjusting for maternal age, parity, gestational age and malpresentation, pregnancies with uterine leiomyomas had higher rates of cesarean deliveries (OR=6.7, 95% CI 5.5-8.1, P<.001), placental abruption (OR=2.6, 95% CI 1.6-4.2, P<.001) and preterm deliveries (<36 weeks' gestation, OR=1.4, 95% CI 1.1-1.7, P=.009) as compared to pregnancies without uterine leiomyomas. Conversely, no significant differences were noted regarding perinatal mortality (OR=1.4, 95% CI 0.7-2.8, P=.351) after controlling for maternal age, parity and gestational age using a multivariable analysis.\n\n\nCONCLUSION\nUterine leiomyomas increase the risk of adverse pregnancy outcomes, thus emphasizing the importance of appropriate intrapartum management of these high-risk pregnancies.","PeriodicalId":192418,"journal":{"name":"The Journal of reproductive medicine","volume":"60 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2004-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"120","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Journal of reproductive medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/01.OGX.0000137615.96233.53","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 120

Abstract

OBJECTIVE To determine the rate, obstetric characteristics and perinatal outcome of pregnancies with uterine leiomyomas. STUDY DESIGN A population-based study comparing all singleton deliveries between the years 1988 and 1999 in women with and without uterine leiomyomas was performed. Patients lacking prenatal care were excluded from the analysis. Multivariable analysis, adjusting for possible confounders, such as maternal age, parity and gestational age, was performed to investigate associations between uterine leiomyomas and selected outcomes. RESULTS There were 105,909 singleton deliveries with 690 (0.65%) complicated by uterine leiomyomas during the study period. Using a multivariable analysis, the following conditions were significantly associated with uterine leiomyomas: nulliparity (odds ratio [OR]=4.0, 95% confidence interval [CI] 3.3-4.7, P<.001), chronic hypertension (OR=1.9, 95% CI 1.6-2.4, P<.001), hydramnios (OR=1.5, 95% CI 1.2-2.0, P<.001), diabetes mellitus (OR=1.4, 95% CI 1.1-1.7, P=.001) and advanced maternal age (OR=1.2, 95% CI 1.1-1.2, P<.001). Higher rates of perinatal mortality (2.2% vs. 1.2%, OR=1.8, 95% CI 1.1-3.2, P<.001) were found in the uterine leiomyoma group as compared to the control group. While adjusting for maternal age, parity, gestational age and malpresentation, pregnancies with uterine leiomyomas had higher rates of cesarean deliveries (OR=6.7, 95% CI 5.5-8.1, P<.001), placental abruption (OR=2.6, 95% CI 1.6-4.2, P<.001) and preterm deliveries (<36 weeks' gestation, OR=1.4, 95% CI 1.1-1.7, P=.009) as compared to pregnancies without uterine leiomyomas. Conversely, no significant differences were noted regarding perinatal mortality (OR=1.4, 95% CI 0.7-2.8, P=.351) after controlling for maternal age, parity and gestational age using a multivariable analysis. CONCLUSION Uterine leiomyomas increase the risk of adverse pregnancy outcomes, thus emphasizing the importance of appropriate intrapartum management of these high-risk pregnancies.

查看原文本刊更多论文

子宫平滑肌瘤妊娠的产科特征和围产儿结局。

目的探讨妊娠合并子宫平滑肌瘤的发生率、产科特点及围产儿结局。研究设计进行了一项基于人群的研究，比较了1988年至1999年间患有和不患有子宫平滑肌瘤的女性的所有单胎分娩。缺乏产前护理的患者被排除在分析之外。多变量分析，调整了可能的混杂因素，如母亲年龄、胎次和胎龄，以调查子宫平滑肌瘤与选定结局之间的关系。结果本研究期间共发生单胎分娩105909例，其中690例(0.65%)合并子宫平滑肌瘤。通过多变量分析，以下情况与子宫平滑肌瘤显著相关:子宫无产(优势比[OR]=4.0, 95%可信区间[CI] 3.3-4.7, P<.001)、慢性高血压(OR=1.9, 95% CI 1.6-2.4, P<.001)、羊水(OR=1.5, 95% CI 1.2-2.0, P<.001)、糖尿病(OR=1.4, 95% CI 1.1-1.7, P=.001)和高龄产妇(OR=1.2, 95% CI 1.1-1.2, P<.001)。子宫平滑肌瘤组围产期死亡率高于对照组(2.2% vs. 1.2%， OR=1.8, 95% CI 1.1-3.2, P<.001)。在调整了产妇年龄、胎次、胎龄和胎位不良等因素后，子宫平滑肌瘤妊娠比无子宫平滑肌瘤妊娠有更高的剖宫产率(OR=6.7, 95% CI 5.5-8.1, P< 0.001)、胎盘早剥(OR=2.6, 95% CI 1.6-4.2, P< 0.001)和早产(<36周妊娠，OR=1.4, 95% CI 1.1-1.7, P= 0.009)。相反，在使用多变量分析控制了产妇年龄、胎次和胎龄后，围产期死亡率没有显著差异(OR=1.4, 95% CI 0.7-2.8, P= 0.351)。结论子宫平滑肌瘤增加了不良妊娠结局的发生风险，强调了对子宫平滑肌瘤高危妊娠进行适当的产时处理的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

The Journal of reproductive medicine

自引率

0.00%

发文量