Preterm Deliveries in Women with Uterine Myomas: The Japan Environment and Children's Study.

Tsuyoshi Murata,Seiji Yasumura,Keiya Fujimori,Koichi Hashimoto,Hidekazu Nishigori,Shun Yasuda,Yuka Ogata,Mitsuaki Hosoya,Hyo Kyozuka,Akiko Yamaguchi,Yuta Endo,Kosei Shinoki,Toma Fukuda,Akiko Sato,The Japan Environment Children’S Study (Jecs) Group

doi:10.3390/ijerph18052246

Abstract

This study aimed to clarify the association between uterine myomas and preterm birth (PTB), preterm premature rupture of membranes (pPROM), and intrauterine infection (II). The study was based on data from the Japan Environment and Children’s Study, a nationwide birth-cohort study. Data of 86,370 women with singleton births after 22 weeks of gestation (with uterine myomas, n = 5354) were retrospectively analyzed. Using logistic regression, adjusted odds ratios (aORs) for PTB, pPROM, and II were calculated considering women without uterine myomas as the reference. Additionally, the effects of II on the incidence of PTB and pPROM were evaluated. In women with uterine myomas, the aORs for PTB before 37 and 34 weeks, pPROM, and II were 1.37 (95% confidence interval, 1.22–1.54), 1.61 (1.27–2.05), 1.65 (1.33–2.04), and 1.05 (0.75–1.46), respectively. The aORs for PTB and pPROM in women with II and uterine myomas were not significantly increased. Uterine myomas during pregnancy were associated with an increased incidence of PTB and pPROM. However, II in women with uterine myomas was not associated with an increased incidence of PTB or pPROM. These findings suggest a potential risk of occult PTB in pregnant women with uterine myomas.

Highlights

A previous retrospective cohort study, in which the prevalence of uterine myomas was approximately 3%, found that uterine myomas during pregnancy were significantly associated with an increased incidence of preterm birth (PTB) before 37 weeks and 34 weeks
Is likely to increase the potential risk of adverse neonatal outcomes in women with uterine myomas. These findings suggested that obstetricians should communicate the fact that uterine myomas during pregnancy may be associated with an increased incidence of premature rupture of membranes (pPROM) and PTB to pregnant women
PTB and pPROM were not associated with II in women with uterine myomas

Summary

Introduction

Uterine myomas ( known as leiomyomata, fibroids, fibromyomas, leiomyofibromas, and fibroleiomyomas) are benign tumors that originate from clonal proliferation of smooth muscle cells of the uterus; they are common among women of reproductive age, with a prevalence of 20–60% [1,2]. The prevalence of uterine myomas in pregnant women has been reported as 0.4–10.7%; there is conflicting evidence regarding the obstetric outcomes in this group [1,2]. Some studies have reported no increased risk of adverse pregnancy outcomes [3,4,5], other studies have found that uterine myomas during pregnancy increase the risk of preterm birth (PTB) [1,2,6,7].

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