Abstract
The aim of this study was to investigate the effect of childbirth and breastfeeding on uterine fibroids and to identify the factors associated with size variations. This was a monocenter observational study carried on women with a sonographic diagnosis of uterine fibroids from January 2007 to December 2016, with no indication for immediate treatment, and who became pregnant within one year from diagnosis. All patients were re-evaluated six months after delivery. Fibroid diameters were compared between pre-pregnancy period, first, second, third trimester and post-delivery. The rate of “regressed” (growth of diameter <−40%), “unchanged” (growth of diameter between −40% and +40%) or “increased” (growth of diameter >+40%) fibroids at the post-delivery evaluation with respect to the pre-pregnancy state was calculated. One-hundred fifty-seven women were included in the final analysis. At the post-delivery ultrasound, a significant reduction of the fibroid diameter with respect to all previous examinations was observed, and there was no evidence of 67 (37.2%) fibroids. Ongoing breastfeeding was positively associated with an “unchanged” or “regressed” fibroid diameter (adOR 3.23, 95%CI: 1.35–7.70, p < 0.01). Smaller pre-gravidic fibroids were more likely to return to pre-pregnancy dimensions or to regress, with a cut-off of 32 mm for lactating women and of 26 mm for non-lactating women. In conclusion, fibroids seem to return to pre-pregnancy dimensions or to regress in the post-partum period. This process may be sustained by uterine involution and hormonal variations, with an additional role of breastfeeding.
Highlights
ObjectivesThe aim of this study was to investigate the effect of childbirth and breastfeeding on uterine fibroids and to identify the factors associated with size variations
Age 34.6 ± 4.9 Body Mass Index 24.7 ± 3.7 Tobacco use 9 (6.8)No previous pregnancies 1 (0–1) Nulliparous 57 (38.9)Ongoing breastfeeding 90 (60.8)Obstetric outcomes
Analyzing the percentage of “unchanged” or “regressed” fibroids at the post-delivery ultrasound according to ongoing breastfeeding, we found that the rate of “unchanged” or “regressed” fibroids was significantly higher in women with a pre-pregnancy fibroid diameter of 10–20 mm or 21–30 mm who were breastfeeding with respect of women who were not lactating, while there was no difference in case of higher pre-pregnancy diameters (Table 4)
Summary
The aim of this study was to investigate the effect of childbirth and breastfeeding on uterine fibroids and to identify the factors associated with size variations
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