Photo Credit: Wildpixel

The following is a summary of “Influence of uterine fibroids on adverse outcomes in pregnant women: a meta-analysis,” published in the May 2024 issue of Obstetrics & Gynecology by Li et al. 

Researchers conducted a retrospective study to examine the impact of large uterine fibroids (≥ 5 cm) on pregnancy outcomes. 

They searched PubMed, Embase, Web of Science, ClinicalTrials.gov, CNKI, and SinoMed databases for studies on uterine fibroids and pregnancy outcomes. Pooled risk ratios (RR) were calculated using fixed or random effect models. 

The results showed that 24 studies with 237,509 participants indicated that fibroids increased the risk of preterm birth, cesarean delivery, placenta previa, miscarriage, preterm premature rupture of membranes (PPROM), placental abruption, postpartum hemorrhage (PPH), fetal distress, malposition, intrauterine fetal death, low birth weight, breech presentation, and preeclampsia. After adjusting for potential factors, negative effects were seen for preterm birth, cesarean delivery, placenta previa, placental abruption, PPH, intrauterine fetal death, breech presentation, and preeclampsia. Subgroup analysis revealed that larger fibroids were linked to significantly elevated risks of breech presentation, PPH, and placenta previa, while multiple fibroids did not increase the risk of these outcomes. Meta-regression analyses showed that maternal age affected preterm birth, and BMI influenced intrauterine fetal death, with no impact from other confounding factors on malposition, fetal distress, PPROM, miscarriage, placental abruption, and PPH. 

They concluded that larger uterine fibroids increased the risk of breech presentation, PPH, and placenta previa, while fibroid number had no impact. 

Source: pmc.ncbi.nlm.nih.gov/articles/PMC11071265/