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Multicenter Study
. 2017 Nov 14;12(11):e0187821.
doi: 10.1371/journal.pone.0187821. eCollection 2017.

Adverse obstetric outcomes in pregnant women with uterine fibroids in China: A multicenter survey involving 112,403 deliveries

Rong Zhao  1 , Xin Wang  1 , Liying Zou  1 , Guanghui Li  1 , Yi Chen  1 , Changdong Li  1 , Weiyuan Zhang  1
Affiliations
Multicenter Study

Adverse obstetric outcomes in pregnant women with uterine fibroids in China: A multicenter survey involving 112,403 deliveries

Rong Zhao et al. PLoS One. .

Abstract

Objective: To estimate the association between uterine fibroids and adverse obstetric outcomes.

Methods: This was a retrospective cross-sectional study of 112,403 deliveries from 14 provinces and 39 different hospitals in 2011 in mainland China. We compared pregnancy outcomes in women with and without uterine fibroids who underwent detailed second trimester obstetric ultrasonography during 18 to 22 weeks. Obstetric outcomes include cesarean delivery, breech presentation, preterm delivery, placenta previa, placental abruption, premature rupture of membranes and neonatal birthweight. Univariate analyses and multivariate logistic regression analyses were performed.

Results: Of 112,403 women who underwent routine obstetric survey, 3,012 (2.68%) women were identified with at least 1 fibroid. By univariate and multivariate analyses, the presence of uterine fibroids was significantly associated with cesarean delivery (Adjusted odds radio [AOR] 1.8, 95% confidence interval [CI] 1.7-2.0), breech presentation (AOR 1.3, 95% CI 1.2-1.5) and postpartum hemorrhage (AOR 1.2, 95% CI 1.1-1.4). The size of uterine fibroids and location in uterus had important effect on the mode of delivery. The rates of PPH were significantly higher with increasing size of the uterine fibroid (P<0.001). And the location of fibroid (intramural, submucosal or subserosal) also have a statistically significant impact on the risk of PPH (5.6% [subserosal] vs 4.7% [submucosal] vs 8.6% [intramural]).

Conclusion: Pregnant women with uterine fibroids are at increased risk for cesarean delivery, breech presentation and postpartum hemorrhage. And different characteristics of uterine fibroids affect obstetric outcomes through different ways. Such detailed information may be useful in risk-stratifying pregnant women with fibroids.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow progress chart of study population.
See this image and copyright information in PMC

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