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Clinical Trial
. 2023 Apr:80:43-52.
doi: 10.1016/j.annepidem.2023.02.008. Epub 2023 Feb 21.

Leiomyomata, neonatal anthropometry, and pregnancy outcomes in singleton pregnancies

Susanna D Mitro  1 , Rajeshwari Sundaram  1 , Zhen Chen  1 , Shyamal Peddada  1 , Germaine M Buck Louis  2 , Cuilin Zhang  3 , Jagteshwar Grewal  1 , Jessica L Gleason  1 , Anthony C Sciscione  4 , Katherine L Grantz  5
Affiliations
Clinical Trial

Leiomyomata, neonatal anthropometry, and pregnancy outcomes in singleton pregnancies

Susanna D Mitro et al. Ann Epidemiol. 2023 Apr.

Abstract

Purpose: To investigate the relationship of fibroids in pregnancy, preterm birth, and neonatal anthropometry.

Methods: Pregnant women (n = 2578) in the National Institute of Child Health and Human Development Fetal Growth Studies-Singletons cohort had up to six ultrasounds across pregnancy. Sonographers recorded fibroid number and volume of the three largest fibroids. Trained personnel measured neonatal anthropometry. Linear and logistic regression compared neonatal anthropometry and pregnancy outcomes among pregnancies with versus without fibroids. Causal mediation analysis evaluated preterm birth as a mediator.

Results: Average birthweight did not differ by fibroid status. However, compared with pregnancies without fibroids, neonates from pregnancies with single fibroids had 0.3- (95% confidence interval [CI], 0.0, 0.5) cm larger head circumferences; those with multiple fibroids had 0.3- (95% CI, 0.0, 0.6) cm larger arm circumferences; and those with small fibroid volume had 0.7- (95% CI, 0.3, 1.2) cm larger head, 0.4- (95% CI, 0.0, 0.8) cm larger arm, and 0.7- (95% CI, 0.1, 1.3) cm larger thigh circumferences. Presence versus absence of fibroids was associated with 1.73-2.65 times higher odds of preterm birth. Differences in preterm birth did not explain fibroid-anthropometry results.

Conclusions: We found no evidence that fibroids negatively impacted fetal growth; instead, fibroids were associated with increased head, arm, and thigh circumferences.

Clinical trial registration: ClinicalTrials.gov, NCT00912132.

Keywords: Birthweight; Fibroid; Preterm birth.

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Conflict of interest statement

Conflict of interest disclosure: The authors declare that they have no conflicts of interest.

Declaration of interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1.
Figure 1.
Associations between fibroid characteristics and neonatal circumference measurements. Estimates are mean differences and 95% confidence intervals from linear regression models for head, mid-upper arm, mid-upper thigh, abdominal, chest, and umbilical circumferences comparing neonates from pregnancies in each fibroid exposure category to those without fibroids at any visit. Models adjusted for race/ethnicity, age, maternal height, education, marital status, employment status, pre-pregnancy body mass index, and infant sex. Dotted line indicates 0 (no difference between groups).
Figure 2.
Figure 2.
Associations between fibroid characteristics and neonatal skinfold thickness measurements. Estimates are mean differences and 95% confidence intervals from linear regression models for subscapular, triceps, abdominal flank, and anterior thigh skinfold thicknesses, comparing neonates from pregnancies in each fibroid exposure category to those without fibroids at any visit. Models adjusted for race/ethnicity, age, maternal height, education, marital status, employment status, pre-pregnancy body mass index, and infant sex. Dotted line indicates 0 (no difference between groups).
Figure 3.
Figure 3.
Associations between fibroid characteristics and neonatal circumference measurements, stratified by cohort (with obesity and low-risk). Estimates are mean differences and 95% confidence intervals from linear regression models for head, mid-upper arm, mid-upper thigh, abdominal, chest, and umbilical circumferences comparing neonates from pregnancies in each fibroid exposure category to those without fibroids at any visit. Models adjusted for race/ethnicity, age, maternal height, education, marital status, employment status, pre-pregnancy body mass index, and infant sex. Dotted line indicates 0 (no difference between groups).
Figure 4.
Figure 4.
Associations between fibroid characteristics and neonatal skinfold thickness measurements, stratified by cohort (with obesity and low-risk). Estimates are mean differences and 95% confidence intervals from linear regression models for subscapular, triceps, abdominal flank, and anterior thigh skinfold thicknesses, comparing neonates from pregnancies in each fibroid exposure category to those without fibroids at any visit. Models adjusted for race/ethnicity, age, maternal height, education, marital status, employment status, pre-pregnancy body mass index, and infant sex. Dotted line indicates 0 (no difference between groups).
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