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Grand Rounds

Are Fibroids Associated with Miscarriage?

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BACKGROUND AND PURPOSE:

  • Data is conflicting as to whether uterine leiomyomas are associated with miscarriage
    • Studies often include women who are obtaining fertility treatment
  • Sundermann et al. (Obstet Gynecol, 2017) examined the associated risk of spontaneous abortion and uterine leiomyomas in the general population

METHODS:

  • Systematic review and meta-analysis
  • Inclusion: Studies reporting risk of spontaneous abortion among pregnant women with  leiomyomas vs pregnant women without leiomyomas
  • Exclusion: Studies that only included women seeking care for recurrent miscarriage, infertility, or assisted reproductive technologies
  • Data was extracted and reviewed by two authors independently
  • Primary outcome: Spontaneous abortion (definition varied across studies) among recognized pregnancies

RESULTS:

  • 9 studies were included in the systematic analysis and 5 studies were used for the meta-analysis
  • Pooled data for the meta-analysis included 21,829 women
  • In the leiomyoma group, 11.5% has spontaneous abortion compared to 8.0% in the non-leiomyoma group
  • Uterine leiomyomas were not associated with an increased risk of spontaneous abortion
    • Relative risk 1.16, 95% CI 0.80–1.52
    • Significant association was still absent even after adjusting for confounders

CONCLUSION:

  • The presence of leiomyomas was not associated with increased risk of spontaneous abortion
  • Prior studies showing an association did not always adjust for confounders
  • This is the first association review that focused on a general risk population

Learn More – Primary Sources:

Leiomyomas in Pregnancy and Spontaneous Abortion: A Systematic Review and Meta-analysis

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Related ObG Topics:

High-Intensity Focused Ultrasound – An Option for Fibroids
Uterine Artery Embolization, Focused Ultrasound, or Hysterectomy for Fibroids?
From Genetics to Soybeans: What are the Risk Factors for Uterine Fibroids?

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