Complications in pregnancy, labor, and delivery with uterine leiomyomas

A population-based study

Gloria D. Coronado, Lynn Marshall, Stephen M. Schwartz

Research output: Contribution to journalArticle

196 Citations (Scopus)

Abstract

Objective: To determine the extent to which uterine leiomyomas are associated with characteristics of pregnancy, labor, and neonatal outcome recorded on birth certificates. Methods: In a population-based series of women who delivered singleton live infants in Washington state from 1987-1993, we linked computerized birth certificates and hospital discharge records to investigate the relationship between uterine leiomyomas and complications in pregnancy and delivery. Subjects were 2065 women with uterine leiomyomas noted on computerized hospital discharge records. From the remaining records, a comparison group of women without uterine leiomyomas diagnoses were selected at random and frequency-matched by birth year to women with leiomyomas. We used unconditional logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of pregnancy or delivery complications in relation to uterine leiomyomas after multivariate adjustment. Results: Women with leiomyomas were more likely than controls to be over age 35 at delivery, nulliparous, or black. We observed independent associations between uterine leiomyomas and abruptio placentae (OR 3.87, 95% CI 1.63, 9.17), first trimester bleeding (OR 1.82, 95% CI 1.05, 3.20), dysfunctional labor (OR 1.85, 95% CI 1.26, 2.72), and breech presentation (OR 3.98, 95% CI 3.07, 5.16). The risk of cesarean was also higher among women with uterine leiomyomas (OR 6.39, 95% CI 5.46, 7.50), but a portion of the excess risk might have been due to biased detection of leiomyomas at cesarean delivery. Conclusion: Leiomyomas appear to increase likelihood of complications during pregnancy, labor, and delivery. Copyright (C) 2000 The American College of Obstetricians and Gynecologists.

Original languageEnglish (US)
Pages (from-to)764-769
Number of pages6
JournalObstetrics and Gynecology
Volume95
Issue number5
DOIs
StatePublished - May 2000
Externally publishedYes

Fingerprint

Pregnancy Complications
Leiomyoma
Population
Odds Ratio
Confidence Intervals
Birth Certificates
Hospital Records
Breech Presentation
Abruptio Placentae
Pregnancy
First Pregnancy Trimester
Logistic Models
Parturition
Hemorrhage

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Complications in pregnancy, labor, and delivery with uterine leiomyomas : A population-based study. / Coronado, Gloria D.; Marshall, Lynn; Schwartz, Stephen M.

In: Obstetrics and Gynecology, Vol. 95, No. 5, 05.2000, p. 764-769.

Research output: Contribution to journalArticle

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abstract = "Objective: To determine the extent to which uterine leiomyomas are associated with characteristics of pregnancy, labor, and neonatal outcome recorded on birth certificates. Methods: In a population-based series of women who delivered singleton live infants in Washington state from 1987-1993, we linked computerized birth certificates and hospital discharge records to investigate the relationship between uterine leiomyomas and complications in pregnancy and delivery. Subjects were 2065 women with uterine leiomyomas noted on computerized hospital discharge records. From the remaining records, a comparison group of women without uterine leiomyomas diagnoses were selected at random and frequency-matched by birth year to women with leiomyomas. We used unconditional logistic regression to estimate odds ratios (ORs) and 95{\%} confidence intervals (CIs) of pregnancy or delivery complications in relation to uterine leiomyomas after multivariate adjustment. Results: Women with leiomyomas were more likely than controls to be over age 35 at delivery, nulliparous, or black. We observed independent associations between uterine leiomyomas and abruptio placentae (OR 3.87, 95{\%} CI 1.63, 9.17), first trimester bleeding (OR 1.82, 95{\%} CI 1.05, 3.20), dysfunctional labor (OR 1.85, 95{\%} CI 1.26, 2.72), and breech presentation (OR 3.98, 95{\%} CI 3.07, 5.16). The risk of cesarean was also higher among women with uterine leiomyomas (OR 6.39, 95{\%} CI 5.46, 7.50), but a portion of the excess risk might have been due to biased detection of leiomyomas at cesarean delivery. Conclusion: Leiomyomas appear to increase likelihood of complications during pregnancy, labor, and delivery. Copyright (C) 2000 The American College of Obstetricians and Gynecologists.",
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