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Preterm deliveries affected by mechanical disadvantage in women with uterine myomas: a prospective cohort study from the Japan Environment and Children’s Study
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  • Tsuyoshi Murata,
  • Hyo Kyozuka,
  • Yuta Endo,
  • Toma Fukuda,
  • Shun Yasuda,
  • Akiko Yamaguchi,
  • Akiko Sato,
  • Yuka Ogata,
  • Kosei Shinoki,
  • Mitsuaki Hosoya,
  • Seiji Yasumura,
  • Koichi Hashimoto,
  • Hidekazu Nishigori,
  • Keiya Fujimori
Tsuyoshi Murata
Fukushima Medical University
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Hyo Kyozuka
Fukushima Medical University
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Yuta Endo
Fukushima Medical University
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Toma Fukuda
Fukushima Medical University
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Shun Yasuda
Fukushima Medical University
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Akiko Yamaguchi
Fukushima Medical University
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Akiko Sato
Fukushima Medical University
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Yuka Ogata
Fukushima Medical University
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Kosei Shinoki
Fukushima Medical University
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Mitsuaki Hosoya
Fukushima Medical University
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Seiji Yasumura
Fukushima Medical University
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Koichi Hashimoto
Fukushima Medical University
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Hidekazu Nishigori
Fukushima Medical University
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Keiya Fujimori
Fukushima Medical University
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Abstract

Objective: To evaluate the incidence of adverse pregnancy outcomes (APOs) in women with uterine myomas and clarify the effect of uterine myomas on pregnancy outcomes. Design: Prospective cohort study Setting: The Japan Environment and Children’s Study (between 2011–2014) Population: Women (86,370) with singleton births after 22 weeks of gestation. Methods: Using logistic regression, the adjusted odds ratios (aORs) for APOs were calculated considering women without uterine myomas as the reference. Additionally, we used logistic regression to evaluate the effect of intrauterine infection (II) on the incidence of preterm births (PTB) and preterm premature rupture of membranes (pPROM). Main Outcome Measures: PTB (before 37 and 34 weeks), pPROM, II, and gestational hypertension (GH). Results: In women with uterine myomas, the aORs for PTB before 37 and 34 weeks, pPROM, II, and GH were 1.37 (95% confidence interval [CI], 1.22–1.54), 1.61 (95% CI, 1.27–2.05), 1.65 (95% CI, 1.33–2.04), 1.05 (95% CI, 0.75–1.46), and 1.20 (95% CI, 1.05–1.38), respectively. In women with both uterine myomas and intrauterine infection, the aORs for PTB before 37 weeks and pPROM were not significantly increased. Conclusions: Intra-pregnancy uterine myomas were associated with an increased risk of APOs. II in women with uterine myomas was not associated with PTB or pPROM. These data suggest a potential mechanical disadvantage in pregnant women with uterine myomas. Funding: Ministry of the Environment, Japan Key words: uterine myoma, preterm birth, preterm premature rupture of membrane, intrauterine infection