Fibroids and reproductive outcomes: a systematic literature review from conception to delivery

Peter C. Klatsky, Nam D. Tran, Aaron B. Caughey, Victor Y. Fujimoto

Research output: Contribution to journalArticle

265 Citations (Scopus)

Abstract

We examined the published relationship between uterine fibroids and reproductive outcomes. Submucosal fibroids had the strongest association with lower ongoing pregnancy rates, odds ratio, 0.5; 95% confidence interval, 0.3-0.8, primarily through decreased implantation. Cumulative pregnancy rates appeared slightly lower in patients with intramural fibroids 36.9% vs 41.1%, which may reflect biases in the literature; however, patients with intramural fibroids also experienced more miscarriages, 20.4% vs 12.9%. Adverse obstetric outcomes are rare and may reflect age or other differences in fibroid populations. Increased risk of malpresentation (odds ratio, 2.9; 2.6-3.2), cesarean (odds ratio, 3.7; 3.5-3.9), and preterm delivery (odds ratio, 1.5; 1.3-1.7) are reported; however, the incidence of labor dystocia was low (7.5%). There was no conclusive evidence that intramural or subserosal fibroids adversely affect fecundity. More prospective, controlled trials are needed to assess the effects of myomectomy. Good maternal and neonatal outcomes are expected in pregnancies with uterine fibroids.

Original languageEnglish (US)
Pages (from-to)357-366
Number of pages10
JournalAmerican Journal of Obstetrics and Gynecology
Volume198
Issue number4
DOIs
StatePublished - Apr 2008
Externally publishedYes

Fingerprint

Leiomyoma
Odds Ratio
Pregnancy Rate
Uterine Myomectomy
Dystocia
Spontaneous Abortion
Obstetrics
Fertility
Mothers
Confidence Intervals
Pregnancy
Incidence
Population

Keywords

  • fibroids
  • infertility
  • myomas
  • pregnancy

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Fibroids and reproductive outcomes : a systematic literature review from conception to delivery. / Klatsky, Peter C.; Tran, Nam D.; Caughey, Aaron B.; Fujimoto, Victor Y.

In: American Journal of Obstetrics and Gynecology, Vol. 198, No. 4, 04.2008, p. 357-366.

Research output: Contribution to journalArticle

Klatsky, Peter C. ; Tran, Nam D. ; Caughey, Aaron B. ; Fujimoto, Victor Y. / Fibroids and reproductive outcomes : a systematic literature review from conception to delivery. In: American Journal of Obstetrics and Gynecology. 2008 ; Vol. 198, No. 4. pp. 357-366.
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