{
    "abstract": "The objective of the meta-analysis was to determine the influence of uterine fibroids on adverse outcomes, with specific emphasis on multiple or large (\u2265\u20095\u00a0cm in diameter) fibroids.\nWe searched PubMed, Embase, Web of Science, ClinicalTrials.gov, China National Knowledge Infrastructure (CNKI), and SinoMed databases for eligible studies that investigated the influence of uterine fibroids on adverse outcomes in pregnancy. The pooled risk ratio (RR) of the variables was estimated with fixed effect or random effect models.\nTwenty-four studies with 237 509 participants were included. The pooled results showed that fibroids elevated the risk of adverse outcomes, including preterm birth, cesarean delivery, placenta previa, miscarriage, preterm premature rupture of membranes (PPROM), placental abruption, postpartum hemorrhage (PPH), fetal distress, malposition, intrauterine fetal death, low birth weight, breech presentation, and preeclampsia. However, after adjusting for the potential factors, negative effects were only seen for preterm birth, cesarean delivery, placenta previa, placental abruption, PPH, intrauterine fetal death, breech presentation, and preeclampsia. Subgroup analysis showed an association between larger fibroids and significantly elevated risks of breech presentation, PPH, and placenta previa in comparison with small fibroids. Multiple fibroids did not increase the risk of breech presentation, placental abruption, cesarean delivery, PPH, placenta previa, PPROM, preterm birth, and intrauterine growth restriction. Meta-regression analyses indicated that maternal age only affected the relationship between uterine fibroids and preterm birth, and BMI influenced the relationship between uterine fibroids and intrauterine fetal death. Other potential confounding factors had no impact on malposition, fetal distress, PPROM, miscarriage, placenta previa, placental abruption, and PPH.\nThe presence of uterine fibroids poses increased risks of adverse pregnancy and obstetric outcomes. Fibroid size influenced the risk of breech presentation, PPH, and placenta previa, while fibroid numbers had no impact on the risk of these outcomes.",
    "authors": [
        {
            "affiliation": "Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.",
            "firstname": "Hong",
            "initials": "H",
            "lastname": "Li"
        },
        {
            "affiliation": "Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.",
            "firstname": "Zhonghua",
            "initials": "Z",
            "lastname": "Hu"
        },
        {
            "affiliation": "Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.",
            "firstname": "Yuyan",
            "initials": "Y",
            "lastname": "Fan"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, China. haoyy_doc@163.com.",
            "firstname": "Yingying",
            "initials": "Y",
            "lastname": "Hao"
        }
    ],
    "conclusions": "The presence of uterine fibroids poses increased risks of adverse pregnancy and obstetric outcomes. Fibroid size influenced the risk of breech presentation, PPH, and placenta previa, while fibroid numbers had no impact on the risk of these outcomes.",
    "copyrights": "\u00a9 2024. The Author(s).",
    "doi": "10.1186/s12884-024-06545-5\n10.1097/AOG.0b013e3181f7496d\n10.1097/AOG.0b013e318197bbaf\n10.1016/j.bpobgyn.2008.04.002\n10.1016/j.bpobgyn.2015.08.018\n10.1097/01.AOG.0000196806.25897.7c\n10.1155/2013/173184\n10.1093/humrep/dep320\n10.1093/humupd/dmv044\n10.1124/pr.57.3.6\n10.1136/bmj.b2535\n10.1136/bmj.327.7414.557\n10.1016/0197-2456(86)90046-2\n10.2307/2533446\n10.1136/bmj.315.7109.629\n10.1097/01.AOG.0000250470.78700.f0\n10.1371/journal.pone.0187821\n10.1016/j.fertnstert.2011.10.009\n10.1001/jamapsychiatry.2018.0572\n10.1093/humrep/del056\n10.20344/amp.11057\n10.1080/07399330500230912\n10.1001/jama.2014.2269\n10.1111/jog.14343",
    "journal": "BMC pregnancy and childbirth",
    "keywords": [
        "Meta-analysis",
        "Obstetric outcome",
        "Pregnancy",
        "Uterine fibroids"
    ],
    "methods": null,
    "publication_date": "2024-05-07",
    "pubmed_id": "38710995\n20966689\n19300327\n18534913\n10775744\n26527305\n23926501\n16449127\n24163697\n19740897\n2296420\n26395640\n22409539\n16109840\n19622551\n31462531\n27733354\n12958120\n3802833\n7786990\n9310563\n17267843\n30153432\n24803127\n29136018\n22100166\n29800984\n16517557\n29681506\n30946794\n16214797\n24737366\n29092661\n32633025\n27844480",
    "results": "Twenty-four studies with 237 509 participants were included. The pooled results showed that fibroids elevated the risk of adverse outcomes, including preterm birth, cesarean delivery, placenta previa, miscarriage, preterm premature rupture of membranes (PPROM), placental abruption, postpartum hemorrhage (PPH), fetal distress, malposition, intrauterine fetal death, low birth weight, breech presentation, and preeclampsia. However, after adjusting for the potential factors, negative effects were only seen for preterm birth, cesarean delivery, placenta previa, placental abruption, PPH, intrauterine fetal death, breech presentation, and preeclampsia. Subgroup analysis showed an association between larger fibroids and significantly elevated risks of breech presentation, PPH, and placenta previa in comparison with small fibroids. Multiple fibroids did not increase the risk of breech presentation, placental abruption, cesarean delivery, PPH, placenta previa, PPROM, preterm birth, and intrauterine growth restriction. Meta-regression analyses indicated that maternal age only affected the relationship between uterine fibroids and preterm birth, and BMI influenced the relationship between uterine fibroids and intrauterine fetal death. Other potential confounding factors had no impact on malposition, fetal distress, PPROM, miscarriage, placenta previa, placental abruption, and PPH.",
    "title": "The influence of uterine fibroids on adverse outcomes in pregnant women: a meta-analysis.",
    "xml": "<Element 'PubmedArticle' at 0x7885051df790>"
}