Association between leiomyoma characteristics and perinatal complications: A retrospective cohort study

Objective

To evaluate the relationship of leiomyoma characteristics with perinatal outcomes.

Methods

A retrospective cohort study was conducted. Women whose pregnancy was complicated with leiomyoma were recruited, and pregnant women without leiomyomas were enrolled as a control group. Demographic data, leiomyoma ultrasound characteristics, and pregnancy outcomes were collected. Subsequently, antepartum, intrapartum, postpartum, and neonatal complications were analyzed.

Results

The overall rate of leiomyomas in pregnancy was 5.46% (4393/80510). Out of the 932 pregnancies studied, 632 were affected by leiomyoma. Women with leiomyomas exhibited significantly higher age, pre-pregnancy BMI, gravidity, and in vitro fertilization-embryo transfer rate. The occurrence of antepartum, intrapartum, and postpartum complications was influenced by different features of leiomyomas. Among leiomyoma with diameter of 9 cm or greater, cervical or submucous types were detrimental. In the multivariate linear regression analyses, a leiomyoma with diameter of at least 9 cm during pregnancy was independently associated with preterm birth, cesarean section, preterm premature rupture of membranes, and postpartum hemorrhage.

Conclusion

The presence of leiomyoma of 9 cm or more increases the risk of antepartum, intrapartum, and postpartum complications; therefore, pre-conception myomectomy can be considered. For leiomyoma 7–9 cm, extensive discussions between patients and clinicians should be conducted. In women with leiomyomas smaller than 7 cm, the risk of obstetric complications is similar to that in women without leiomyomas, except for those with cervical or submucous leiomyomas.