School of Public Health, Taipei Medical University, Taipei, Taiwan, Republic of China.
Hum Reprod. 2009 Dec;24(12):3049-56. doi: 10.1093/humrep/dep320. Epub 2009 Sep 9.
Using a 3-year nationwide population-based database, this study examines the risk of adverse pregnancy outcomes [lower birthweight, preterm gestation and babies small for gestational age (SGA)] in pregnant women with uterine leiomyoma.
This study linked two data sets: Taiwan's birth certificate registry and its National Health Insurance Research Data set. A total of 5627 mothers with uterine leiomyoma and 28 135 unaffected mothers were included for analysis. After adjusting for mother and infant characteristics and monthly family income, log-binominal regression and multivariate regression analyses were conducted to examine the risks of preterm birth, SGA and lower birthweight among mothers with uterine leiomyoma and unaffected mothers.
Women with uterine leiomyoma had a significantly higher percentage of preterm births (10.98 versus 7.78%, P < 0.001) and SGA infants (19.00 versus 17.28%, P = 0.002) than unaffected mothers. The mean birthweights for mothers with and without uterine leiomyoma were 3083 and 3172 g, respectively (P < 0.001). Log-binominal regression models show that the adjusted risk ratios of preterm births and SGA infants for mothers with uterine leiomyoma were 1.32 (95% CI 1.19-1.46) and 1.16 (95% CI 1.08-1.26), respectively, compared with unaffected mothers. After finally adjusting for gestational age and other covariates, a multivariate regression analysis revealed that women with uterine leiomyoma had, on average, a 14.7 g lower birthweight than unaffected mothers (P = 0.022).
We concluded that after adjusting for potential confounders, women with uterine leiomyoma experience a small yet significant increased risk of preterm and SGA infants. We suggest that clinicians intensively monitor women with uterine leiomyoma during pregnancy.
本研究利用一个为期 3 年的全国人口基础数据库，考察了子宫肌瘤孕妇不良妊娠结局（低出生体重、早产和胎儿小于胎龄（SGA））的风险。
本研究将两个数据集进行了关联：台湾的出生证明登记处和其全民健康保险研究数据集。共纳入了 5627 名子宫肌瘤母亲和 28135 名未受影响的母亲进行分析。在调整了母婴特征和每月家庭收入后，采用对数二项式回归和多元回归分析，以检验子宫肌瘤母亲和未受影响母亲的早产、SGA 和低出生体重风险。
子宫肌瘤母亲的早产率（10.98%比 7.78%，P<0.001）和 SGA 婴儿的比例（19.00%比 17.28%，P=0.002）明显高于未受影响的母亲。有和没有子宫肌瘤的母亲的平均出生体重分别为 3083 和 3172g（P<0.001）。对数二项式回归模型显示，与未受影响的母亲相比，患有子宫肌瘤的母亲早产和 SGA 婴儿的调整风险比分别为 1.32（95%CI 1.19-1.46）和 1.16（95%CI 1.08-1.26）。最终调整了胎龄和其他协变量后，多元回归分析显示，患有子宫肌瘤的女性平均出生体重比未受影响的母亲低 14.7g（P=0.022）。
我们的结论是，在调整了潜在混杂因素后，患有子宫肌瘤的女性早产和 SGA 婴儿的风险略有增加，但具有统计学意义。我们建议临床医生在怀孕期间对患有子宫肌瘤的女性进行密切监测。
