Wang Xiuling, Wang Gui, Han Ru, Gao Mei, Wang Fangmin, Hong Yarong, Chen Qiuxia
Infection and Disease Control Section, Haikou Maternal and Child Health Hospital, Haikou, China.
Department of Obstetrics and Gynecology, Tunchang People's Hospital, Tunchang, China.
Transl Pediatr. 2022 Jun;11(6):978-986. doi: 10.21037/tp-22-215.
Uterine fibroids may cause preterm birth. This meta-analysis evaluates the effect of uterine fibroids on the risk of preterm birth and other obstetric outcomes.
Using the literature review method, the databases PubMed, Medline, Embase and Central were retrieved to obtain relevant research literature. The selected studies were analyzed and evaluated. The literature was a cohort study or a case-control study of pregnant women as the research object and uterine fibroids as the exposure factor to observe adverse events during pregnancy. The chi-square test was used to test for heterogeneity. Subgroup analyses were used to explore sources of heterogeneity. Publication bias was assessed using Egger's test. Enumeration data were described by odds ratio (OR). Measurement data were described by mean difference (MD). Calculate the confidence interval (CI).
A total of 11 studies were included in this study, including 7 cohort studies and 4 case-control studies, with a total of 313,913 women. The probability of uterine fibroids among women was 3.99%. The results of meta-analysis showed that women with uterine fibroids experienced preterm birth <37 weeks (OR =1.43, 95% CI: 1.25 to 1.64, P<0.00001), preterm birth <34 weeks (OR =1.73, 95% CI: 1.34 to 2.25, P<0.0001), premature rupture of membranes (OR =1.38, 95% CI: 1.08 to 1.75, P=0.009), placental abruption (OR =1.60, 95% CI: 1.20 to 2.14, P=0.001), cesarean section (OR =2.09, 95% CI: 1.69 to 2.58, P<0.00001), and postpartum hemorrhage (OR =2.95, 95% CI: 1.86 to 4.66, P<0.00001) were all at higher risk, and the mean gestational age at delivery [mean difference (MD) =-0.58, 95% CI: -0.66 to -0.51, P<0.00001] and birth weight (MD =-117.82, 95% CI: -155.19 to -80.45, P<0.00001) were lower. Egger's test indicated that there was no publication bias among the included studies (P>0.05).
Pregnant women with uterine fibroids are at higher risk for preterm birth and other adverse obstetric outcomes and require closer monitoring.
子宫肌瘤可能导致早产。本荟萃分析评估子宫肌瘤对早产风险及其他产科结局的影响。
采用文献回顾法，检索PubMed、Medline、Embase和Central数据库以获取相关研究文献。对所选研究进行分析和评估。文献为以孕妇为研究对象、子宫肌瘤为暴露因素观察孕期不良事件的队列研究或病例对照研究。采用卡方检验检测异质性。进行亚组分析以探索异质性来源。使用Egger检验评估发表偏倚。计数资料用比值比（OR）描述。计量资料用均数差（MD）描述。计算置信区间（CI）。
本研究共纳入11项研究，其中队列研究7项，病例对照研究4项，共313913名女性。女性患子宫肌瘤的概率为3.99%。荟萃分析结果显示，患有子宫肌瘤的女性发生<37周早产（OR =1.43，95%CI：1.25至1.64，P<0.00001）、<34周早产（OR =1.73，95%CI：1.34至2.25，P<0.0001）、胎膜早破（OR =1.38，95%CI：1.08至1.75，P=0.009）、胎盘早剥（OR =1.60，95%CI：1.20至2.14，P=0.001）、剖宫产（OR =2.09，95%CI：1.69至2.58，P<0.00001）及产后出血（OR =2.95，95%CI：1.86至4.66，P<0.00001）的风险均更高，且平均分娩孕周[均数差（MD）=-0.58，95%CI：-0.66至-0.51，P<0.00001]和出生体重（MD =-117.82，95%CI：-155.19至-80.45，P<0.00001）更低。Egger检验表明纳入研究间不存在发表偏倚（P>0.05）。
患有子宫肌瘤的孕妇发生早产及其他不良产科结局的风险更高，需要更密切的监测。
