Abstract
Background Our objective was to evaluate risks of adverse obstetric outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy.Methods We analyzed the national health insurance database, which covers almost the entire Korean population, between 2004 and 2015. The risks of adverse pregnancy outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy, compared to those in women without a diagnosed myoma, were analyzed in multivariate logistic regression analysisResults During the study period, 38,402 women with diagnosed myoma(s), 9,890 women with a history of myomectomy, and 740,675 women without a diagnosed myoma gave birth. Women with a history of diagnosed myoma(s) and women with a history of myomectomy had significantly higher risks of cesarean section (aOR 1.13, 95% CI 1.1-1.16, p = 0.042; and aOR 7.46, 95% CI 6.97-7.98, p < 0.001, respectively) and placenta previa (aOR 1.41, 95% CI 1.29-1.54, p = 0.042; and aOR 1.58, 95% CI 1.35-1.83, p < 0.001, respectively), compared to women without a diagnosed myoma. And the risks of uterine rupture, preterm birth, and low birth weight were significantly higher in women with previous myomectomy but not in women with diagnosed myoma(s), compared to women without a diagnosed myoma (aOR 12.78, 95% CI 6.5-25.13, p < 0.001; aOR 1.64, 95% CI 1.47-1.84, p < 0.001; and aOR 1.53, 95% CI 1.39-1.68, p < 0.001, respectively). The incidence of uterine rupture was the highest at delivery within one year after myomectomy and decreased over time after myomectomy.Conclusions When a woman who might become pregnant later on is diagnosed with uterine myoma, she should be counseled about the risk of myoma(s) and myomectomy on obstetric complications, especially including the significant risk of uterine rupture in pregnancies following myomectomy.
Nationwide population-based cohort study of adverse obstetric outcomes in pregnancies with myoma or following myomectomy: Retrospective cohort study
