Perinatal outcome and long-term pediatric morbidity of pregnancies with a fibroid uterus.
Fibroid uterus
Long term
Offspring morbidity
Perinatal outcome
Uterine leiomyomas
Journal
Early human development
ISSN: 1872-6232
Titre abrégé: Early Hum Dev
Pays: Ireland
ID NLM: 7708381
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
19
12
2018
revised:
01
01
2019
accepted:
02
01
2019
pubmed:
15
1
2019
medline:
14
6
2019
entrez:
15
1
2019
Statut:
ppublish
Résumé
Uterine fibroids are a common morbidity in women and its prevalence is increasing with age. As maternal age rises, fibroids become more prevalent during pregnancy. To assess perinatal outcome and long-term health of children to mothers with uterine fibroids during pregnancy. A population-based cohort analysis assessing long-term hospitalizations of offspring, up to the age of 18 years, due to gastrointestinal, neurological, cardiovascular, endocrine, and respiratory morbidity, following pregnancies diagnosed with and without a fibroid uterus. Multivariable generalized estimating equation (GEE) analysis adjusted for maternal clusters and other possible confounders was performed. Kaplan-Meier survival curves and Cox survival regression models were used to compare cumulative morbidity incidence and control for confounders. All singleton deliveries occurring between 1991 and 2014. Perinatal outcome and long-term pediatric morbidity. A total of 242,445 singleton deliveries were included; 0.5% of which were diagnosed with uterine fibroids (n = 1237). In the GEE multivariable analyses, advanced maternal age, hypertensive disorder and diabetes mellitus, fetal growth restriction, low birthweight (<2500 g), and small for gestational age newborns, were all independently associated with uterine fibroids during pregnancy. Hospitalizations up to the age of 18 years in the different health categories were comparable between the groups, using Cox regression models, controlled for clinically significant confounders in the long-term outcomes. Maternal uterine fibroids appear to negatively impact perinatal outcome, mainly fetal growth. However, no independent major impact on future health of the offspring can be detected.
Sections du résumé
BACKGROUND
Uterine fibroids are a common morbidity in women and its prevalence is increasing with age. As maternal age rises, fibroids become more prevalent during pregnancy.
AIM
To assess perinatal outcome and long-term health of children to mothers with uterine fibroids during pregnancy.
STUDY DESIGN
A population-based cohort analysis assessing long-term hospitalizations of offspring, up to the age of 18 years, due to gastrointestinal, neurological, cardiovascular, endocrine, and respiratory morbidity, following pregnancies diagnosed with and without a fibroid uterus. Multivariable generalized estimating equation (GEE) analysis adjusted for maternal clusters and other possible confounders was performed. Kaplan-Meier survival curves and Cox survival regression models were used to compare cumulative morbidity incidence and control for confounders.
SUBJECTS
All singleton deliveries occurring between 1991 and 2014.
OUTCOME MEASURES
Perinatal outcome and long-term pediatric morbidity.
RESULTS
A total of 242,445 singleton deliveries were included; 0.5% of which were diagnosed with uterine fibroids (n = 1237). In the GEE multivariable analyses, advanced maternal age, hypertensive disorder and diabetes mellitus, fetal growth restriction, low birthweight (<2500 g), and small for gestational age newborns, were all independently associated with uterine fibroids during pregnancy. Hospitalizations up to the age of 18 years in the different health categories were comparable between the groups, using Cox regression models, controlled for clinically significant confounders in the long-term outcomes.
CONCLUSION
Maternal uterine fibroids appear to negatively impact perinatal outcome, mainly fetal growth. However, no independent major impact on future health of the offspring can be detected.
Identifiants
pubmed: 30639463
pii: S0378-3782(18)30734-5
doi: 10.1016/j.earlhumdev.2019.01.004
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
33-37Informations de copyright
Copyright © 2019 Elsevier B.V. All rights reserved.