Table 3.
Association between history of uterine fibroids prior to delivery and adverse pregnancy outcomes among deliveries to women aged ≥ 18 in Massachusetts between October 1, 2013-December 31, 2017
| No history of uterine fibroids | History of uterine fibroids | Relative Risk (95% Confidence Interval)1 | |||||
|---|---|---|---|---|---|---|---|
| n | % | n | % | Crude | Adjusted1 | Adjusted2 | |
| Total deliveries | 87,613 | 100.0 | 4,212 | 100.0 | |||
| Maternal morbidity | |||||||
| Gestational diabetes | 6,716 | 7.7 | 464 | 11.0 | 1.41 (1.29–1.55) | 1.06 (0.97–1.16) | 1.06 (0.96–1.16) |
| PIH3/Eclampsia/Preeclampsia | 9,117 | 10.4 | 536 | 12.7 | 1.20 (1.11–1.31) | 1.12 (1.03–1.21) | 1.08 (0.99–1.17) |
| Caesarean delivery4 | 27,436 | 31.3 | 1,921 | 45.6 | 1.36 (1.31–1.41) | 1.18 (1.14–1.23) | 1.17 (1.13–1.21) |
| Caesarean delivery (primipara only)4 | 13,371 | 31.3 | 978 | 46.7 | 1.49 (1.42–1.57) | 1.22 (1.16–1.28) | 1.20 (1.15–1.27) |
| Placental abnormalities5 | 2,433 | 2.8 | 190 | 4.5 | 1.63 (1.41–1.88) | 1.43 (1.23–1.65) | 1.38 (1.19–1.60) |
| Delivery complications | |||||||
| Total infants | 89,698 | 100.0 | 4,379 | 100.0 | |||
| Total livebirths | 89,458 | 99.7 | 4,361 | 99.6 | |||
| Small for gestational age6 | 6,336 | 7.2 | 292 | 6.9 | 0.93 (0.82–1.04) | 0.97 (0.86–1.09) | 0.97 (0.86–1.09) |
| Low birthweight (<2500 grams) | 5,769 | 6.4 | 409 | 9.4 | 1.03 (0.81–1.32) | 1.12 (1.01–1.24) | 1.09 (0.98–1.20) |
| Preterm birth (<37 weeks) | 6,802 | 7.6 | 513 | 11.8 | 1.00 (0.58–1.72) | 1.21 (1.11–1.33) | 1.17 (1.07–1.29) |
| Neonatal mortality6,7,8 | 177 | 0.2 | 11 | 0.3 | 0.72 (0.17–3.09) | 1.14 (0.58–2.23) | 1.20 (0.61–2.37) |
| Neonatal prolonged hospital stay6,8,9 | 3,751 | 4.4 | 243 | 5.9 | 1.33 (1.17–1.53) | 1.13 (0.99–1.29) | 1.02 (0.90–1.17) |
| Neonatal Conditions | |||||||
| Infectious disease8,10 | 817 | 1.2 | 54 | 1.7 | 1.45 (1.13–1.97) | 1.35 (1.01–1.79) | 1.23 (0.93–1.61) |
| Cardiovascular8,10 | 1,498 | 2.1 | 117 | 3.7 | 1.72 (1.42–2.08) | 1.46 (1.20–1.77) | 1.29 (1.06–1.55) |
| Respiratory8,10 | 11,557 | 16.5 | 667 | 20.9 | 1.26 (1.17–1.36) | 1.19 (1.11–1.28) | 1.12 (1.04–1.20) |
| GI/Nutritional8,10 | 4,371 | 6.2 | 324 | 10.2 | 1.67 (1.48–1.90) | 1.30 (1.16–1.46) | 1.19 (1.05–1.34) |
| Neurologic8,10 | 2,827 | 4.0 | 136 | 4.3 | 1.06 (0.90–1.26) | 1.13 (0.95–1.34) | 1.07 (0.90–1.27) |
| Hematologic8,10 | 9,631 | 13.7 | 606 | 19.0 | 1.41 (1.30–1.52) | 1.08 (1.01–1.17) | 1.02 (0.95–1.10) |
Crude and adjusted relative risk approximated using general estimating equations with a log link and poisson distribution to take into account multiple deliveries by the same women; multivariate models adjusted for maternal age (continuous), body mass index (<25.0, 25.0+, unknown), race (non-Hispanic White, other race/ethnicity, unknown), education (high school + some college, completed college, unknown), plurality (singleton, multiples), and birth year (2013–2017 ordinal categorical variable).
Relative risk additionally adjusted for history of hypertension, diabetes, and endometriosis
PIH: Pregnancy Induced Hypertension
Excluding those with unknown mode of delivery
Placental abnormalities include: ICD 641.0–641.2, 663.5, 667.0, 762.1, O45, P02.1, O43.21, O44, O69
Limited to livebirths only
Neonatal death= 0–27 days after birth
Limited analysis to those whose gestational age ≥ 35 weeks, with known data on mode of delivery and birth hospital records. Prolonged stay defined as > 3 days for vaginal delivery or > 5 days for cesarean delivery
Relative risk additionally adjusted for gestational age (continuous variable, range 17–44), excluding those with unknown GA.
Limited to livebirths October 1, 2013-December 31, 2016 (to allow capture of conditions up to one-year after birth)