Leiomyomas do not increase risk of spontaneous abortion
The risk of spontaneous abortion does not appear to increase in the presence of leiomyoma, according to a study.
Researchers performed a systematic review and meta-analysis of studies evaluating the risk of spontaneous abortion among pregnant women of typical reproductive potential with and without uterine leiomyomas.
Exclusion criteria were the failure to use imaging to uniformly document leiomyoma status of all participants, the absence of a comparison group without leiomyomas, or the primary inclusion of women seeking care for recurrent miscarriage, infertility care or assisted reproductive technologies.
The final analysis included nine studies, of which five recruited general obstetric populations and four included women undergoing amniocentesis. In five studies in general obstetric populations, which involved 21,829 pregnancies in 1,394 women with leiomyomas and 20,435 without, only one adjusted for potential confounders.
Pooled data showed that the risk of spontaneous abortion was not significantly different between women with and without leiomyomas (11.5 vs 8.0 percent; risk ratio [RR], 1.16; 95 percent CI, 0.80 to 1.52). RR dropped to 0.83 (0.68 to 0.98) when bias from confounding was estimated for nonadjusted studies.
Findings of the present analysis challenge the common clinical belief of uterine leiomyomas as a risk factor for spontaneous abortion in women of typical reproductive potential, researchers said.
“The misconception that leiomyomas increase risk of spontaneous abortion in the general population may lead to undue anxiety for patients with leiomyomas, inappropriate risk counseling or the recommendation of unnecessary surgeries,” they pointed out.