Impact of history of myomectomy on preterm birth risk in women with a leiomyomatous uterus: a propensity score analysis
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RESEARCH ARTICLE
Open Access
Impact of history of myomectomy on preterm birth risk in women with a leiomyomatous uterus: a propensity score analysis Emmanuel Rault1, Pierre Delorme2,1, François Goffinet2,1 and Aude Girault2,1*
Abstract Background: To evaluate if women with a history of myomectomy have a modified preterm birth risk compared to women with myomas during pregnancy. Methods: Retrospective cohort study including all women with a history of myomectomy (operated group) or uterine myomas during pregnancy (unoperated group) who delivered in a tertiary center between January, 2011 and December, 2017. The operated group included women who had a myomectomy history with or without myomas during the ongoing pregnancy. The unoperated group included women with uterine myoma(s) seen on at least one ultrasound during pregnancy without history of myomectomy. The primary outcome was preterm birth < 37 weeks, and the secondary outcome spontaneous preterm birth < 37 weeks. To control for confounding factors, a propensity score approach was used. Two sensitivity analysis were performed, one repeating the analysis using the propensity score after excluding operated women with persistent myomas and one using a classical multivariable logistic regression model. Results: The cohort included 576 women: 283 operated women and 293 unoperated women. The rate of preterm birth was similar in the two groups: 12.6% in the unoperated group and 12.0% in the operated group (p = 0.82). No difference in preterm birth risk was shown between unoperated and operated women in the cohort matched on the propensity score: OR 0.86; 95%CI [0.47–1.59]. These results were consistent for spontaneous preterm birth (OR 1.61; 95%CI [0.61–4.23]) and for the sensitivity analyses. Conclusion: In women with a leiomyomatous uterus, a history of myomectomy is not associated with a reduced preterm birth risk. Keywords: Myomas, Preterm birth, Myomectomy, Spontaneous preterm birth
* Correspondence: [email protected] 2 Université de Paris, INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, FHU PREMA, Université de Paris, 123 boulevard Port Royal, 75014 Paris, France 1 Maternité Port Royal, AP-HP, Hôpital Cochin, FHU PREMA, F-75014 Paris, France © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permi
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