Fibroids May Lead to Stillbirths

A new study shows a definite increase in the incidence of intrauterine fetal death (IUFD), the tragic occurrence more commonly known as stillbirth in those women who suffer from those benign uterine tumors known as intrauterine fibroids. This research was carried out by researchers at Washington University, located in St. Louis, Mo. The study was based on women diagnosed with fibroids during pregnancy. These women were identified by routine ultrasound screens performed during the second trimester of pregnancy. These fetal anatomic surveys are done during weeks 16-22 of gestation.

Common Finding

Dr. Molly J. Stout, one of the study's co-authors commented, "Fibroids are very common. We think they occur in 5% to 20% of all women, but most women are asymptomatic and don't even know they have them."

In total, the study was comprised from data on 64,047 female participants. The data was chosen for its relevance on several scores: maternal socio-demographics, medical history, and obstetrical outcomes. Those pregnancies having fetal anomalies were excluded from the trial. Inclusion in the study was based on having at least one fibroid tumor at the time of the fetal anatomic survey or having had no tumor at all at this time—to provide the necessary control group.

Week 20

The main finding was that the risk for stillborn fetuses could be determined at the 20th week of pregnancy. The risk for IUFD in women diagnosed with fibroids was assessed using univariate and multiple logistic regression analyses, while a subgroup was analyzed according to the whether or not there was fetal growth restriction (IUGR) at the 20th week.

Out of the entire group of 64,047 participants, the incidence for fibroids stood at 3.2%. It was found that the rate of IUFD (stillbirths) was much higher in the fibroid group than in those women who had no fibroids. The results stood up to scrutiny even after such factors as race, smoking, high blood pressure, and diabetes prior to pregnancy were taken into account.

Meantime, the subgroup analysis showed that the link between fibroids and IUFD remained only in those pregnancies affected by IUGR at the 20th week of gestation. Another co-author for the study, Dr. Alison G. Cahill, commented, "Our results showed that women with a combination of fibroids and fetal growth restriction were at two-and-a-half times the risk of having a stillbirth, though the absolute risk remained rare. This may lead to a future recommendation for serial growth scans to monitor fetal growth in women with fibroids."

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