Leiomyomas in Pregnancy and Spontaneous Abortion: A Systematic Review and Meta-analysis
Open accessAbstract
OBJECTIVE: To systematically review studies reporting the risk of spontaneous abortion among pregnant women of typical reproductive potential with and without uterine leiomyomas. DATA SOURCES: We searched PubMed, EMBASE, Web of Science, and ClinicalTrials.gov for publications from January 1970 to December 2016. METHODS OF STUDY SELECTION: We excluded studies that did not use imaging to uniformly document leiomyoma status of all participants, did not have a comparison group without leiomyomas, or primarily included women seeking care for recurrent miscarriage, infertility care, or assisted reproductive technologies. TABULATION, INTEGRATION, AND RESULTS: Two authors independently reviewed eligibility, extracted data, and assigned overall quality ratings based on predetermined criteria. Of 1,469 articles identified, nine were eligible. Five enrolled general obstetric populations and four included women undergoing amniocentesis. In five studies in general obstetric populations that included 21,829 pregnancies (1,394 women with leiomyomas and 20,435 without), only one adjusted for potential confounders. This meta-analysis revealed no increase in risk of spontaneous abortion among those with leiomyomas compared with those without (11.5% compared with 8.0%; risk ratio 1.16, 95% CI 0.80–1.52). When bias from confounding was estimated for nonadjusted studies, the aggregate calculated risk ratio was 0.83 (95% CI 0.68–0.98). CONCLUSION: Leiomyoma presence was not associated with increased risk of spontaneous abortion in an analysis of more than 20,000 pregnant women. Failure of prior studies to adjust for confounders may have led to the common clinical belief that leiomyomas are a risk factor for spontaneous abortion.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In a large meta-analysis of a general obstetric population, no increase in risk of miscarriage was found in women with myomas (11.5% versus 8.0%; RR 1.16, 95% CI 0.80-1.52).
“In a large meta-analysis of a general obstetric population, including 1394 women with myomas and 20 435 without, no increase in risk of miscarriage was found (11.5% versus 8.0%; RR 1.16, 95% CI 0.80-1.52).67”
From Recurrent MiscarriageGreen‐top Guideline No. 17 (2023) · cites this paper as [67]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2008.08.010 · Cited by 51,384 · see citing works
Dermyshi, E., Wang, Y., Yan, C., Hong, W., Qiu, G., Gong, X., & Zhang, T. (2017) · Neonatology · doi:10.1159/000454668 · Cited by 24,577 · see citing works
Stroup, D. F. (2000) · JAMA · doi:10.1001/jama.283.15.2008 · Cited by 20,623 · see citing works
High cumulative incidence of uterine leiomyoma in black and white women: Ultrasound evidence
Baird, D. D., Dunson, D. B., Hill, M. C., Cousins, D. S., & Schectman, J. M. (2003) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2003.99 · Cited by 2,437 · see citing works
Fibroids and infertility: an updated systematic review of the evidence
Pritts, E. A., Parker, W. H., & Olive, D. L. (2009) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.01.051 · Cited by 913 · see citing works
Fibroids and reproductive outcomes: a systematic literature review from conception to delivery
Klatsky, P. C., Tran, N. D., Caughey, A. B., & Fujimoto, V. Y. (2008) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2007.12.039 · Cited by 579 · see citing works
Prevalence of Uterine Leiomyomas in the First Trimester of Pregnancy
Laughlin, S. K., Baird, D. D., Savitz, D. A., Herring, A. H., & Hartmann, K. E. (2009) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e318197bbaf · Cited by 340 · see citing works
Self-citationEpidemiology of Uterine Fibroids
Wise, L. A., & Laughlin-Tommaso, S. K. (2016) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0000000000000164 · Cited by 340 · see citing works
Sunkara, S. K., Khairy, M., El‐Toukhy, T., Khalaf, Y., & Coomarasamy, A. (2009) · Human Reproduction · doi:10.1093/humrep/dep396 · Cited by 332 · see citing works
A systematic review to calculate background miscarriage rates using life table analysis
Avalos, L. A., Galindo, C. M., & Li, D. (2012) · Birth Defects Research Part A Clinical and Molecular Teratology · doi:10.1002/bdra.23014 · Cited by 328 · see citing works
Ultrasound diagnosis of uterine myomas and complications in pregnancy
Exacoustós, C., & Rosati, P. (1994) · International Journal of Gynecology & Obstetrics · doi:10.1016/0020-7292(94)90784-6 · Cited by 234 · see citing works
Surgical treatment of fibroids for subfertility
Metwally, M., Cheong, Y. C., & Horne, A. W. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003857.pub3 · Cited by 198 · see citing works
Benson, C. B., Chow, J. S., Chang‐Lee, W., Hill, J. A., & Doubilet, P. M. (2001) · Journal of Clinical Ultrasound · doi:10.1002/jcu.1031 · Cited by 181 · see citing works
Risk of Miscarriage Among Black Women and White Women in a US Prospective Cohort Study
Mukherjee, S., Edwards, D. R. V., Baird, D. D., Savitz, D. A., & Hartmann, K. E. (2013) · American Journal of Epidemiology · doi:10.1093/aje/kws393 · Cited by 174 · see citing works
Self-citationPertinency of an extraneous variable
Bross, I. D. J. (1967) · Journal of Chronic Diseases · doi:10.1016/0021-9681(67)90080-x · Cited by 118 · see citing works
Elective uterine myomectomy in pregnant women.
Mollìca, G., Pittini, L., Minganti, E., et al. (1996) · PubMed · Cited by 71 · see citing works
Prospective Cohort Study of Uterine Fibroids and Miscarriage Risk
Hartmann, K. E., Velez Edwards, D. R., Savitz, D. A., Jonsson-Funk, M. L., Wu, P., Sundermann, A. C., & Baird, D. D. (2017) · American Journal of Epidemiology · doi:10.1093/aje/kwx062 · Cited by 51 · see citing works
Self-citationLeiomyomata uteri, genetic amniocentesis, and the risk of second-trimester spontaneous abortion
Salvador, E., Bienstock, J. L., Blakemore, K. J., et al. (2002) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2002.123988 · Cited by 43 · see citing works
Pregnancy outcome following mid-trimester amniocentesis
Corrado, F., Cannata, M. L., Galia, T. L., Magliarditi, M., Imbruglia, L., D’Anna, R., & Stella, N. C. (2012) · Journal of Obstetrics and Gynaecology · doi:10.3109/01443615.2011.633717 · Cited by 29 · see citing works
Greenland, S., & Mickey, R. M. (1988) · Journal of the Royal Statistical Society Series C (Applied Statistics) · doi:10.2307/2347308 · Cited by 27 · see citing works
Theodora, M. K., Antsaklis, A. J., Antsaklis, P. J., Blanas, K., Daskalakis, G., Sindos, M., Mesogitis, S., & Papantoniou, N. E. (2015) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.3109/14767058.2015.1012061 · Cited by 22 · see citing works
Uterine fibroids and risk for complications following second-trimester amniocentesis.
Cignini, P., Mobili, L., D’Emidio, L., et al. (2011) · PubMed · Cited by 3 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- [11]Viswanathan M Ansari MT Berkman ND Chang S Hartling L McPheeters LM Assessing the Risk of Bias of Individual Studies in Systematic Reviews of Health Care Interventions Agency for Healthcare Research and Quality Methods Guide for Comparative Effectiveness Reviews AHRQ Publication No 12-EHC047-EF 2012 22479713
- [12]Rothman KJ Greenland S Lash TL Chapter 33: Meta-analysis Modern Epidemiology 3rd Philadelphia (PA) Lippincott Williams & Wilkins 2008 660 2
- [24]Laughlin SK Baird DD Savitz DA Herring AH Hartmann KE Prevalence of Uterine Leiomyomas in the First Trimester of Pregnancy An Ultrasound-Screening Study Obstet Gynecol 2009 113 630 5 19300327 PMC3384531
Cited by
Sorted by citations
Recurrent MiscarriageGreen‐top Guideline No. 17
Regan, L., Rai, R., Saravelos, S., Li, T., & the Royal College of Obstetricians and Gynaecologists (2023) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.17515 · Cited by 158 · see citing works
- Authors
- Sundermann, A. C., Velez Edwards, D. R., Bray, M. J., Jones, S. H., Latham, S. M., & Hartmann, K. E.
- Affiliations
- Vanderbilt University (US)
- Venue
- Obstetrics & Gynecology
- Published
- 2017-11
- Volume
- 130
- Issue
- 5
- Pages
- 1065-1072
- ISSN
- 0029-7844 (ISSN-L)
- PMC
- PMC5656535
- OpenAlex
- W2762801440
- Cited by
- 58
- References
- 22
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 10 · 2021: 22 · 2020: 9 · 2019: 3 · 2018: 2 · 2017: 1
- FWCI
- 4.83
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000445)
- National Institute of General Medical Sciences (T32GM007347, T32GM080178)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Keywords
- uterine fibroids, miscarriage, pregnancy, miscarriage risk, confounding, risk factors, amniocentesis
- MeSH terms
- Abortion, Spontaneous, Abortion, Habitual, Adult, Female, Humans, Leiomyoma, Pregnancy, Pregnancy Complications, Neoplastic, Risk Factors, Uterine Neoplasms
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
