Background: Uterine fibroids are among the most common benign tumors affecting women of reproductive age, with potential implications for pregnancy outcomes. While some studies suggest that fibroids may contribute to obstetric complications, there is a need for further evidence regarding their specific impact on maternal and neonatal health. This study aimed to evaluate pregnancy-related complications, mode of delivery, and neonatal outcomes in women with fibroid-complicated pregnancies compared to those with normal pregnancies.
Methods: This retrospective longitudinal observational cohort study was conducted at the Department of Obstetrics and Gynecology, Saveetha Medical College and Hospital, utilizing electronic health records. The study population consisted of pregnant women who delivered at the institution over a defined period. Participants were classified into two groups: those with documented uterine fibroids confirmed by obstetric ultrasound and those with no evidence of fibroids during pregnancy. The study included a total of 348 women, with 174 in each group, based on a predetermined sample size calculation considering preterm birth as the primary outcome measure. Maternal characteristics, including age and body mass index, were analyzed along with obstetric and neonatal outcomes such as hypertensive disorders of pregnancy, mode of delivery, neonatal birth weight, and neonatal intensive care unit admissions. Statistical analysis included repeated measures analysis of variance (RM-ANOVA) to assess longitudinal changes in maternal and neonatal parameters. Mauchly's test of sphericity was applied to evaluate variance assumptions, and where violations occurred, the Greenhouse-Geisser correction was used. Post-hoc pairwise comparisons were conducted using Tukey's Honestly Significant Difference (HSD) test to determine significant differences between groups. Subgroup analyses were performed using Generalized Estimating Equations (GEE) to evaluate the influence of body mass index and baseline insulin resistance on maternal and neonatal outcomes.
Results: The findings revealed that maternal age and body mass index were comparable between the two groups, with no statistically significant differences. However, pregnancies complicated by fibroids were associated with a significantly higher incidence of preterm birth, affecting 20.0% of cases compared to 6.3% in the normal pregnancy group. Neonatal birth weight was lower in fibroid-complicated pregnancies, with an average birth weight of 2981.35 ± 520.32 grams compared to 3236.51 ± 458.93 grams in the normal pregnancy group. Cesarean section was the predominant mode of delivery among women with fibroids, with 64.9% of them undergoing surgical delivery compared to 25.3% in the normal pregnancy group. The study also observed a higher prevalence of hypertensive disorders in the fibroid-complicated pregnancy group, with 16.7% of women affected compared to 10.9% in the normal pregnancy group. Neonatal intensive care unit admissions were more frequent in pregnancies complicated by fibroids, occurring in 10.0% of cases compared to 6.3% in normal pregnancies. Hospital stay duration was significantly longer in fibroid-complicated pregnancies, with an average stay of 5.08 ± 1.10 days compared to 3.52 ± 0.82 days in the normal pregnancy group. The need for maternal intensive care unit admission was also notably higher in the fibroid group, affecting 5.3% of cases compared to 1.1% in normal pregnancies. In contrast, postpartum hemorrhage rates did not differ significantly between the two groups, suggesting that fibroids may not substantially increase the risk of excessive postpartum bleeding.
Conclusion: The presence of fibroids during pregnancy was associated with an increased risk of adverse obstetric and neonatal outcomes, including higher rates of preterm birth, hypertensive disorders, and cesarean deliveries. Women with fibroid-complicated pregnancies also required longer hospital stays and were more likely to need intensive care, indicating a higher burden of maternal morbidity. These findings underscore the need for close antenatal monitoring and individualized obstetric management for women with fibroids to optimize maternal and neonatal outcomes. Further prospective studies are warranted to explore the underlying mechanisms and develop targeted interventions for this high-risk population.
Keywords: Uterine fibroids, Pregnancy complications, Neonatal outcomes, Retrospective cohort study, Maternal health.
How to cite this article: Sharma N, Aysha M. Maternal and neonatal outcomes in pregnancies complicated by uterine fibroids: a retrospective longitudinal observational cohort study. Int J Drug Deliv Technol. 2026;16(6s): 134-141; DOI: 10.25258/ijddt.16.6s.17
Source of support: None.
Conflict of interest: None