Uterine Anomalies Linked to Adverse Pregnancy Outcomes

Increased risk of preterm birth, nonbreech cesarean delivery, premature membrane rupture

TUESDAY, Nov. 29 (HealthDay News) -- The presence of a uterine anomaly is significantly associated with preterm birth (PTB), primary nonbreech cesarean delivery, preterm rupture of membranes, and breech presentation, according to a study published in the December issue of the American Journal of Obstetrics & Gynecology.

Meiling Hua, M.D., from Washington University School of Medicine in St. Louis, and colleagues investigated whether the presence of a maternal uterine anomaly was associated with adverse pregnancy outcomes. A total of 66,956 women with singleton pregnancies, who underwent routine anatomic surveys between 1990 and 2008, were included. Outcomes were compared for pregnancies with a diagnosis of uterine anomaly (uterine septum, unicornuate uterus, bicornuate uterus, uterine didelphys) and those with normal anatomy. Spontaneous PTB, breech presentation, and cesarean delivery were the primary outcomes assessed.

The investigators identified 203 pregnancies that were complicated by maternal uterine anomaly at the anatomic survey. There was a significant association between the presence of anomaly and adverse outcomes: PTB at less than 34 weeks (adjusted odds ratio [aOR], 7.4), PTB at less than 37 weeks (aOR, 5.9), primary nonbreech cesarean delivery (aOR, 2.6), preterm rupture of membranes (aOR, 3.2), and breech presentation (aOR, 8.6).

"Women with a uterine anomaly are at risk for PTB, highlighting an at-risk population that needs additional study for possible interventions for PTB prevention," the authors write.

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