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- Title
How do bicornuate uteri alter pregnancy, intra-partum and neonatal risks? A population based study of more than three million deliveries and more than 6000 bicornuate uteri.
- Authors
Kadour Peero, Einav; Badeghiesh, Ahmad; Baghlaf, Haitham; Dahan, Michael H.
- Abstract
To explore maternal and neonatal outcomes in pregnant women with bicornuate uteri. Retrospective population-based cohort study utilizing data from the Healthcare-Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) from 2010 to 2014. There were 3,846,342 births between 2010 and 2014, included in the study. Six thousand and 195 deliveries were to women with bicornuate uterus. The remaining deliveries without other uterine anomalies were categorized as the reference group (n=3,840,147). Pregnant women with bicornuate uterus were older and more likely to be obese (p=0.0001) with previous cesarean deliveries (CD) (31 vs. 17.1%, p=0.0001). After adjustment for confounders, they were more likely to experience pregnancy-induced hypertension (HTN) (aOR 1.21, 95%CI: 1.1–1.3), p=0.0001), preeclampsia (aOR 1.4, 95%CI: 1.2–1.6, p=0.0001) and placenta previa (aOR 1.7, 95%CI: 1.3–2.2, p=0.0001). Moreover, they were more likely to deliver preterm (aOR 2.8, 95%CI: 2.6–3.1, p=0.0001), deliver by CD (aOR 5, 95%CI: 3.1–4.1, p=0.0001), experience preterm pre-labor rupture of membranes (PPROM) (aOR 3.5, 95%CI: 2.6–3.1, p=0.0001), and have a placental abruption (aOR 3.0, 95%CI: 2.5–3.5, p=0.0001). There were increased risks of PPH (aOR 1.4, 95%CI: 1.2–1.6, p=0.0001), wound-complications (aOR 2.0, 95%CI: 1.5–2.7, p=0.0001), hysterectomy (aOR 2.6, 95%CI: 1.6–4.1, p=0.0001), blood-transfusion (aOR 1.7, 95%CI: 1.5–2.1, p=0.0001), and DIC (aOR 1.6, 95%CI: 1.1–2.5), p=0.014) in the group with bicornuate uteri. Also there was higher risk of SGA (aOR 2.9, 95%CI: 2.6–3.2, p=0.0001) and IUFD (aOR 2.5, 95%CI: 1.8–3.3, p=0.0001). Bicornuate uteri can increase risks in pregnancy by many folds. Particularly risks of: premature delivery, CD, PPROM, placental abruption, hysterectomy, SGA and IUFD were increased 250–500%.
- Subjects
OBESITY complications; RISK factors of preeclampsia; PERINATAL death; BICORNUATE uterus; HYPERTENSION in pregnancy; DISSEMINATED intravascular coagulation; OBSTETRICS surgery; PREMATURE infants; POSTPARTUM hemorrhage; HYSTERECTOMY; CONFIDENCE intervals; NEONATAL diseases; AGE distribution; ABRUPTIO placentae; BLOOD transfusion; PREGNANT women; RETROSPECTIVE studies; RISK assessment; PREGNANCY outcomes; PREGNANCY complications; PLACENTA praevia; SURGICAL site infections; DESCRIPTIVE statistics; CESAREAN section; ODDS ratio; LONGITUDINAL method; SECONDARY analysis; SMALL for gestational age; INTRAPARTUM care; DISEASE risk factors; DISEASE complications; PREGNANCY
- Publication
Journal of Perinatal Medicine, 2023, Vol 51, Issue 3, p305
- ISSN
0300-5577
- Publication type
Article
- DOI
10.1515/jpm-2022-0075