Title:The Association between Uterine Leiomyoma and Postpartum Hemorrhage: A Meta-Analysis
VOLUME: 16 ISSUE: 4
Author(s):Ensiyeh Jenabi, Salman Khazaei* and Seyedeh Zahra Masoumi
Affiliation:Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan
Keywords:Uterine leiomyoma, postpartum hemorrhage, meta-analysis, epidemiology studies, risk factor, pregnancy.
Abstract:
Background: Some studies have shown a relationship between uterine fibroids and PPH,
while other studies have not shown a risk increase for PPH with uterine fibroids.
Objective: The aim of performing the present study was in order to assess the association between
uterine leiomyoma and postpartum hemorrhage (PPH) based on epidemiology studies.
Methods: We searched for several major international databases (PubMed, Scopus, EBSCO and
Web of Science) till Oct 2019. OR was used to measure the association between uterine leiomyoma
and postpartum hemorrhage. The combined OR and the corresponding 95 % CI were calculated
using random-effects models. In order to control potential confounders, a meta-analysis was carried
out based on crude and adjusted form. Homogeneity of effect size was tested by using the Q statistic
and to measure the inconsistency across studies and the I2 statistic was used. Funnel plot and the
Begg's test was employed to assess possible publication bias. Data were analyzed by the Stata software,
version 14, with significance level 0.05.
Results: Based on OR estimates obtained from adjusted studies, there was a significant relationship
between the uterine leiomyoma and PPH (OR=1.44; 95% CI: 1.14, 1.73). We assessed the association
according to statistical adjustment for confounding factors (crude/adjusted) and the association
between uterine leiomyoma and PPH in both crude (OR=1.96; 95% CI: 1.03, 2.88) and adjusted
(OR=1.23; 95% CI: 1.02, 1.44) report was statistically significant.
Conclusion: In this study, uterine leiomyoma was a risk factor for PPH. Therefore, based on our
findings in pregnant women with uterine leiomyoma, clinicians should be prepared to manage postpartum
hemorrhage after vaginal births and cesarean deliveries.
