Uterine Fibroid Severity in Pregnancy

Abstract

Uterine fibroids are benign tumors associated with an increased risk of irregular vaginal bleeding and abdominal pain. Disease severity can be described in the context of total fibroid volume, number of tumors, and growth of tumors. Despite more than one-in-ten pregnant women being affected by fibroids, the influence of increasing disease severity on symptoms is not well described among this population. Data from a prospective pregnancy cohort (Right from the Start: A study of early pregnancy health, 2000-2012) were used to show that non-linear relationships between total fibroid volume and the risks for bleeding and pain in the first trimester exist—and that these relationships differ by maternal race. Increasing number of tumors increased risk of self-reported pain and pain with bleeding. Longitudinal models were used to identify maternal and fibroid characteristics associated with fibroid growth during pregnancy. As in previous studies, increases in disease severity (increases in total fibroid volume), were noted for many women at the beginning of pregnancy, regardless of race. Nulliparity and first trimester bleeding and pain were possible risk factors for growth in total volume and number of tumors—suggesting that experiencing symptoms may be indicative of fibroid formation or growth.