The effect of uterine leiomyoma on the risk of malpresentation and cesarean: a meta-analysis

J Matern Fetal Neonatal Med. 2018 Jan;31(1):87-92. doi: 10.1080/14767058.2016.1275553. Epub 2017 Jan 17.


Background: some epidemiological studies have found that uterine leiomyoma can increase the risk of cesarean and malpresentation at term. To date, the meta-analysis has not been conducted for assessing the relationship between uterine leiomyoma and cesarean/malpresentation. This meta-analysis was conducted to estimate the association between uterine leiomyoma and the risk of cesarean/malpresentation.

Methods: A literature search was conducted out in major databases PubMed, Web of Science, and Scopus up to September 2016. The heterogeneity across studies was conducted by Q-test and I2 statistic. The publication bias was assessed by Begg's and Egger's tests. The results were shown using odds ratio (OR) estimate with 95% confidence intervals (CI) conducting a random-effect model.

Results: The literature search included 1244 articles until September 2016 with 232,177 participants. Based on OR estimates obtained from case-control and cohort studies, there was significant association between uterine leiomyoma and cesarean (2.60; 95% CI: 2.02, 3.18) and between leiomyoma and malpresentation at term (2.65; 95% CI: 1.60, 3.70).

Conclusions: We showed based on reports in observational studies that uterine leiomyoma increased the risk of cesarean and malpresentation at term.

Keywords: Cesarean section; malpresentation; meta-analysis; pregnancy; uterine leiomyoma.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Cesarean Section / statistics & numerical data*
  • Female
  • Humans
  • Labor Presentation*
  • Leiomyoma / complications*
  • Obstetric Labor Complications / etiology*
  • Pregnancy
  • Uterine Neoplasms / complications*