PubMed · 14598984
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Theresa O'Connor. Matthew.. https://pubmed.ncbi.nlm.nih.gov/14598984/
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OBJECTIVE: The objective was to determine if uterine leiomyoma increases the risk of cesarean section (CS) among women who conceived following fertility treatment. STUDY DESIGN: The study population consisted of all women who conceived after fertility treatment with singleton gestation and who delivered between the years 1988 and 1999 in the Soroka University Medical Center. A comparison was performed between patients with and without uterine leiomyomas. The Mantel-Haenszel procedure was used to obtain the weighted odds ratio (OR) for CS, while controlling for confounding variables. RESULTS: During the study period 1,995 women conceived following fertility treatment. Of these, 63 patients had uterine leiomyomas (3.2%). Women treated for fertility with uterine leiomyomas had statistically significant higher rates of CS than those without uterine leiomyomas (61.9% vs. 28.1%, OR=4.2, 95% CI 2.4-7.2; P<0.001). Stratified analysis (the Mantel-Haenszel technique) was used to control for possible confounders, such as gestational diabetes, hypertensive disorders, maternal age, failure of labor to progress, placental abruption, malpresentation, hydramnios, oligohydramnios, and a previous CS. None of those variables changed the significant association or explained the higher incidence of CS in the uterine leiomyoma group. CONCLUSIONS: Uterine leiomyoma is an independent risk factor for CS among women who conceived following fertility treatment.
This study examined the relationship between folate/homocysteine-related genetic polymorphisms: MTHFD1 1958G --> A (R653Q), MTHFR 677C --> T (A222V), MTHFR 1298A --> C (E429A), and risk of severe abruptio placentae. We genotyped 62 women with a pregnancy history complicated by severe abruptio placentae and 184 control pregnancies. Analysis of the MTHFD1 1958G --> A (R653Q) polymorphism showed increased frequency of the 'QQ' homozygote genotype in pregnancies affected by severe abruptio placentae compared to control pregnancies (odds ratio 2.85 (1.47-5.53), P = 0.002). In contrast to previous reports, the MTHFR polymorphisms 677C --> T (A222V) and 1298A --> C (E429A) were not associated with abruptio placentae risk in our cohort, when analyzed either independently or in combination. We conclude that women who are 'QQ' homozygote for the MTHFD1 1258G --> A (R653Q) polymorphism are almost three times more likely to develop severe abruptio placentae during their pregnancy than women who are 'RQ' or 'RR.'