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Licensed Unlicensed Requires Authentication Published by De Gruyter August 11, 2022

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

  • Einav Kadour Peero EMAIL logo , Ahmad Badeghiesh , Haitham Baghlaf and Michael H. Dahan

Abstract

Objectives

To explore maternal and neonatal outcomes in pregnant women with bicornuate uteri.

Methods

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).

Results

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).

Conclusions

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%.


Corresponding author: Dr. Einav Kadour Peero, MD, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, 888, Blvd. de Maisonneuve East, Suite 200 Montreal, QC H2L 4S8, Canada; and MUHC Reproductive Center, McGill University, Montreal, QC, Canada, Phone: +438-4-3565390, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Not applicable.

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Received: 2022-02-08
Accepted: 2022-06-20
Published Online: 2022-08-11
Published in Print: 2023-03-28

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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