Skip to main content
SMFM 2025 Pregnancy Meeting Main banner
Final Program


Program Book
Icon Legend
Presentation Icons
Additional registration fee required
Additional registration fee required
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Poster Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Back

Poster Session 3

(862) The impact of antepartum fibroid characteristics on severe maternal morbidity

Friday, January 31, 2025
10:30 AM – 12:30 PM  

    Submitting Author and Presenting Author(s)

  • Moti Gulersen, MD, MSc

    Assistant Professor, Obstetrics and Gynecology
    Sidney Kimmel Medical College of Thomas Jefferson University
    Philadelphia, Pennsylvania, United States

    • Coauthor(s)

  • DK

    David Krantz, MA

    Northwell
    New Hyde Park, New York, United States

  • BR

    Burton Rochelson, MD

    Chief, Maternal-Fetal Medicine
    Northwell
    New Hyde Park, New York, United States

  • Matthew J. Blitz, MD

    Director of Clinical Research, Maternal-Fetal Medicine, Northwell; Program Director, Maternal Fetal Medicine Fellowship, South Shore University Hospital
    Northwell
    Bay Shore, NY, United States

Objective: To evaluate the association between uterine fibroids and their characteristics (e.g. number, size) with severe maternal morbidity (SMM).

Study Design: Multicenter retrospective cross-sectional study of all singletons who had a prenatal ultrasound at ≥ 18 weeks and delivered from 2019-2023. Fibroid characteristics were documented when identified on ultrasound. Patients with >1 delivery during the study period had only their first included for analysis. The primary outcomes were SMM, defined based on the Centers for Disease Control and Prevention list of 21 indicators, and non-transfusion SMM. Both were assessed based on the presence of any fibroid, fibroid number (1, 2, ≥3), and size (largest dimension < 5cm, 5-10cm, >10cm), compared to patients with no fibroids. Multivariate logistic regression was performed to adjust for maternal race/ethnicity and obstetric comorbidity index, a validated screening tool used to predict SMM. Data were presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI).

Results: Of the 79,802 patients included, 4,756 (6.0%) had at least one fibroid. The prevalence of SMM and non-transfusion SMM were 4.3% and 1.1%, respectively. Outcomes are displayed in the Table. The presence of any fibroid, regardless of number or size, was associated with an increased risk of SMM. There was no statistically significant association between fibroids and non-transfusion SMM. Patients with more and larger fibroids were at higher risk of SMM compared to those without fibroids. Fibroid number and size did not impact the risk of non-transfusion SMM. After adjusting for fibroid number and size, patients with fibroids in the lower uterine segment or cervix were at higher risk of SMM compared to those without fibroids in that location (aOR 1.48, 95% 1.12-1.96).

Conclusion: The association between fibroids and their characteristics with risk of SMM is likely related to hemorrhage. Providers should consider these risks and interventions to help reduce such risk when caring for patients with fibroids during pregnancy and their delivery.