Prevalence of Uterine Leiomyomas in the First Trimester of Pregnancy: An Ultrasound-Screening Study


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Abstract

OBJECTIVE:To estimate the proportion of pregnant women with one or more leiomyomas detected by research-quality ultrasound screening in the first trimester, to describe the size and location of leiomyomas identified, and to report variation in prevalence by race/ethnicity.METHODS:Within an ongoing prospective cohort, we conducted 4,271 first-trimester or postmiscarriage ultrasound examinations. Sonographers measured each leiomyoma three separate times, recording the maximum diameter in three perpendicular planes each time. Sonographers and investigators classified type and location.RESULTS:Among 458 women with one or more leiomyomas (prevalence 10.7%), we identified a total of 687 leiomyomas. The mean size of the largest leiomyoma was 2.3 cm (95% confidence interval [CI] 1.8–2.8). Mean gestational age at ultrasonography was 61±13 days from last menstrual period. Prevalence varied by race/ethnicity: 18% in African-American women (95% CI 13–25), 8% in white women (95% CI 7–11), and 10% in Hispanic women (95% CI 5–19). The proportion of women with leiomyomas increased with age much more steeply for African-American women than for white women.CONCLUSION:Leiomyomas are common in pregnancy and occur more often among African-American women. Given the limited research on effects of leiomyomas on reproductive outcomes, the degree to which race/ethnic disparities in prevalence of leiomyomas may contribute to disparities in events such as miscarriage and preterm birth warrants investigation.LEVEL OF EVIDENCE:II

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