{"id":88,"title":"Fibroids and the risk of miscarriage: a prospective observational study in an early pregnancy population","title_zh":"子宫肌瘤与流产风险：一项针对早期妊娠人群的前瞻性观察研究","url":"https://pubmed.ncbi.nlm.nih.gov/42978111","doi":"10.1080/01443615.2026.2752340","pmid":"42978111","journal":"J Obstet Gynaecol","kind":"paper","lang":"en","published_at":"2026-11-03T00:00:00+00:00","fetched_at":"2026-11-08T03:43:53+00:00","authors":["Vasireddy A","Sampson U","Channing R","Ross JA","Johns J"],"primary_topic":"early-pregnancy","topics":[{"slug":"early-pregnancy","score":9.0,"hits":["early pregnancy","miscarriage","pregnancy outcomes"]},{"slug":"endometrium","score":6.0,"hits":["fibroid","fibroids","uterine"]},{"slug":"art-clinical","score":1.0,"hits":["in vitro fertilisation"]},{"slug":"repro-aging","score":1.0,"hits":["advanced maternal age"]}],"topic_score":9.0,"preference_score":0.0,"preference_labels":[],"llm_score":66.0,"final_score":66.0,"score_dims":{"novelty":55,"rigor":65,"impact":52,"relevance":76,"translation":64},"recommend_reason":"这是英国早期妊娠人群的前瞻性数据，弥补了非IVF人群的证据空白；但为单中心、检验效能不足，校正后关联不显著，结论偏保守，可作为 counselling 与样本量设计的参考。","keywords":["子宫肌瘤","流产","早期妊娠","前瞻性队列","超声","母体年龄"],"selected":1,"story_id":162,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该研究在伦敦一家三级医院的早期妊娠单元开展为期15个月的前瞻性观察，纳入416例孕周小于10周的单胎妊娠，其中104例合并子宫肌瘤，312例为对照，均接受系统超声检查并采集混杂因素。主要结局为24周前流产。结果：肌瘤组流产率为22.9%，对照组为14.6%（未调整OR 1.74，95%CI 0.98–3.10，p=0.059）；多因素调整后关联减弱（aOR 1.49，0.82–2.70，p=0.19）。肌瘤数目增加与流产风险升高相关（每增加1个OR 1.17，1.01–1.37）。肌瘤组孕中期疼痛更常见（OR 2.92），出血无差异。作者结论：肌瘤组流产率数值更高，但校正后不存在独立关联，且研究对微小差异的检验效能不足；高龄女性流产风险主要受年龄而非肌瘤影响。","summary":"BACKGROUND: The impact of fibroids on pregnancy outcomes has been studied extensively in the context of in vitro fertilisation; however, evidence in the general obstetric population is limited. No prospective studies from the United Kingdom have examined the relationship between fibroids and early pregnancy loss in a mixed population. This study evaluated the association between fibroids and miscarriage in women presenting to an Early Pregnancy Unit (EPU). METHODS: Prospective observational study conducted over 15 months, involving 416 women with singleton pregnancies <10 weeks' gestation at a London tertiary EPU. Participants with fibroids (n = 104) were compared with controls (n = 312); all underwent systematic ultrasound, and confounder data were collected. The primary outcome was miscarriage before 24 weeks; secondary outcomes included gestation of miscarriage, second-trimester pain and bleeding. RESULTS: Miscarriage occurred in 65 women: 22.9% with fibroids versus 14.6% without (unadjusted odds ratio [OR] 1.74, 95% CI 0.98-3.10; p =.059); after adjustment, the association was attenuated (adjusted OR [aOR] 1.49, 95% CI 0.82-2.70; p =.19). Increasing fibroid number was associated with higher risk (OR per additional fibroid 1.17, 95% CI 1.01-1.37; p =.04). First-trimester miscarriage was higher with fibroids (unadjusted relative risk ratio [RRR] 1.99, 95% CI 1.09-3.61, p =.024); although this association was attenuated with age (aOR 1.59, 95% CI 0.86-2.93, p =.14; adjusted RRR 1.63, 95% CI 0.88-3.04, p =.12). Other fibroid characteristics and uterine volume did not significantly influence miscarriage risk. Second-trimester pain was more common with fibroids (OR 2.92, 95% CI 1.43-5.97, p <.05); there was no difference in bleeding. CONCLUSION: A higher miscarriage rate was observed with fibroids; however, there was no independent association after adjustment. Our study was underpowered to detect a small difference in miscarriage rate. Women of advanced maternal age can be counselled that their risk of miscarriage is influenced more by age than the presence of fibroids.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}