The effect of uterine leiomyoma on the risk of malpresentation and cesarean: a meta-analysis

Background: some epidemiological studies have found that uterine leiomyoma can increase the risk of cesarean and malpresentation at term. To date, the meta-analysis has not been conducted for assessing the relationship between uterine leiomyoma and cesarean/malpresentation. This meta-analysis was conducted to estimate the association between uterine leiomyoma and the risk of cesarean/malpresentation.Methods: A literature search was conducted out in major databases PubMed, Web of Science, and Scopus up to September 2016. The heterogeneity across studies was conducted by Q-test and I2 statistic. The publication bias was assessed by Begg's and Egger's tests. The results were shown using odds ratio (OR) estimate with 95% confidence intervals (CI) conducting a random-effect model.Results: The literature search included 1244 articles until September 2016 with 232,177 participants. Based on OR estimates obtained from case–control and cohort studies, there was significant association between uterine leiomyoma and cesarean (2.60; 95% CI: 2.02, 3.18) and between leiomyoma and malpresentation at term (2.65; 95% CI: 1.60, 3.70).Conclusions: We showed based on reports in observational studies that uterine leiomyoma increased the risk of cesarean and malpresentation at term.