Conclusion
Uterine myomas during pregnancy significantly increase the incidence of PTB, pPROM, and GH, regardless of number, size and localization. PTB and pPROM in women with uterine myomas were not associated with II, suggesting a mechanical disadvantage and the risk of occult PTB and pPROM in this patient group. Obstetricians should counsel their patients regarding the risks associated with uterine myomas in pregnancy and offer suitable interventions to prevent and manage APOs.
Acknowledgements: The findings and conclusions of this article are solely the responsibility of the authors and do not represent the official views of the Ministry of the Environment, Japan. The authors are grateful to all participants of the study.
Members of the JECS Group as of 2020: Michihiro Kamijima (principal investigator, Nagoya City University, Nagoya, Japan), Shin Yamazaki (National Institute for Environmental Studies, Tsukuba, Japan), Yukihiro Ohya (National Center for Child Health and Development, Tokyo, Japan), Reiko Kishi (Hokkaido University, Sapporo, Japan), Nobuo Yaegashi (Tohoku University, Sendai, Japan), Koichi Hashimoto (Fukushima Medical University, Fukushima, Japan), Chisato Mori (Chiba University, Chiba, Japan), Shuichi Ito (Yokohama City University, Yokohama, Japan), Zentaro Yamagata (University of Yamanashi, Chuo, Japan), Hidekuni Inadera (University of Toyama, Toyama, Japan), Takeo Nakayama (Kyoto University, Kyoto, Japan), Hiroyasu Iso (Osaka University, Suita, Japan), Masayuki Shima (Hyogo College of Medicine, Nishinomiya, Japan), Youichi Kurozawa (Tottori University, Yonago, Japan), Narufumi Suganuma (Kochi University, Nankoku, Japan), Koichi Kusuhara (University of Occupational and Environmental Health, Kitakyushu, Japan), and Takahiko Katoh (Kumamoto University, Kumamoto, Japan).
Disclosure of Interests: The authors report no conflicts of interest.
Contribution to Authorship: All authors approved the final manuscript. T.M. initiated study concept and design. T.M., H.K., Y.E., T.F., S.Y., A.Y., K.H., H.N., and K.F. contributed to study design. K.S., A.S., and Y.O. collected the data. T.M. analyzed the data and wrote the manuscript. M.H., S.Y., K.H., K.S., A.S., Y.O., H.N., K.F., and the JECS group reviewed the manuscript and provided critical advice.
Details of Ethics Approval: The JECS protocol was reviewed and approved by the Ministry of the Environment Institutional Review Board on Epidemiological Studies on March 23, 2010 (No. 15000141)18,19 and by the Ethics Committees of all participating institutions. The JECS was conducted in accordance with the Helsinki Declaration and other national regulations and guidelines. Written informed consent was obtained from all participating women.
Funding: The Japan Environment and Children’s Study was funded by the Ministry of the Environment, Japan. The findings and conclusions of this article are solely the responsibility of the authors and do not represent the official views of the Ministry of the Environment, Japan.
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