ArticlePregnancy hypertension2026
Uterine fibroids and hypertensive disorders of pregnancy: Persistence of risk regardless of myomectomy or fibroid location.
Article in Pregnancy hypertension, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo determine whether prior myomectomy reduces hypertensive disorders of pregnancy (HDP) risk in women with fibroids, and whether fibroid location modifies this risk. STUDY
designRetrospective propensity score-matched cohort study using TriNetX, a federated health record network spanning over 100 US healthcare organizations. Women aged 18-55 years attending a prenatal visit were assigned to three groups: fibroids with prior myomectomy; fibroids without myomectomy; and no fibroids (reference). Groups were matched 1: 1 on age, race/ethnicity, BMI, chronic hypertension, pregestational diabetes, tobacco use, and prior assisted reproductive technology.
main outcome measuresGestational hypertension, preeclampsia, eclampsia, and superimposed preeclampsia within one year of the prenatal visit, reported as risk ratios (RR) with 95% confidence intervals. A secondary analysis examined HDP risk by fibroid location.
resultsAfter matching, women with fibroids without myomectomy had significantly increased risk of overall HDP (RR 1.21, 95% CI 1.17-1.25), gestational hypertension (RR 1.29, 95% CI 1.22-1.36), preeclampsia (RR 1.31, 95% CI 1.24-1.39), superimposed preeclampsia (RR 1.25, 95% CI 1.12-1.39), and eclampsia (RR 1.38, 95% CI 1.05-1.80) versus reference. Prior myomectomy similarly conferred elevated overall HDP risk (RR 1.24, 95% CI 1.12-1.37). No significant differences were observed between myomectomy and no-myomectomy groups. HDP risk was elevated across all fibroid locations, including subserosal fibroids (overall HDP RR 1.47, 95% CI 1.32-1.65).
conclusionsUterine fibroids are associated with increased HDP risk regardless of prior myomectomy or fibroid location, suggesting fibroids may represent a marker of systemic vascular dysfunction. Fibroid status should be incorporated into preconception and prenatal HDP risk stratification.
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