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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