Uterine Fibroids Causing Preterm Birth: A New Pathophysiological Hypothesis on the Role of Fibroid Necrosis and Inflammation

• Published in: International journal of molecular sciences Vol. 23; no. 15; p. 8064
• Main Authors: Don, Emma E., Landman, Anadeijda J. E. M. C., Vissers, Guus, Jordanova, Ekaterina S., Post Uiterweer, Emiel D., de Groot, Christianne J. M., de Boer, Marjon A., Huirne, Judith A. F.
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.08.2022; MDPI
• Subjects: Amniotic fluid; Asymptomatic; Binding sites; Birth; Childbirth & labor; Cytokines; degeneration; Enzymes; Fibroids; Gene expression; Gestational age; Hypotheses; Hypothesis; Infections; Inflammation; Inflammatory response; Localization; Mass spectrometry; Menstruation; MicroRNAs; Necrosis; Oxidative stress; Parturition; Pathogenesis; Pregnancy; Premature birth; premature labor; preterm birth; Scientific imaging; Tumor necrosis factor-TNF; Uterus
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms23158064

According to recent studies and observations in clinical practice, uterine fibroids increase the risk of preterm birth. There are several theories on the pathogenesis of preterm birth in the presence of fibroids. One theory proclaims that fibroid necrosis leads to preterm birth, though pathophysiological mechanisms have not been described. Necrotic tissue secretes specific cytokines and proteins and we suggest these to be comparable to the inflammatory response leading to spontaneous preterm birth. We hypothesize that fibroid necrosis could induce preterm parturition through a similar inflammatory response. This new hypothesis generates novel perspectives for future research and the development of preventative strategies for preterm birth. Moreover, we emphasize the importance of the recognition of fibroids and especially fibroid necrosis by clinicians during pregnancy.