How do pregnancy complications, intrapartum, and neonatal risks differ in bicornuate and didelphys uteri? A...

This study researched if there are differences between didelphys and bicornuate uteri regarding obstetric and neonatal outcomes based on an analysis of a population database.

This retrospective population-based cohort study utilized data from the Healthcare Cost and Utilization Project - Nationwide Inpatient Sample (HCUP-NIS) from 2010 to 2014, including 3,846,342 births and analyzing 1,146 women with didelphys uteri and 6,327 with bicornuate uteri.

HCUP-NIS is the largest inpatient database in the USA, encompassing hospitalizations nationwide. It represents over 96% of Americans and provides data on approximately seven million yearly inpatient stays. Multivariate logistic regression was utilized to evaluate associations between uterine anomalies and delivery outcomes, controlling for confounding factors. IRB approval was deemed unnecessary since the data were anonymous and publicly accessible.

Women with didelphys uteri experienced significantly higher rates of preeclampsia (aOR = 1.38, 95% CI: 1.05-1.80), PPROM (aOR = 1.76, 95% CI: 1.32-2.34), preterm delivery (aOR = 1.39, 95% CI: 1.18-1.64), and cesarean delivery (aOR = 1.41, 95% CI: 1.20-1.64) compared to those with bicornuate uteri. Conversely, women with didelphys uteri had lower risks of placenta previa (aOR = 0.26, 95% CI: 0.08-0.84) and placental abruption (aOR = 0.52, 95% CI: 0.31-0.87). No significant differences were noted in other maternal or neonatal outcomes.

The study highlights critical differences in pregnancy complications between didelphys and bicornuate uteri, underscoring the need for tailored perinatal care for affected women.

Some women are born with a womb that has an unusual shape, which may affect pregnancy. Two types are a bicornuate uterus, where the womb has a heart-like shape, and a didelphys uterus, where the womb and cervix are divided into two parts. These conditions are often studied together, but it is not known whether they affect pregnancy in the same way. In this study, we used a national database of over 3.8 million hospital births in the US. We compared pregnancy outcomes in women with a didelphys uterus and a bicornuate uterus. We found that the risks were different. Women with a didelphys uterus were more likely to have high blood pressure, waters breaking early, early birth, and delivery by a cesarean section. Women with a bicornuate uterus were more likely to have placenta problems. These findings show that the two conditions are different and may need different care during pregnancy.