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Long-Term Effect on Ovarian Function After Uterine Artery Embolization During the Postpartum Period: A Nationwide Population-Based Study

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Abstract

Uterine artery embolization(UAE) is widely used in obstetrical indications, including postpartum bleeding and placental implantation abnormality, to manage many conditions to conserve the uterus. However, physicians are concerned about future fertility or ovarian function due to the occlusion of major pelvic vessels in the uterine artery embolization. However, there are limited data related to UAE usage during the postpartum period. This study was to evaluate the impact of UAE during the postpartum period on primary ovarian failure(POF), menstrual disorders, and infertility in women. Using the Korea National Health Insurance claims database, all pregnant women who delivered between January 2007 and December 2015 and underwent UAE during the postpartum period were identified. The occurrence of POF, female infertility, and menstrual disorders after delivery was evaluated. Using Cox proportional hazards models, the adjusted hazard ratios and 95% confidence intervals were estimated. 779,612 cases were analyzed in the study with 947 women in the UAE group. After delivery, the incidence of POF (0.84% vs.0.27%, P<.0001) and female infertility (10.24% vs. 6.89%, P<.0001) were higher in UAE group than in the control group. After adjusting for covariates, the POF risk was significantly higher in UAE group than in the control group (HR 2.37, 95% CI 1.16-4.82). The risk for the disorder of menstrual frequency (HR 1.28, 95% CI 1.10-1.50) and female infertility (HR 1.37, 95% CI 1.10-1.71) was significantly higher in UAE group than in the control group. This study confirmed UAE during the postpartum period is a risk factor for POF after delivery.

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Data Availability

The data used in the study are potentially identifiable and are not publicly available. The raw claims datasets generated and/or analyzed during the study are not publicly available due ethical restriction by the HIRA.

Code Availability

Not applicable.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea

    Seung Yeon Pyeon

  2. Korea University Guro Hospital Smart Healthcare Center, Seoul, Republic of Korea

    Eunjin Noh

  3. Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea

    Geum Joon Cho

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Contributions

Conceptualization: Geum Joon Cho; Data curation: Eunjin Noh; Formal analysis and investigation: Eunjin Noh; Methodology: Geum Joon Cho; Progect administration: Geum Joon Cho; Resources: Geum Joon Cho; Supervision: Geum Joon Cho; validation: Geum Joon Cho; Visualization: Seung Yeon Pyeon; Writing - original draft preparation: Seung Yeon Pyeon; Writing - review and editing: Geum Joon Cho.

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Correspondence to Geum Joon Cho.

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Ethics Approval

Approval was obtained from the ethics committee of Korea University Guro Hospital. The procedures used in this study adhere to the tenets of the Declaration of Helsinki. (Ethics approval number; 2020GR0012).

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Written informed consent was waived as the data were de-identified in the database used.

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The authors have no competing interests to declare that are relevant to the content of this article.

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Pyeon, S.Y., Noh, E. & Cho, G.J. Long-Term Effect on Ovarian Function After Uterine Artery Embolization During the Postpartum Period: A Nationwide Population-Based Study. Reprod. Sci. 30, 2990–2995 (2023). https://doi.org/10.1007/s43032-023-01257-1

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