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

Emma E. Don, Anadeijda J. E. M. C. Landman, Guus Vissers, Ekaterina S. Jordanova, Emiel D. Post Uiterweer, Christianne J. M. de Groot, Marjon A. de Boer, Judith A. F. Huirne

Research output: Contribution to journalArticleAcademicpeer-review


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.
Original languageEnglish
Article number8064
JournalInternational journal of molecular sciences
Issue number15
Publication statusPublished - Aug 2022


  • degeneration
  • inflammation
  • necrosis
  • pregnancy
  • premature labor
  • preterm birth
  • uterine fibroid

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