{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T22:56:08Z","timestamp":1775861768041,"version":"3.50.1"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This study aimed to characterize the risk of adverse pregnancy outcomes among patients with congenital uterine anomalies (CUA) using electronic health record data.<\/jats:p>\n                  <jats:p>Retrospective cohort study utilizing the TriNetX analytics research network, including female patients aged 10 to 55 with a documented singleton and intrauterine pregnancy.<\/jats:p>\n                  <jats:p>A total of 561,440 patients met inclusion criteria, of whom 3,381 (0.6%) had one or more International Classification of Diseases (ICD) encounter diagnosis codes for CUA. Compared with patients with no documented ICD encounter diagnosis of CUA, patients with CUA had lower rates of live birth (odds ratio [OR]: 0.36, 95% confidence interval [CI]: 0.33\u20130.38). CUA patients had higher rates of preterm labor (OR: 1.41, 95% CI: 1.20\u20131.65), fetal malpresentation (OR: 2.48, 95% CI: 2.16\u20132.85), and postpartum hemorrhage (OR: 1.54, 95% CI: 1.31\u20131.80). Severe maternal morbidity (SMM) was increased in patients with CUA, including for hysterectomy (OR: 3.41, 95% CI: 1.26\u20139.17) and acute renal failure (OR: 1.97, 95% CI: 1.08\u20133.57).<\/jats:p>\n                  <jats:p>Patients with CUA are at higher risk of adverse pregnancy outcomes compared with patients with normal uterine anatomy, including for SMM and postpartum complications. These patients should be counseled about these possible risks, and CUA should be incorporated into risk-stratification and prevention strategies.<\/jats:p>","DOI":"10.1055\/a-2682-6137","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T22:41:12Z","timestamp":1757371272000},"page":"768-774","source":"Crossref","is-referenced-by-count":0,"title":["Adverse Pregnancy Outcomes in Patients with Congenital Uterine Anomalies: Evaluation of a Population Dataset"],"prefix":"10.1055","volume":"43","author":[{"given":"Zoe O.","family":"Silsby","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine, Cleveland, Ohio, United States"},{"name":"Department of Obstetrics and Gynecology, Inova Fairfax Hospital, Fairfax, Virginia, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Abou Zeki","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Swensen","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine, Cleveland, Ohio, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Rhodes","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David C.","family":"Kaelber","sequence":"additional","affiliation":[{"name":"Departments of Internal Medicine, Pediatrics, and Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, United States"},{"name":"The Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, Ohio, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Sheyn","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin R.","family":"Lappen","sequence":"additional","affiliation":[{"name":"Division of Maternal and Fetal Medicine, OB\/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1093\/humupd\/dmr028","article-title":"The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review","volume":"17","author":"Y Y Chan","year":"2011","journal-title":"Hum Reprod Update"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"161","DOI":"10.31083\/j.ceog.2021.01.2198","article-title":"Congenital uterine anomalies and perinatal outcomes: a retrospective single-center cohort study","volume":"48","author":"E Zambrotta","year":"2021","journal-title":"Clin Exp Obstet Gynecol"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1080\/14767058.2017.1370703","article-title":"The association between M\u00fcllerian anomalies and perinatal outcome","volume":"32","author":"A Cahen-Peretz","year":"2019","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"21","key":"ref4","doi-asserted-by":"crossref","first-page":"4797","DOI":"10.3390\/jcm10214797","article-title":"Reproductive, obstetric and neonatal outcomes in women with congenital uterine anomalies: a systematic review and meta-analysis","volume":"10","author":"M A Kim","year":"2021","journal-title":"J Clin Med"},{"issue":"11","key":"ref5","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1007\/s40264-021-01113-8","article-title":"Validating claims-based algorithms determining pregnancy outcomes and gestational age using a linked claims-electronic medical record database","volume":"44","author":"K Moll","year":"2021","journal-title":"Drug Saf"},{"issue":"26","key":"ref6","doi-asserted-by":"crossref","first-page":"10494","DOI":"10.1080\/14767058.2022.2130240","article-title":"What type of uterine anomalies had an additional effect on pregnancy outcomes, compared to other uterine anomalies? An evaluation of a large population database","volume":"35","author":"E Kadour Peero","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"558.e1","DOI":"10.1016\/j.ajog.2011.07.022","article-title":"Congenital uterine anomalies and adverse pregnancy outcomes","volume":"205","author":"M Hua","year":"2011","journal-title":"Am J Obstet Gynecol"},{"issue":"09","key":"ref8","doi-asserted-by":"crossref","first-page":"949","DOI":"10.3109\/14767058.2013.847082","article-title":"Type of congenital uterine anomaly and adverse pregnancy outcomes","volume":"27","author":"N S Fox","year":"2014","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"06","key":"ref9","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.jpag.2023.07.008","article-title":"Pregnancy outcomes in patients with obstructed hemivagina ipsilateral renal agenesis","volume":"36","author":"E Erkkinen","year":"2023","journal-title":"J Pediatr Adolesc Gynecol"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.ejogrb.2003.10.030","article-title":"Gestational hypertension and preeclampsia associated with unilateral renal agenesis in women with uterine malformations","volume":"114","author":"P K Heinonen","year":"2004","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"61","author":"E von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1002\/uog.10056","article-title":"Reproductive outcomes in women with congenital uterine anomalies: a systematic review","volume":"38","author":"Y Y Chan","year":"2011","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.rbmo.2014.09.006","article-title":"Clinical implications of congenital uterine anomalies: a meta-analysis of comparative studies","volume":"29","author":"C A Venetis","year":"2014","journal-title":"Reprod Biomed Online"},{"issue":"04","key":"ref15","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1007\/s00404-018-4663-2","article-title":"Independent association between uterine malformations and cervical insufficiency: a retrospective population-based cohort study","volume":"297","author":"S A Mastrolia","year":"2018","journal-title":"Arch Gynecol Obstet"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1515\/jpm-2022-0075","article-title":"How do bicornuate uteri alter pregnancy, intra-partum and neonatal risks? A population based study of more than three million deliveries and more than 6000 bicornuate uteri","volume":"51","author":"E Kadour Peero","year":"2022","journal-title":"J Perinat Med"},{"key":"ref18","volume-title":"Chapter 2. Embryology of the Urogenital System & Congenital Anomalies of the Genital Tract","author":"C M DeUgarte","year":"2013"},{"issue":"05","key":"ref19","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1007\/s00404-012-2680-0","article-title":"Pregnancies in women with uterine malformation, treated obstruction of hemivagina and ipsilateral renal agenesis","volume":"287","author":"P K Heinonen","year":"2013","journal-title":"Arch Gynecol Obstet"},{"issue":"01","key":"ref20","first-page":"64","article-title":"Causes and outcome of pregnancy related acute kidney injury","volume":"40","author":"N Mohammad","year":"2023","journal-title":"Pak J Med Sci"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2682-6137.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T22:35:40Z","timestamp":1775860540000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2682-6137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,8]]},"references-count":18,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2026,4,10]]},"published-print":{"date-parts":[[2026,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2682-6137","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,8]]}}}