title: The effect of uterine leiomyoma on the risk of malpresentation and cesarean: a meta-analysis.
abstract: BACKGROUND
  some epidemiological studies have found that uterine leiomyoma can increase the risk of cesarean and malpresentation at term. To date, the meta-analysis has not been conducted for assessing the relationship between uterine leiomyoma and cesarean/malpresentation. This meta-analysis was conducted to estimate the association between uterine leiomyoma and the risk of cesarean/malpresentation.
  
  
  METHODS
  A literature search was conducted out in major databases PubMed, Web of Science, and Scopus up to September 2016. The heterogeneity across studies was conducted by Q-test and I2statistic. The publication bias was assessed by Begg's and Egger's tests. The results were shown using odds ratio (OR) estimate with 95% confidence intervals (CI) conducting a random-effect model.
  
  
  RESULTS
  The literature search included 1244 articles until September 2016 with 232,177 participants. Based on OR estimates obtained from case-control and cohort studies, there was significant association between uterine leiomyoma and cesarean (2.60; 95% CI: 2.02, 3.18) and between leiomyoma and malpresentation at term (2.65; 95% CI: 1.60, 3.70).
  
  
  CONCLUSIONS
  We showed based on reports in observational studies that uterine leiomyoma increased the risk of cesarean and malpresentation at term.
authors.affiliation: a Department of Midwifery , Tuyserkan Branch, Islamic Azad University , Tuyserkan , Iran.
authors.forename: Ensiyeh
authors.initials: E
authors.lastname: Jenabi
authors.affiliation: b Department of Epidemiology, School of Public Health , Hamadan University of Medical Sciences , Hamadan , Iran.
authors.forename: Salman
authors.initials: S
authors.lastname: Khazaei
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007746:Labor Presentation; D007889:Leiomyoma / Q000150:complications*; D007744:Obstetric Labor Complications / Q000209:etiology*; D011247:Pregnancy; D014594:Uterine Neoplasms / Q000150:complications*
keywords: Cesarean section; malpresentation; meta-analysis; pregnancy; uterine leiomyoma