Endometriosis increases risk for pregnancy complications

  • Obstet Gynecol

  • International Clinical Digest
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Takeaway

  • Endometriosis is a risk factor for pregnancy complications.

Why this matters

  • Prior studies, although limited by size and patient selection, have shown an association between endometriosis and spontaneous abortion, preterm birth, and low birth weight.
  • Endometriosis is associated with inflammation and progesterone resistance.
  • Increased antepartum surveillance may be warranted.

Key results

  • Endometriosis was associated with an increased relative risk (95% CI) for:
    • Spontaneous abortion: 1.40 (1.31-1.49);
    • Ectopic pregnancy: 1.46 (1.19-1.80);
    • Stillbirth: 1.27 (1.01-1.60);
    • Gestational diabetes mellitus (GDM): 1.35 (1.11-1.63);
    • Hypertensive disorders of pregnancy: 1.30 (1.16-1.45);
    • Preterm birth: 1.16 (1.05-1.28); and
    • Low birth weight: 1.16 (1.03-1.29).

Study design

  • Cohort was taken from the Nurses' Health Study II, a large, well-characterised prospective cohort study of 116,429 US registered nurses between the ages of 25 and 42 years at enrollment in 1989.
  • Women diagnosed with laparoscopically confirmed endometriosis (n=8875) were identified and compared with controls.
  • Main outcomes included spontaneous abortion, ectopic pregnancy, stillbirth, GDM, hypertensive disorders of pregnancy, preterm birth, and low birth weight.
  • Funding: NIH.

Limitations

  • Misclassification of endometriosis is possible.

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