- 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.
- 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).
- 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.
- Misclassification of endometriosis is possible.