Impact of Endometriosis on Obstetric Outcome After Natural Conception: a Multicenter Italian Study

Overview

Journal Arch Gynecol Obstet

Specialty Gynecology & Obstetrics

Date 2021 Oct 8

PMID 34623489

Citations 14

Authors

N Berlanda

W Alio

S Angioni

V Bergamini

C Bonin

P Boracchi

M Candiani

G Centini

M N DAlterio

S Del Forno

A Donati

D Dridi

D Incandela

L Lazzeri

A Maiorana

A Mattei

J Ottolina

A Orenti

A Perandini

F Perelli

I Piacenti

I Pino

M G Porpora

S Scaramuzzino

R Seracchioli

E Solima

E Somigliana

R Venturella

P Vercellini

P Vigano

M Vignali

F Zullo

E Zupi

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate obstetric outcome in women with endometriosis who conceive naturally and receive standard obstetric care in Italy.

Methods: Cases were consecutive women with endometriosis managed in eleven Italian referral centers. Controls were women in whom endometriosis was excluded. All women filled in a questionnaire addressing previous natural pregnancies. Marginal logistic regression models were fitted to evaluate the impact of endometriosis on obstetric outcome. A post hoc analysis was performed within the endometriosis group comparing women with severe adenomyosis versus women with absent or mild adenomyosis.

Results: Three hundred and fifty-five pregnancies in endometriosis group and 741 pregnancies in control group were included. Women with endometriosis had a higher risk of preterm delivery < 34 weeks (6.4% vs 2.8%, OR 2.42, 95% CI 1.22-4.82), preterm delivery < 37 weeks (17.8% vs 9.7%, OR 1.98, 95% CI 1.23-3.19), and neonatal admission to Intensive Care Unit (14.1% vs 7.0%, OR 2.04, 95% CI 1.23-3.36). At post hoc analysis, women with endometriosis and severe adenomyosis had an increased risk of placenta previa (23.1% vs 1.8%, OR 16.68, 95% CI 3.49-79.71), cesarean delivery (84.6% vs 38.9%, OR 8.03, 95% CI 1.69-38.25) and preterm delivery < 34 weeks (23.1% vs 5.7%, OR 5.52, 95% CI 1.38-22.09).

Conclusion: Women with endometriosis who conceive naturally have increased risk of preterm delivery and neonatal admission to intensive care unit. When severe adenomyosis is coexistent with endometriosis, women may be at increased risk of placenta previa and cesarean delivery.

Trial Registration: Clinical trial registration number: NCT03354793.

Citing Articles

Endometriosis and adverse pregnancy outcomes: A case-control study.

Shahmoradi F, Haghighi L, Noori M, Derakhshan R, Hashemi N, Rokhgireh S Int J Reprod Biomed. 2024; 22(6):473-480.

PMID: 39205922 PMC: 11347764. DOI: 10.18502/ijrm.v22i6.16798.

The impact of endometriosis on depressive and anxiety symptoms and quality of life: a systematic review.

Szyplowska M, Tarkowski R, Kulak K Front Public Health. 2023; 11:1230303.

PMID: 37744486 PMC: 10512020. DOI: 10.3389/fpubh.2023.1230303.

Effects of localization of uterine adenomyosis on clinical features and pregnancy outcome.

Shi J, Wu Y, Li X, Gu Z, Zhang C, Yan H Sci Rep. 2023; 13(1):14714.

PMID: 37679426 PMC: 10485030. DOI: 10.1038/s41598-023-40816-z.

Impact of adenomyosis on perinatal outcomes: a large cohort study (JSOG database).

Komatsu H, Taniguchi F, Harada T BMC Pregnancy Childbirth. 2023; 23(1):579.

PMID: 37568120 PMC: 10422787. DOI: 10.1186/s12884-023-05895-w.

Higher miscarriage rate in subfertile women with endometriosis receiving unbiopsied frozen-warmed single blastocyst transfers.

Sachs M, Makieva S, Dedes I, Kalaitzopoulos D, El-Hadad S, Xie M Front Cell Dev Biol. 2023; 11:1092994.

PMID: 37123402 PMC: 10140404. DOI: 10.3389/fcell.2023.1092994.

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