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Grand Rounds

Is There a Link Between Endometriosis and Adverse Pregnancy Outcomes?

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BACKGROUND AND PURPOSE:

  • Farland et al. (Obstetrics & Gynecology, 2019) examined the association between endometriosis and adverse pregnancy outcomes

METHODS:

  • Prospective cohort study (the Nurses’ Health Study II)
  • Participants
    • Women between ages 25 and 42 years
    • Ongoing study that began in 1989
    • Endometriosis: Diagnosed via laparoscopy
  • Data collection
    • Self-administered questionnaires at baseline and then every 2 years
    • Includes information on pregnancies and reproductive health
    • Pregnancy-focused questionnaire in 2009
  • Adverse pregnancy outcomes
    • Spontaneous abortion | Ectopic pregnancy | Stillbirth | GDM | Preeclampsia or gestational hypertension | Preterm birth | LBW
  • Data analysis
    • Calculated relative risk (RRs) and 95% CIs of adverse pregnancy outcomes using multivariable adjusted models
    • Generalized estimating equations were used to account for multiple pregnancies per woman

RESULTS:

  • Endometriosis was associated with an increased risk of
    • Pregnancy loss
      • Spontaneous abortion: RR 1.40 (95% CI, 1.31 to 1.49)
      • Ectopic pregnancy: RR 1.46 (95% CI, 1.19 to 1.80)
    • GDM: RR 1.35 (95% CI, 1.11 to 1.63)
    • Preeclampsia or gestational hypertension: RR 1.30 (95% CI, 1.16 to 1.45)
    • Preterm birth: RR 1.16 (95% CI,1.05–1.28
    • LBW: RR 1.16 (95% CI, 1.03–1.29
    • Stillbirth risk appeared elevated among women with confirmed endometeriosis, but authors caution small ‘n’ and at 99% CI, was no longer significant

CONCLUSION:

  • Endometriosis was associated with increased risk for adverse events
  • The authors suggest further research to confirm findings and understand underlying mechanisms to inform potential screening and/or treatment programs

Learn more – Primary Sources:

Endometriosis and Risk of Adverse Pregnancy Outcomes

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Related ObG Topics:

Evaluation and Treatment of Endometriosis
Does Vasopressin Injection Reduce Risk of Reduced Ovarian Reserve During Surgery for Bilateral Endometriomas?
Comparing IUD vs Implant for the Management of Endometriosis
Does the Oral GnRH Antagonist Elagolix Improve Endometriosis-Associated Pain?

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