Vol 95, No 9 (2024)
Research paper
Published online: 2021-08-03

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Adverse pregnancy outcomes for women with endometriosis: a systematic review and meta-analysis

Jian-Qing Wang1, Jia-Miao Zhang2, Bin Qian1
Pubmed: 34541648
Ginekol Pol 2024;95(9):668-676.

Abstract

Objectives: This study aimed at assessing the adverse outcomes of pregnancy in women with endometriosis. Material and methods: The Cochrane, Embase and PubMed databases were searched for identifying the required studies published before June 2019. Meta-analyses of relative risk (RR) were performed under the random-effects model to estimate the risk of selected adverse outcomes of pregnancy in females with endometriosis. Results: Twenty-eight studies (53,141 women with and 2,355,923 women without endometriosis data) were selected for meta-analysis. Endometriosis bearing females had a significantly higher risk placenta previa (RR 3.92 [95% CI 2.48–6.20]), miscarriage (RR 1.31 [95% CI 1.06–1.61), gestational hypertension (RR 1.30 [95% CI 1.02–1.65]), cesarean section (RR 1.48 [95% CI 1.33–1.65]) and preeclampsia (RR 1.18 [95% CI 1.09–1.28]). The incidence of placental abruption was not statistically significant between the groups (RR 3.62 [95% CI [0.99–13.28]). Conclusions: Women suffering from endometriosis are at higher risks of miscarriage, preterm birth, gestational hypertension, placenta previa, cesarean section, and preeclampsia.

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References

  1. Greene AD, Lang SA, Kendziorski JA, et al. Endometriosis: where are we and where are we going? Reproduction. 2016; 152(3): R63–R78.
  2. Burney RO, Giudice LC, Tamaresis JS, et al. Gene expression analysis of endometrium reveals progesterone resistance and candidate susceptibility genes in women with endometriosis. Endocrinology. 2007; 148(8): 3814–3826.
  3. Practice Committee of the American Society for Reproductive Medicine. Endometriosis and infertility. Fertil Steril. 2004; 81(5): 1441–1446.
  4. Brosens I, Brosens JJ, Fusi L, et al. Risks of adverse pregnancy outcome in endometriosis. Fertil Steril. 2012; 98(1): 30–35.
  5. Jenkins S, Olive DL, Haney AF. Endometriosis: pathogenetic implications of the anatomic distribution. Obstet Gynecol. 1986; 67(3): 335–338.
  6. Abbas S, Ihle P, Köster I, et al. Prevalence and incidence of diagnosed endometriosis and risk of endometriosis in patients with endometriosis-related symptoms: findings from a statutory health insurance-based cohort in Germany. Eur J Obstet Gynecol Reprod Biol. 2012; 160(1): 79–83.
  7. Parasar P, Ozcan P, Terry KL. Endometriosis: epidemiology, diagnosis and clinical management. Curr Obstet Gynecol Rep. 2017; 6(1): 34–41.
  8. Sampson JA, et al. Metastatic or embolic endometriosis, due to the menstrual dissemination of endometrial tissue into the venous circulation. Am J Pathol. 1927; 3(2): 93–110.43.
  9. Laganà AS, Vitale SG, Salmeri FM, et al. Unus pro omnibus, omnes pro uno: A novel, evidence-based, unifying theory for the pathogenesis of endometriosis. Med Hypotheses. 2017; 103: 10–20.
  10. Vitale SG, Capriglione S, Peterlunger I, et al. The role of oxidative stress and membrane transport systems during endometriosis: A fresh look at a busy corner. Oxid Med Cell Longev. 2018; 2018: 7924021.
  11. Vercellini P, Viganò P, Somigliana E, et al. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol. 2014; 10(5): 261–275.
  12. Vitale SG, La Rosa VL, Rapisarda AM, et al. Impact of endometriosis on quality of life and psychological well-being. J Psychosom Obstet Gynaecol. 2017; 38(4): 317–319.
  13. Aris A. A 12-year cohort study on adverse pregnancy outcomes in Eastern Townships of Canada: impact of endometriosis. Gynecol Endocrinol. 2014; 30(1): 34–37.
  14. Benaglia L, Bermejo A, Somigliana E, et al. Pregnancy outcome in women with endometriomas achieving pregnancy through IVF. Hum Reprod. 2012; 27(6): 1663–1667.
  15. Benaglia L, Candotti G, Papaleo E, et al. Pregnancy outcome in women with endometriosis achieving pregnancy with IVF. Hum Reprod. 2016; 31(12): 2730–2736.
  16. Bourdon M, Raad J, Dahan Y, et al. Endometriosis and ART: A prior history of surgery for OMA is associated with a poor ovarian response to hyperstimulation. PLoS One. 2018; 13(8): e0202399.
  17. Chen I, Shen M, Singh SS, et al. The association between surgically-diagnosed endometriosis and adverse pregnancy outcomes. J Minim Invasive Gynecol. 2015; 22(6S): S72–S73.
  18. Conti N, Cevenini G, Vannuccini S, et al. Women with endometriosis at first pregnancy have an increased risk of adverse obstetric outcome. J Matern Fetal Neonatal Med. 2015; 28(15): 1795–1798.
  19. Exacoustos C, Lauriola I, Lazzeri L, et al. Complications during pregnancy and delivery in women with untreated rectovaginal deep infiltrating endometriosis. Fertil Steril. 2016; 106(5): 1129–1135.e1.
  20. FitzSimmons J, Stahl R, Gocial B, et al. Spontaneous abortion and endometriosis. Fertil Steril. 1987; 47(4): 696–698.
  21. Glavind MT, Forman A, Arendt LH, et al. Endometriosis and pregnancy complications: a Danish cohort study. Fertil Steril. 2017; 107(1): 160–166.
  22. González-Comadran M, Schwarze JE, Zegers-Hochschild F, et al. The impact of endometriosis on the outcome of Assisted Reproductive Technology. Reprod Biol Endocrinol. 2017; 15(1): 8.
  23. Harada T, Taniguchi F, Onishi K, et al. Japan Environment & Children’s Study Group. Obstetrical complications in women with endometriosis: A cohort study in Japan. PLoS One. 2016; 11(12): e0168476.
  24. Hjordt Hansen MV, Dalsgaard T, Hartwell D, et al. Reproductive prognosis in endometriosis. A national cohort study. Acta Obstet Gynecol Scand. 2014; 93(5): 483–489.
  25. Jacques M, Freour T, Barriere P, et al. Adverse pregnancy and neo-natal outcomes after assisted reproductive treatment in patients with pelvic endometriosis: a case-control study. Reprod Biomed Online. 2016; 32(6): 626–634.
  26. Kortelahti M, Anttila MA, Hippeläinen MI, et al. Obstetric outcome in women with endometriosis--a matched case-control study. Gynecol Obstet Invest. 2003; 56(4): 207–212.
  27. Kuivasaari-Pirinen P, Raatikainen K, Hippeläinen M, et al. Adverse Outcomes of IVF/ICSI Pregnancies Vary Depending on Aetiology of Infertility. ISRN Obstet Gynecol. 2012; 2012: 451915.
  28. Li H, Zhu HL, Chang XH, et al. Effects of previous laparoscopic surgical diagnosis of endometriosis on pregnancy outcomes. Chin Med J (Engl). 2017; 130(4): 428–433.
  29. Lin H, Leng JH, Liu JT, et al. Obstetric outcomes in Chinese women with endometriosis: a retrospective cohort study. Chin Med J (Engl). 2015; 128(4): 455–458.
  30. Mannini L, Sorbi F, Noci I, et al. New adverse obstetrics outcomes associated with endometriosis: a retrospective cohort study. Arch Gynecol Obstet. 2017; 295(1): 141–151.
  31. Matorras R, Rodríguez F, Gutierrez de Terán G, et al. Endometriosis and spontaneous abortion rate: a cohort study in infertile women. Eur J Obstet Gynecol Reprod Biol. 1998; 77(1): 101–105.
  32. Mekaru K, Masamoto H, Sugiyama H, et al. Endometriosis and pregnancy outcome: are pregnancies complicated by endometriosis a high-risk group? Eur J Obstet Gynecol Reprod Biol. 2014; 172: 36–39.
  33. Nirgianakis K, Gasparri ML, Radan AP, et al. Obstetric complications after laparoscopic excision of posterior deep infiltrating endometriosis: a case-control study. Fertil Steril. 2018; 110(3): 459–466.
  34. Pittaway DE, Vernon C, Fayez JA. Spontaneous abortions in women with endometriosis. Fertil Steril. 1988; 50(5): 711–715.
  35. Safdarian L, Ghalandarpoor Attar SN, Aleyasin A, et al. Investigation of anti-mullerian hormone (AMH) level and ovarian response in infertile women with endometriosis in IVF cycles. Int J Reprod Biomed. 2018; 16(11): 719–722.
  36. Saraswat L, Ayansina DT, Cooper KG, et al. Pregnancy outcomes in women with endometriosis: a national record linkage study. BJOG. 2017; 124(3): 444–452.
  37. Stephansson O, Kieler H, Granath F, et al. Endometriosis, assisted reproduction technology, and risk of adverse pregnancy outcome. Hum Reprod. 2009; 24(9): 2341–2347.
  38. Stern JE, Liu CL, Hwang SS, et al. Adverse pregnancy and birth outcomes associated with underlying diagnosis with and without assisted reproductive technology treatment. Fertil Steril. 2015; 103(6): 1438–1445.
  39. Yang P, Wang Y, Wu Z, et al. Risk of miscarriage in women with endometriosis undergoing IVF fresh cycles: a retrospective cohort study. Reprod Biol Endocrinol. 2019; 17(1): 21.
  40. Lalani S, Choudhry AJ, Firth B, et al. Endometriosis and adverse maternal, fetal and neonatal outcomes, a systematic review and meta-analysis. Hum Reprod. 2018; 33(10): 1854–1865.
  41. Zullo F, Spagnolo E, Saccone G, et al. Endometriosis and obstetrics complications: a systematic review and meta-analysis. Fertil Steril. 2017; 108(4): 667–672.e5.
  42. Pan ML, Chen LR, Tsao HM, et al. Risk of gestational hypertension-preeclampsia in women with preceding endometriosis: A nationwide population-based study. PLoS One. 2017; 12(7): e0181261.
  43. Pérez-López FR, Calvo-Latorre J, Alonso-Ventura V, et al. Health Outcomes, Systematic Analyses (HOUSSAY) Project. Systematic review and meta-analysis regarding the association of endometriosis and preeclampsia in women conceiving spontaneously or through assisted reproductive technology. Pregnancy Hypertens. 2018; 14: 213–221.
  44. Gasparri ML, Nirgianakis K, Taghavi K, et al. Placenta previa and placental abruption after assisted reproductive technology in patients with endometriosis: a systematic review and meta-analysis. Arch Gynecol Obstet. 2018; 298(1): 27–34.
  45. Laganà AS, Vitale SG, Granese R, et al. Clinical dynamics of Dienogest for the treatment of endometriosis: from bench to bedside. Expert Opin Drug Metab Toxicol. 2017; 13(6): 593–596.
  46. Raffaelli R, Garzon S, Baggio S, et al. Mesenteric vascular and nerve sparing surgery in laparoscopic segmental intestinal resection for deep infiltrating endometriosis. Eur J Obstet Gynecol Reprod Biol. 2018; 231: 214–219.
  47. Laganà AS, Vitale SG, Trovato MA, et al. Full-thickness excision versus shaving by laparoscopy for intestinal deep infiltrating endometriosis: rationale and potential treatment options. Biomed Res Int. 2016; 2016: 3617179.