Adenomyosis and adverse perinatal outcomes: increased risk of second trimester miscarriage, preeclampsia, and placental malposition

Hashimoto, Ayako; Iriyama, Takayuki; Sayama, Seisuke; Nakayama, Tsuneyoshi; Komatsu, Akira; Miyauchi, Akira; Nishii, Osamu; Nagamatsu, Takeshi; Osuga, Yutaka; Fujii, Tomoyuki

doi:10.1080/14767058.2017.1285895

Cited by 96 publications

(126 citation statements)

References 22 publications

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“…Consistent with our results, high rates of miscarriage in pregnant women with adenomyosis were reported by Youm (adenomyosis: 31.8% [21/66] vs control: 12.5% [29/224]), and Martinez‐Conejero (adenomyosis: 32.8% [43/131] vs control: 16.3% [24/147]) . A recent report also showed a marked increase in the incidence of second trimester miscarriage (12.2%; 6/49) in pregnancies complicated by adenomyosis . Patients with adenomyosis also show high levels of inflammatory substances, such as prostaglandins, which have been suggested as potential causes of uterine contraction .…”

Section: Discussionsupporting

confidence: 91%

Complications and outcomes of pregnant women with adenomyosis in Japan

Tamura

Kishi

Kitade

et al. 2017

Reprod Medicine & Biology

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PurposeTo investigate the impact of adenomyosis on the complications and outcomes of pregnancy in Japan.MethodsWe carried out a multicenter retrospective questionnaire survey. A questionnaire regarding pregnancy complications and the outcomes of pregnancy was sent to 725 facilities.ResultsData were obtained on the cases of 272 pregnant women with adenomyosis from 65 facilities. The complications of pregnancy included miscarriage before 12 weeks of pregnancy (14.8%), miscarriage after 12 weeks of pregnancy (9.9%), preterm delivery (24.4%), fetal growth restriction (11.8%), pregnancy‐induced hypertension (9.9%), intrauterine infection (7.3%), and cervical incompetency (5.3%). The rates of pregnancy complications in the three groups classified according to pretreatment for adenomyosis (no pretreatment, medication, surgery) did not differ to a statistically significant extent. The rates of miscarriage (>12 weeks) and cervical incompetency increased according to the size of the adenomyosis. The rates of pregnancy‐induced hypertension and uterine infection in patients with diffuse‐type adenomyosis were higher than that in patients with focal‐type adenomyosis.ConclusionsOur results show that the increased size and diffuse type of adenomyosis are associated with adverse pregnancy outcome. We should be aware of the higher incidence of pregnancy‐induced hypertension and uterine infection in patients with diffuse‐type adenomyosis.

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Section: Discussionsupporting

confidence: 91%

Complications and outcomes of pregnant women with adenomyosis in Japan

Tamura

Kishi

Kitade

et al. 2017

Reprod Medicine & Biology

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“…The six studies were conducted between 2006 and 2018, and four were published after 2015. The studies were conducted in Japan (n=2), Turkey (n=1), Italy (n=1), Taiwan (n=1), and Korea (n=1) . The sample size ranged from 69 to 8326 women.…”

Section: Resultsmentioning

confidence: 99%

“…Only Hashimoto et al . reported the association between adenomyosis and spontaneous abortion with 294 participants (49 cases and 245 controls).…”

Section: Resultsmentioning

confidence: 99%

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Systematic review and meta‐analysis of adverse pregnancy outcomes after uterine adenomyosis

Razavi

Maleki‐Hajiagha

Sepidarkish

et al. 2019

Intl J Gynecology & Obste

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Background Studies on the impact of adenomyosis and its pregnancy complications have yielded conflicting results. Objective To determine the likelihood of adverse pregnancy outcomes among women with adenomyosis relative to women without adenomyosis. Search strategy PubMed, Embase, Scopus, and Web of Science were searched for studies published up to June 15, 2018. Selection criteria Observational studies with medically confirmed pregnancy outcomes as endpoints. Data collection and analysis Two researchers independently screened and selected relevant studies. Dichotomous data for all adverse pregnancy outcomes were expressed as an odds ratio (OR) with 95% confidence interval (CI), and combined in a meta‐analysis by using a random‐effects model. Main results Six studies (322 cases and 9420 controls) were eligible for inclusion in the meta‐analysis. Women with adenomyosis had an increased likelihood of preterm birth (OR, 3.05; 95% CI, 2.08–4.47; P˂0.001), small for gestational age (OR, 3.22; 95% CI, 1.71–6.08; P˂0.001), and pre‐eclampsia (OR, 4.35; 95% CI, 1.07–17.72; P=0.042). Conclusion Adenomyosis seems to have a detrimental impact on pregnancy outcomes, resulting in a higher likelihood of preterm birth, small for gestational age, and pre‐eclampsia.

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“…9,12 However, previous studies were conducted using retrospective reviews of patients from just one or only a few tertiary medical institutions. Preterm birth (PTB), which may cause low birthweight (LBW) in neonates, is a common obstetric complication, leading to significant neonatal morbidity and mortality.…”

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confidence: 99%

Risk of preterm birth, low birthweight and small‐for‐gestational‐age infants in pregnancies with adenomyosis: A cohort study of the Japan Environment and Children's Study

Yamaguchi

Kyozuka

Fujimori

et al. 2018

Acta Obstet Gynecol Scand

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Introduction This study evaluated the risk of preterm birth, low birthweight and small‐for‐gestational‐age neonates born to mothers with adenomyosis during pregnancy. Material and methods We used the results of a Japanese nationwide prospective birth cohort study, identifying 93 668 singleton deliveries from 2011 to 2014. We identified 314 pregnancies with adenomyosis using self‐reported questionnaires. Multiple logistic regression analyses were conducted to examine whether adenomyosis was associated with adverse pregnancy outcome. Maternal age, smoking status, method of conception, history of parity, fibroids, endometriosis and body mass index before pregnancy were analyzed as confounding factors. Results Multiple logistic regression analysis showed that pregnancy with adenomyosis was a risk factor for preterm birth at less than 37 weeks (adjusted odds ratio [aOR: 2.49, 95% confidence interval [CI] 1.89‐3.41), preterm birth at less than 34 weeks (aOR 1.91, 95% CI 1.02‐3.55), low birthweight <2500 g (aOR 1.83, 95% CI 1.36‐2.45), low birthweight <1500 g (aOR 2.39, 95% CI 1.20‐4.77) and small‐for‐gestational‐age neonates (aOR 1.68, 95% CI 1.13‐2.51). Conclusions This study found that pregnancy with adenomyosis was associated with preterm birth, low birthweight and small‐for‐gestational‐age neonates.

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Adenomyosis and adverse perinatal outcomes: increased risk of second trimester miscarriage, preeclampsia, and placental malposition

Abstract: Adenomyosis was associated not only with an increased incidence of preterm delivery, as previously reported, but also with an increased risk of second trimester miscarriage, preeclampsia, and placental malposition, which could lead to poor perinatal outcomes.

Cited by 96 publications

References 22 publications

Complications and outcomes of pregnant women with adenomyosis in Japan

Complications and outcomes of pregnant women with adenomyosis in Japan

Systematic review and meta‐analysis of adverse pregnancy outcomes after uterine adenomyosis

Risk of preterm birth, low birthweight and small‐for‐gestational‐age infants in pregnancies with adenomyosis: A cohort study of the Japan Environment and Children's Study

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