Adverse pregnancy outcomes associated with adenomyosis with uterine enlargement

Mochimaru, Aya; Aoki, Shigeru; Oba, Mari S.; Kurasawa, Kentaro; Takahashi, Tsuneo; Hirahara, Fumiki

doi:10.1111/jog.12604

Cited by 87 publications

(122 citation statements)

References 20 publications

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“…12,15 In our study, the risk of PTB and SGA was significantly increased in women with adenomyosis, which was consistent with previous data. Adenomyosis was associated with an increased risk of PTB 9-12 and fetal growth restriction.…”

Section: Discussionsupporting

confidence: 93%

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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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Section: Discussionsupporting

confidence: 93%

“…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.…”

mentioning

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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“…2,3 However, the potential impact of adenomyosis on the outcomes of pregnancy is still unclear, because few studies have addressed the associations between adenomyosis and pregnancy outcomes, and because the study populations of those studies were small.…”

Section: Introductionmentioning

confidence: 99%

Complications and outcomes of pregnant women with adenomyosis in Japan

Tamura

Maekawa

Sugino

2018

Fertility and Sterility

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Purpose: To investigate the impact of adenomyosis on the complications and outcomes of pregnancy in Japan. Methods:We carried out a multicenter retrospective questionnaire survey. A questionnaire regarding pregnancy complications and the outcomes of pregnancy was sent to 725 facilities.Results: Data 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. Conclusions:Our 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. K E Y W O R D Sadenomyosis, complication, miscarriage, pregnancy, preterm delivery

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“…10 Dosing in each cohort occurred sequentially. Dose escalation proceeded once preliminary safety/tolerability (days [1][2][3][4][5][6][7][8][9][10][11][12][13][14] and PK data (days 1 and 7) had been reviewed for all subjects at the previous dose. Blood samples for safety and PK analysis were collected on days 1, 7, and 14 of the 14-day in-house treatment period.…”

Section: Multiple-day Dosing Studymentioning

confidence: 99%

“…2 In addition, the presence of adenomyosis has been implicated in impaired reproductive function including infertility, in vitro fertilization failure, idiopathic spontaneous abortions, and other adverse pregnancy outcomes. [3][4][5][6] The true incidence of adenomyosis is unknown; reliable epidemiological studies are unavailable because confirmation of the diagnosis of adenomyosis has primarily occurred at the time of hysterectomy. The prevalence of adenomyosis in women undergoing hysterectomy for menorrhagia or dysmenorrhea has been reported to range from 20% to 50%.…”

mentioning

confidence: 99%

Single‐ and Multiple‐Day Dosing Studies to Investigate High‐Dose Pharmacokinetics of Epelsiban and Its Metabolite, GSK2395448, in Healthy Female Volunteers

Mahar

Enslin

Gress

et al. 2017

Clinical Pharm in Drug Dev

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Open-label single-and double-blind repeat-dose studies in healthy female volunteers were conducted to investigate the pharmacokinetics (PK) and safety/tolerability of epelsiban total daily doses ranging from 600 to 900 mg. In 1 study (n = 12), epelsiban was dosed at 300 or 450 mg twice daily (every 12 hours) for a single day. In the repeat-dose doubleblind study, epelsiban and placebo were administered to 31 subjects as 200 mg 3 times daily, 300 mg 3 times daily (TID), or 450 mg twice daily (BID) for 14 days. After both single and 14 daily repeat doses, the PK profiles for epelsiban and its metabolite, GSK2395448, remained linear at all administered doses. The exposures at a given total daily dose were also similar between BID and TID dosing regimens. Exposure (AUC 0-τ ), based on dosing intervals, for both epelsiban and GSK2395448 was similar. However, compared with morning dosing, C max was lower after evening dosing, possibly because of a food effect. The highest accumulation of epelsiban and GSK2395448 exposures (AUC 0-τ ) was approximately 34% for each after repeat dosing, consistent with the short half-life. At total daily doses of 600 and 900 mg, epelsiban was generally well tolerated, and there were no significant safety concerns identified.

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Adverse pregnancy outcomes associated with adenomyosis with uterine enlargement

Abstract: Pregnancies in women with adenomyosis were associated with a higher preterm delivery rate and more frequent occurrences of fetal growth restriction and fetal malpresentation, such that both pregnancy and delivery outcomes were poor.

Cited by 87 publications

References 20 publications

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

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

Complications and outcomes of pregnant women with adenomyosis in Japan

Single‐ and Multiple‐Day Dosing Studies to Investigate High‐Dose Pharmacokinetics of Epelsiban and Its Metabolite, GSK2395448, in Healthy Female Volunteers

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