Endometriosis and adenomyosis are associated with increased risk of preterm delivery and a small‐for‐gestational‐age child: a systematic review and meta‐analysis

Bruun, Mette Rahbek; Arendt, Linn Håkonsen; Forman, Axel; Ramlau‐Hansen, Cecilia Høst

doi:10.1111/aogs.13364

Cited by 59 publications

(54 citation statements)

References 48 publications

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“…In particular, the studies included in the systematic review conducted by Bruun et al did not distinguish elective from spontaneous preterm deliveries. All these confounding factors may have influenced the results and the correlation between endometriosis and poor fetal outcome [32]. In the present study, no significant difference was found between cases and controls regarding birth weight, Apgar score, and newborn health.…”

Section: Discussioncontrasting

confidence: 66%

“…Recent studies found that preterm birth rate increases independently of the pregnancy onset (spontaneous or after ART) [14,30,31]. A significant correlation between preterm birth/premature rupture of membranes and adenomyosis [13,32] and DIE has recently been reported [33]. However, hormonal changes related to pregnancy may also have a protective role, as the rise of progesterone levels may reduce the typical inflammation caused by endometriosis, thereby reducing obstetrical complications in subsequent pregnancies [24].…”

Section: Discussionmentioning

confidence: 99%

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Endometriosis and Pregnancy: A Single Institution Experience

Porpora

Tomao

Ticino

et al. 2020

IJERPH

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Endometriosis may compromise the physiological course of pregnancy. The aim of this prospective observational study was to evaluate whether endometriosis causes a higher prevalence of obstetric and neonatal complications as well as a higher risk of caesarean section and to detect a possible correlation between the presence, type, and location of endometriosis and obstetric complications, previous surgery, and pregnancy outcome, as well as the influence of pregnancy on the course of the disease. We compared two cohorts of women with spontaneous pregnancy, with and without endometriosis. Obstetric and neonatal outcomes, mode of delivery, presence, type, and location of endometriotic lesions and the effect of pregnancy on the disease were analyzed. A total of 425 pregnancies were evaluated: 145 cases and 280 controls. Patients with endometriosis showed a higher incidence of miscarriage, threatened miscarriage, threatened preterm labor, preterm delivery, placental abruption, and a higher incidence of caesarean section. A significant correlation with pregnancy-induced hypertension and preeclampsia was found in the presence of adenomyosis. No difference in fetal outcome was found. One case of hemoperitoneum during pregnancy was observed. Pregnancy in women with endometriosis carries a higher risk of obstetric complications, such as miscarriage, threatened miscarriage, preterm labor, preterm birth, and a higher caesarean section rate. Endometriosis does not seem to influence fetal well-being.

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Endometriosis and Pregnancy: A Single Institution Experience

Porpora

Tomao

Ticino

et al. 2020

IJERPH

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“…The thickened junctional zone is diagnostic for adenomyosis and can lead to a disrupted placental bed and thereby obstetrical complications [85,89]. A recent review showed adenomyosis to have an even stronger association with preterm birth and SGA than endometriosis [90].…”

Section: Potential Mechanismsmentioning

confidence: 99%

Endometriosis and Risk of Adverse Pregnancy Outcome: A Systematic Review and Meta-Analysis

Breintoft

Pinnerup

Henriksen

et al. 2021

JCM

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Background: This systematic review and meta-analysis summarizes the evidence for the association between endometriosis and adverse pregnancy outcome, including gestational hypertension, pre-eclampsia, low birth weight, and small for gestational age, preterm birth, placenta previa, placental abruption, cesarean section, stillbirth, postpartum hemorrhage, spontaneous hemoperitoneum in pregnancy, and spontaneous bowel perforation in pregnancy. Methods: We performed the literature review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), by searches in PubMed and EMBASE, until 1 November 2020 (PROSPERO ID CRD42020213999). We included peer-reviewed observational cohort studies and case-control studies and scored them according to the Newcastle–Ottawa Scale, to assess the risk of bias and confounding. Results: 39 studies were included. Women with endometriosis had an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth, compared to women without endometriosis. These results remained unchanged in sub-analyses, including studies on spontaneous pregnancies only. Spontaneous hemoperitoneum in pregnancy and bowel perforation seemed to be associated with endometriosis; however, the studies were few and did not meet the inclusion criteria. Conclusions: The literature shows that endometriosis is associated with an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth.

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“…Disturbed uteroplacental hemodynamics associated with insufficient trophoblastic invasion, fetal growth restriction and pre-eclampsia are well-known complications in diffuse adenomyosis. This thesis was supported by reduced pregnancy-associated placental protein-A (PAPP-A) level and increased pulsatile index (PI) in uterine artery detected in several investigations 5,6 . Preterm birth and preterm rupture of the fetal membrane were also found as reasons for adverse perinatal outcome 3,4,[6][7][8] .…”

Section: Introductionmentioning

confidence: 84%

“…The activity of the angiogenic factors was a possible compensatory mechanism responsible for the trophoblastic invasion. Chorionic and placental polypeptide growth factors and antioxidants also could be thought to ameliorate placentation 3,5 . Therefore, the abnormal myometrial structure did not induce any placental disorders.…”

Section: Discussionmentioning

confidence: 99%

Hiding in plain sight or going beyond the duodenal papilla: a case series

Opriță

Constantinescu

Berea

et al. 2021

Arch Balk Med Union

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Grossesse spontanée, macrosomie et disproportion céphalopelvienne dans l'adénomyose diffuse: rapport de casIntroduction. L'adénomyose augmente les complications obstétricales et périnatales. Présentation du cas. Nous présentons un cas rare de grossesse spontanée, de gros foetus et de disproportion céphalopelvienne chez une femme atteinte d'adénomyose diffuse. Aucun marqueur biophysique ou biochimique d'échec de la placentation n'a été détecté pendant la grossesse. Cependant, l'accouchement a été compliqué par une disproportion céphalopelvienne. Un bébé mâle de 4350 g de poids, 59 cm de longueur, avec un tour de tête de 38 cm et un score d'Apgar de 8 à 9 a été né par césarienne. La conception spontanée et l'absence d'insuffisance placentaire chronique étaient des présentations inhabituelles dans ce cas. Conclusions. Le fait d'une dilatation cervicale complète et d'une disproportion céphalopelvienne dans l'adénomyose diffuse est d'un grand intérêt. Le cas clinique présenté est un motif pour la poursuite des études dans le domaine de l'évolution foetale et de l'activité contractile utérine dans l'adénomyose.

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Endometriosis and adenomyosis are associated with increased risk of preterm delivery and a small‐for‐gestational‐age child: a systematic review and meta‐analysis

Cited by 59 publications

References 48 publications

Endometriosis and Pregnancy: A Single Institution Experience

Endometriosis and Pregnancy: A Single Institution Experience

Endometriosis and Risk of Adverse Pregnancy Outcome: A Systematic Review and Meta-Analysis

Hiding in plain sight or going beyond the duodenal papilla: a case series

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