Risk of gestational hypertension-preeclampsia in women with preceding endometriosis: A nationwide population-based study

Pan, Mei Lien; Chen, Li Ru; Tsao, Hsiao Mei; Chen, Kuo Hu

doi:10.1371/journal.pone.0181261

Cited by 23 publications

(24 citation statements)

References 36 publications

(65 reference statements)

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“…However, a lack of distinction between women with DE and with other forms was lacking: These nationwide studies reported only the presence or absence of endometriosis, without subdividing different types, probably because the clinical data were extracted from large national databases. Another recent nationwide study in Taiwan confirmed the results of the previous three studies (adjusted OR 2.27; 95% CI 1.76-2.93; P< .05) and presented the same limitations (107). In 2007, a Belgian retrospective casecontrol study compared the incidence of preeclampsia and pregnancy-induced hypertension between 245 pregnancies of women with endometriosis and 274 pregnancies following treatment for male-factor infertility.…”

Section: Hypertensive Disorderssupporting

confidence: 61%

Obstetrical complications of endometriosis, particularly deep endometriosis

Maggiore

Inversetti

Schimberni

et al. 2017

Fertility and Sterility

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Over the past few years, a new topic in the field of endometriosis has emerged: the potential impact of the disease on pregnancy outcomes. This review aims to summarize in detail the available evidence on the relationship between endometriosis, particularly deep endometriosis (DE), and obstetrical outcomes. Acute complications of DE, such as spontaneous hemoperitoneum, bowel perforation, and uterine rupture, may occur during pregnancy. Although these events represent life-threatening conditions, they are rare and unpredictable. Therefore, the current literature does not support any kind of prophylactic surgery before pregnancy to prevent such complications. Results on the impact of DE on obstetrical outcomes are debatable and characterized by several limitations, including small sample size, lack of adjustment for confounders, lack of adequate control subjects, and other methodologic flaws. For these reasons, it is not possible to draw conclusions on this topic. The strongest evidence shows that DE is associated with higher rates of placenta previa; for other obstetrical outcomes, such as miscarriage, intrauterine growth restriction, preterm birth and hypertensive disorders, results are controversial. Although it is unlikely that surgery of DE may modify the impact of the disease on the course of pregnancy, no study has yet investigated this issue.

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Section: Hypertensive Disorderssupporting

confidence: 61%

Obstetrical complications of endometriosis, particularly deep endometriosis

Maggiore

Inversetti

Schimberni

et al. 2017

Fertility and Sterility

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“…Following title and abstract screen, 117 studies were included for full text review, and 33 studies (sample size, n = 3 280 488) were included in the meta-analysis (Fig. 1 ) ( Kortelahti et al , 2003 ; Omland et al , 2005 ; Brosens et al , 2007 ; Fernando et al , 2009 ; Hadfield et al , 2009 ; Healy et al , 2010 ; Kuivasaari-Pirinen et al , 2012 ; Takemura et al , 2013 ; Aris, 2014 ; Conti et al , 2014 ; Mekaru et al , 2014 ; Rombauts et al , 2014 ; Baggio et al , 2015 ; Lin et al , 2015 ; Messerlian et al , 2015 ; Stern et al , 2013 , 2015 ; Benaglia et al , 2012 , 2016 ; Exacoustos et al , 2016 ; Fujii et al , 2016 ; Guo et al , 2016 ; Harada et al , 2016 ; Jacques et al , 2016 ; Morassutto et al , 2016 ; Berlac et al , 2017 ; Glavind et al , 2017 ; Li et al , 2017 ; Mannini et al , 2017 ; Pan et al , 2017 ; Saraswat et al , 2017 ; Tzur et al , 2018 ; Chen et al , 2018 ).…”

Section: Resultsmentioning

confidence: 99%

“…(2015) Retrospective cohort 269 16 712 Combined spontaneous and assisted Not described Omland et al . (2005) Retrospective cohort 212 274 Assisted reproduction Surgical/Histological Pan et al (2017) Retrospective cohort 2578 10 312 Combined spontaneous and assisted Surgical/Histological Rombauts et al . (2014) Retrospective cohort 376 4016 Assisted reproduction Clinical Saraswat et al .…”

Section: Resultsmentioning

confidence: 99%

Endometriosis and adverse maternal, fetal and neonatal outcomes, a systematic review and meta-analysis

et al. 2018

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STUDY QUESTIONHow is endometriosis associated with adverse maternal, fetal and neonatal outcomes of pregnancy?SUMMARY ANSWERWomen with endometriosis are at elevated risk for serious and important adverse maternal (pre-eclampsia, gestational diabetes, placenta praevia and Cesarean section) and fetal or neonatal outcomes (preterm birth, PPROM, small for gestational age, stillbirth and neonatal death).WHAT IS KNOWN ALREADYA number of studies have shown an association between endometriosis and certain adverse maternal and fetal outcomes, but the results have been conflicting with potential for confounding by the use of assisted reproductive technology.STUDY DESIGN, SIZE, DURATIONA systematic review and meta-analysis of observational studies (1 January 1990–31 December 2017) that evaluated the effect of endometriosis on maternal, fetal and neonatal outcomes was conducted.PARTICIPANTS/MATERIALS, SETTING, METHODSStudies were considered for inclusion if they were prospective or retrospective cohort or case–control studies; included women greater than 20 weeks gestational age with endometriosis; included a control group of gravid women without endometriosis; and, reported at least one of the outcomes of interest. Each study was reviewed for inclusion, data were extracted and risk of bias was assessed by two independent reviewers.MAIN RESULTS AND THE ROLE OF CHANCEThe search strategy identified 33 studies (sample size, n = 3 280 488) for inclusion. Compared with women without endometriosis, women with endometriosis had higher odds of pre-eclampsia (odds ratio [OR] = 1.18 [1.01–1.39]), gestational hypertension and/or pre-eclampsia (OR = 1.21 [1.05–1.39]), gestational diabetes (OR = 1.26 [1.03–1.55]), gestational cholestasis (OR = 4.87 [1.85–12.83]), placenta praevia (OR = 3.31 [2.37, 4.63]), antepartum hemorrhage (OR = 1.69 [1.38–2.07]), antepartum hospital admissions (OR = 3.18 [2.60–3.87]), malpresentation (OR = 1.71 [1.34, 2.18]), labor dystocia (OR = 1.45 [1.04–2.01]) and cesarean section (OR = 1.86 [1.51–2.29]). Fetuses and neonates of women with endometriosis were also more likely to have preterm premature rupture of membranes (OR = 2.33 [1.39–3.90]), preterm birth (OR = 1.70 [1.40–2.06]), small for gestational age <10th% (OR = 1.28 [1.11–1.49]), NICU admission (OR = 1.39 [1.08–1.78]), stillbirth (OR = 1.29 [1.10, 1.52]) and neonatal death (MOR = 1.78 [1.46–2.16]). Among the subgroup of women who conceived spontaneously, endometriosis was found to be associated with placenta praevia, cesarean section, preterm birth and low birth weight. Among the subgroup of women who conceived with the use of assisted reproductive technology, endometriosis was found to be associated with placenta praevia and preterm birth.LIMITATIONS, REASONS FOR CAUTIONAs with any systematic review, the review is limited by the quality of the included studies. The diagnosis for endometriosis and the selection of comparison groups were not uniform across studies. However, the effect of potential misclassification would be bias towards the nul...

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“…The risk of pregnancy-induced hypertension and preeclampsia in women with endometriosis is a controversial issue; some studies have reported that the risk of pregnancy-induced hypertension/preeclampsia in women with endometriosis has decreased [15], others report that it is unchanged [16] or increased [14,41]. The mechanism involved seems to be a defective remodeling of the spiral arteries in the junctional zone and in the placental bed, probably due to immunological disorders, chronic inflammation, and oxidative stress [42].…”

Section: Discussionmentioning

confidence: 99%

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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Risk of gestational hypertension-preeclampsia in women with preceding endometriosis: A nationwide population-based study

Cited by 23 publications

References 36 publications

Obstetrical complications of endometriosis, particularly deep endometriosis

Obstetrical complications of endometriosis, particularly deep endometriosis

Endometriosis and adverse maternal, fetal and neonatal outcomes, a systematic review and meta-analysis

Endometriosis and Pregnancy: A Single Institution Experience

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