Endometriosis and pregnancy complications: a Danish cohort study

Women with endometriosis were at increased risk of preeclampsia, preterm birth, and cesarean section, irrespective of use of assisted reproductive technology.

Volume 107, Issue 1, Pages 160-166

Authors:

Maria Tølbøll Glavind, M.D., Axel Forman, Ph.D., Linn Håkonsen Arendt, M.D., Karsten Nielsen, M.D., Tine Brink Henriksen, Ph.D.

Abstract:

Objective

To study the association between endometriosis and risk of pre-eclampsia, cesarean section, postpartum hemorrhage, preterm birth, and small for gestational age (SGA), in a large Danish birth cohort, while taking fertility treatment into account.

Design

Population-based study.

Setting

Not applicable.

Patient(s)

A total population of 82,793 singleton pregnancies from the Aarhus Birth Cohort (1989 through 2013); 1,213 women had a diagnosis of endometriosis, affecting 1,719 pregnancies.

Intervention(s)

None.

Main Outcome Measure(s)

Pre-eclampsia, cesarean section, postpartum hemorrhage, preterm birth, and SGA.

Result(s)

Endometriosis was associated with an increased risk of preterm birth (adjusted odds ratio [AOR] 1.67, 95% confidence interval [CI] 1.37–2.05), with the risk being highest for very preterm birth (AOR 1.91, 95% CI 1.16–3.15). Compared with unaffected women, women with endometriosis also had an increased risk of pre-eclampsia (AOR 1.37, 95% CI 1.06–1.77) and cesarean section (AOR 1.83, 95% CI 1.60–2.09). Assisted reproductive technology did not explain these findings. No association was found between endometriosis and postpartum hemorrhage or SGA.

Conclusion(s)

Women with endometriosis were at increased risk of pre-eclampsia, preterm birth, and cesarean section, irrespective of use of assisted reproductive technology.


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