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.

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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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Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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