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Endometriosis is linked to greater risk of complications in pregnancy and birth, study finds

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h3252 (Published 16 June 2015) Cite this as: BMJ 2015;350:h3252
  1. Zosia Kmietowicz
  1. 1The BMJ

Women with endometriosis have a higher risk of miscarriage and ectopic pregnancy, a large cohort study in Scotland has found. Women with the condition who maintain a pregnancy for more than 24 weeks face further risks, including a higher risk of placenta praevia, bleeding before and after birth, and caesarean section.

To evaluate pregnancy outcomes researchers used discharge data from all NHS hospitals in Scotland and linked records of women with and without a confirmed diagnosis of endometriosis to their maternity records. Altogether 5375 women with endometriosis were compared with 8280 women without the condition and were followed up for a maximum of 30 years from 1981 to 2010.

Lucky Saraswat, consultant gynaecologist at Aberdeen Royal Infirmary, presented the data at the Science Media Centre in London ahead of the annual meeting of the European Society of Human Reproduction and Embryology in Lisbon from 14 to 17 June. The study has been submitted for publication.

After adjusting the data for age and previous pregnancy the researchers found that women with endometriosis were nearly three times more likely than those without the condition to have an ectopic pregnancy (adjusted odds ratio 2.7 (95% confidence interval 1.09 to 6.72)) and nearly twice as likely to have a miscarriage (1.76 (1.44 to 2.15)).

Among the women who carried on with the pregnancy past 24 weeks those with endometriosis were also more likely than women without the condition to have placenta praevia (2.24 (1.52 to 3.31)), unexplained antepartum haemorrhage (1.67 (1.39 to 2.00)), postpartum bleeding (1.30 (1.61 to 1.46)), caesarean delivery (1.40 (1.26 to 1.55)), and preterm birth (1.26 (1.07 to 1.49)).

Saraswat said that, although the findings might not be surprising, they provided a set of data with which to counsel women with endometriosis that was not previously available. She said that increased monitoring of women with endometriosis could help to identify problems in pregnancy early, before they become catastrophic. Knowing the risks associated with endometriosis could also help to ensure that women were treated in the appropriate setting, where specialist care is on hand, added Saraswat.

Notes

Cite this as: BMJ 2015;350:h3252

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