TY - JOUR
T1 - Endometriosis and Risk of Adverse Pregnancy Outcomes
AU - Farland, Leslie V.
AU - Prescott, Jennifer
AU - Sasamoto, Naoko
AU - Tobias, Deirdre K.
AU - Gaskins, Audrey J.
AU - Stuart, Jennifer J.
AU - Carusi, Daniela A.
AU - Chavarro, Jorge E.
AU - Horne, Andrew W.
AU - Rich-Edwards, Janet W.
AU - Missmer, Stacey A.
N1 - Publisher Copyright:
© 2019 by the American College of Obstetricians and Gynecologists.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - OBJECTIVE:To investigate the relationship between endometriosis and adverse pregnancy outcomes.METHODS:Women between ages 25 and 42 years in 1989 (n=116,429) reported detailed information on pregnancies and reproductive health at baseline and every 2 years thereafter in the Nurses' Health Study II, a cohort study. In 2009, they completed a detailed, pregnancy-focused questionnaire. A total of 196,722 pregnancies were reported. Adverse pregnancy outcomes included spontaneous abortion, ectopic pregnancy, stillbirth, gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (preeclampsia or gestational hypertension), preterm birth, and low birth weight. We estimated the relative risks (RRs) and 95% CIs of adverse pregnancy outcomes comparing pregnancies in women with and without a history of laparoscopically confirmed endometriosis using multivariable log-binomial regression, with generalized estimating equations to account for multiple pregnancies per woman.RESULTS:Endometriosis was associated with a greater risk of pregnancy loss (spontaneous abortion: RR 1.40, 95% CI 1.31-1.49; ectopic pregnancy: RR 1.46, 95% CI 1.19-1.80). Endometriosis was also associated with a greater risk of GDM (RR 1.35, 95% CI 1.11-1.63) and hypertensive disorders of pregnancy (RR 1.30, 95% CI 1.16-1.45).CONCLUSIONS:We observed an association between laparoscopically confirmed endometriosis and several adverse pregnancy outcomes. Future research should focus on the potential biological pathways underlying these relationships to inform screening or preventive interventions.
AB - OBJECTIVE:To investigate the relationship between endometriosis and adverse pregnancy outcomes.METHODS:Women between ages 25 and 42 years in 1989 (n=116,429) reported detailed information on pregnancies and reproductive health at baseline and every 2 years thereafter in the Nurses' Health Study II, a cohort study. In 2009, they completed a detailed, pregnancy-focused questionnaire. A total of 196,722 pregnancies were reported. Adverse pregnancy outcomes included spontaneous abortion, ectopic pregnancy, stillbirth, gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (preeclampsia or gestational hypertension), preterm birth, and low birth weight. We estimated the relative risks (RRs) and 95% CIs of adverse pregnancy outcomes comparing pregnancies in women with and without a history of laparoscopically confirmed endometriosis using multivariable log-binomial regression, with generalized estimating equations to account for multiple pregnancies per woman.RESULTS:Endometriosis was associated with a greater risk of pregnancy loss (spontaneous abortion: RR 1.40, 95% CI 1.31-1.49; ectopic pregnancy: RR 1.46, 95% CI 1.19-1.80). Endometriosis was also associated with a greater risk of GDM (RR 1.35, 95% CI 1.11-1.63) and hypertensive disorders of pregnancy (RR 1.30, 95% CI 1.16-1.45).CONCLUSIONS:We observed an association between laparoscopically confirmed endometriosis and several adverse pregnancy outcomes. Future research should focus on the potential biological pathways underlying these relationships to inform screening or preventive interventions.
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U2 - 10.1097/AOG.0000000000003410
DO - 10.1097/AOG.0000000000003410
M3 - Article
C2 - 31403584
AN - SCOPUS:85071712880
SN - 0029-7844
VL - 134
SP - 527
EP - 536
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 3
ER -