Endometriosis and Risk of Adverse Pregnancy Outcomes

To investigate the relationship between endometriosis and adverse pregnancy outcomes. 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 stu...

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Published in:Obstetrics and gynecology (New York. 1953) Vol. 134; no. 3; p. 527
Main Authors: Farland, Leslie V, Prescott, Jennifer, Sasamoto, Naoko, Tobias, Deirdre K, Gaskins, Audrey J, Stuart, Jennifer J, Carusi, Daniela A, Chavarro, Jorge E, Horne, Andrew W, Rich-Edwards, Janet W, Missmer, Stacey A
Format: Journal Article
Language:English
Published: United States 01.09.2019
Subjects:
Abortion, Spontaneous - epidemiology
Abortion, Spontaneous - etiology
Adult
Cohort Studies
Endometriosis - complications
Female
Humans
Pregnancy
Pregnancy Complications - epidemiology
Pregnancy Complications - etiology
Pregnancy Outcome
Risk
ISSN:1873-233X, 1873-233X
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Abstract To investigate the relationship between endometriosis and adverse pregnancy outcomes. 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. 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). 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.
AbstractList To investigate the relationship between endometriosis and adverse pregnancy outcomes.OBJECTIVETo investigate the relationship between endometriosis and adverse pregnancy outcomes.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.METHODSWomen 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.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).RESULTSEndometriosis 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).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.CONCLUSIONSWe 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.
To investigate the relationship between endometriosis and adverse pregnancy outcomes. 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. 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). 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.
Author Farland, Leslie V
Horne, Andrew W
Gaskins, Audrey J
Rich-Edwards, Janet W
Tobias, Deirdre K
Stuart, Jennifer J
Carusi, Daniela A
Sasamoto, Naoko
Chavarro, Jorge E
Missmer, Stacey A
Prescott, Jennifer
Author_xml – sequence: 1
  givenname: Leslie V
  surname: Farland
  fullname: Farland, Leslie V
  organization: Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona; the Channing Division of Network Medicine, the Department of Obstetrics, Gynecology, and Reproductive Biology, the Division of Preventive Medicine, and the Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, and the Department of Nutrition and the Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; the MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland; and the Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, Michigan
– sequence: 2
  givenname: Jennifer
  surname: Prescott
  fullname: Prescott, Jennifer
– sequence: 3
  givenname: Naoko
  surname: Sasamoto
  fullname: Sasamoto, Naoko
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  givenname: Deirdre K
  surname: Tobias
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  givenname: Audrey J
  surname: Gaskins
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  givenname: Jennifer J
  surname: Stuart
  fullname: Stuart, Jennifer J
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  givenname: Daniela A
  surname: Carusi
  fullname: Carusi, Daniela A
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  givenname: Jorge E
  surname: Chavarro
  fullname: Chavarro, Jorge E
– sequence: 9
  givenname: Andrew W
  surname: Horne
  fullname: Horne, Andrew W
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  surname: Rich-Edwards
  fullname: Rich-Edwards, Janet W
– sequence: 11
  givenname: Stacey A
  surname: Missmer
  fullname: Missmer, Stacey A
BackLink https://www.ncbi.nlm.nih.gov/pubmed/31403584$$D View this record in MEDLINE/PubMed
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Snippet To investigate the relationship between endometriosis and adverse pregnancy outcomes. Women between ages 25 and 42 years in 1989 (n=116,429) reported detailed...
To investigate the relationship between endometriosis and adverse pregnancy outcomes.OBJECTIVETo investigate the relationship between endometriosis and adverse...
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SubjectTerms Abortion, Spontaneous - epidemiology
Abortion, Spontaneous - etiology
Adult
Cohort Studies
Endometriosis - complications
Female
Humans
Pregnancy
Pregnancy Complications - epidemiology
Pregnancy Complications - etiology
Pregnancy Outcome
Risk
Title Endometriosis and Risk of Adverse Pregnancy Outcomes
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