Endometriosis and obstetrics complications: a systematic review and meta-analysis.

Abstract:

OBJECTIVE:To evaluate the effect of endometriosis on pregnancy outcomes. DESIGN:Systematic review and meta-analysis. SETTING:Not applicable. PATIENT(S):Women with or without endometriosis. INTERVENTION(S):Electronic databases searched from their inception until February 2017 with no limit for language and with all cohort studies reporting the incidence of obstetric complications in women with a diagnosis of endometriosis compared with a control group (women without a diagnosis of endometriosis) included. MEAN OUTCOME MEASURE(S):Primary outcome of incidence of preterm birth at <37 weeks with meta-analysis performed using the random effects model of DerSimonian and Laird to produce an odds ratio (OR) with 95% confidence interval (CI). RESULT(S):Twenty-four studies were analyzed comprising 1,924,114 women. In most of them, the diagnosis of endometriosis was made histologically after surgery. Women with endometriosis had a statistically significantly higher risk of preterm birth (OR 1.63; 95% CI, 1.32-2.01), miscarriage (OR 1.75; 95% CI, 1.29-2.37), placenta previa (OR 3.03; 95% CI, 1.50-6.13), small for gestational age (OR 1.27; 95% CI, 1.03-1.57), and cesarean delivery (OR 1.57; 95% CI, 1.39-1.78) compared with the healthy controls. No differences were found in the incidence of gestational hypertension and preeclampsia. CONCLUSION(S):Women with endometriosis have a statistically significantly higher risk of preterm birth, miscarriage, placenta previa, small for gestational age infants, and cesarean delivery.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Zullo F,Spagnolo E,Saccone G,Acunzo M,Xodo S,Ceccaroni M,Berghella V

doi

10.1016/j.fertnstert.2017.07.019

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

667-672.e5

issue

4

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(17)30539-3

journal_volume

108

pub_type

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