Associations between endometriosis and adverse pregnancy and perinatal outcomes: a population-based cohort study
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(Published version)
Date
2023
Authors
Gebremedhin, A.T.
Mitter, V.R.
Duko, B.
Tessema, G.A.
Pereira, G.F.
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Journal article
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Archives of Gynecology and Obstetrics, 2023; 309(4):1323-1331
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Amanuel T. Gebremedhin, Vera R. Mitter, Bereket Duko, Gizachew A. Tessema, Gavin F. Pereira
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Abstract
Purpose: To examine the association between endometriosis and adverse pregnancy and perinatal outcomes (preeclampsia, placenta previa, and preterm birth). Methods:: A population-based retrospective cohort study was conducted among 468,778 eligible women who contributed 912,747 singleton livebirths between 1980 and 2015 in Western Australia (WA). We used probabilistically linked perinatal and hospital separation data from the WA data linkage system’s Midwives Notification System and Hospital Morbidity Data Collection databases. We used a doubly robust estimator by combining the inverse probability weighting with the outcome regression model to estimate adjusted risk ratios (RR) and 95% confidence intervals (CIs). Results There were 19,476 singleton livebirths among 8874 women diagnosed with endometriosis. Using a doubly robust estimator, we found pregnancies in women with endometriosis to be associated with an increased risk of preeclampsia with RR of 1.18, 95% CI 1.11–1.26, placenta previa (RR 1.59, 95% CI 1.42–1.79) and preterm birth (RR 1.45, 95% CI 1.37–1.54). The observed association persisted after stratified by the use of Medically Assisted Reproduction, with a slightly elevated risk among pregnancies conceived spontaneously. Conclusions: In this large population-based cohort, endometriosis is associated with an increased risk of preeclampsia, placenta previa, and preterm birth, independent of the use of Medically Assisted Reproduction. This may help to enhance future obstetric care among this population.
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Published online: 20 March 2023
Data source: Supplementary information, https://doi.org/10.1007/s00404-023-07002-y
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© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.