Childbirth, otherwise classified as obstetrics, in women with endometriosis can be full of complications and adverse outcomes. With the prevalence of endometriosis estimated at 6-10% of women in reproductive age, it is important to understand the effects of the condition on obstetrics. A group from the Department of Obstetrics and Gynecology of Peking Union Medical College Hospital conducted a study that investigated the impacts of endometriosis on women’s childbirthing process. The team found that women with endometriosis were more likely to have preterm labor, placenta previa, and cesarean section.

Women analyzed for the study were matched one-to-one, where 249 women with endometriosis were compared to 249 women without an association with to the condition. All had become pregnant naturally and did not require assisted reproduction techniques. When the researchers were analyzing data collected during these women’s childbirthing, they were interested in adverse obstetric outcomes, as well as the need for luteal support during the first trimester.

Results were reported in the study, “Obstetric Outcomes in Chinese Women with Endometriosis: A Retrospective Cohort Study,” which was published in the journal Chinese Medical Journal. Interestingly, there was a noticeable difference in the age at which endometriosis patients became pregnant: compared to women without endometriosis, they were much older by an average of two years. Despite the older age, there was not a greater need for luteal support, where women are injected with progesterone to increase the chances of implantation in the uterus.

When it came time to give birth, women with endometriosis were more likely to go into preterm labor. Reasons for preterm labor included premature rupture of membrane, maternal or fetal indications, or purely spontaneous preterm labor. Finally, women with endometriosis were more prone to need a cesarean section or experience placental previa, where the placenta blocks the opening of the uterus and makes childbirthing extremely difficult.

“We speculated that endometriosis may promote the occurrences of adverse obstetric outcomes in affected pregnant women,” wrote the authors. “Our study showed that women with endometriosis are at a higher risk of preterm labor, placenta previa, and cesarean section compared with women without endometriosis.” While the study was relatively small and conducted only in Chinese women, the researchers believe the results may be representative of women with endometriosis in general.