Endometriosis may be associated with higher risk of pregnancy and delivery complications, such as preeclampsia (high blood pressure) and placental complications, according to a new study. Also, newborns delivered by mothers with endometriosis may have increased risk of preterm birth, congenital malformations and death.
In light of findings in the study “Endometriosis Increases The Risk Of Obstetrical And Neonatal Complications” researchers have called for improved pregnancy and delivery surveillance for women with endometriosis.The study was published in the journal Acta Obstetricia et Gynecologica Scandinavica.
Previous studies have suggested that pregnant women with endometriosis may be at risk of having complications in pregnancy and during labor. However, results sometimes have been controversial and based on studies with small groups of patients.
“Current consequences of endometriosis on pregnancy, birth and neonatal outcome need therefore to be clarified in a large contemporary cohort of women with endometriosis,” researchers wrote.
With this goal in mind, the scientists analyzed the medical record data of all delivering women and their newborns in Denmark from 1997 to 2014, to investigate whether endometriosis was associated with obstetrical complications and negative neonatal outcomes.
The analysis identified 19,331 women diagnosed with endometriosis. The disease was associated with a higher risk of pregnancy and delivery complications, including a higher risk of severe preeclampsia, hemorrhage in pregnancy, placental abruption (premature separation of the placenta from the uterus), placenta previa (the placenta grows abnormally), premature rupture of membranes and retained placenta.
Moreover, newborns had increased risks of being born prematurely before 28 weeks, being small for the gestational age, having congenital malformations and an increased death rate.
Similar results were found in a sub-group of endometriosis patients who had been pregnant only once. Also, gynecological surgery to treat severe endometriosis before pregnancy further increased risk.
“In our study the women with a diagnosis of endometriosis and gynecological surgery before pregnancy had higher rates of complications than all women with endometriosis,” researchers wrote. “The surgery could be a marker of more advanced/severe disease and therefore possibly affecting the intrauterine environment more seriously, leading to more complications. However, surgery as such may cause adhesions and influence the intrauterine environment. We need studies on a possible effect of abdominal surgery.”
“Endometriosis increases the risk of obstetrical complications and adverse neonatal outcomes,” they concluded. “The magnitude of these complications calls for increased attention and surveillance of women with endometriosis during pregnancy and childbirth.”
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