Data from more than 1.9 million subjects shows that women with endometriosis have a statistically higher risk of obstetric complications including preterm birth (PTB) than those without the condition. The findings, published in Fertility & Sterility, are from a systematic review and meta-analysis of 24 studies.
For the analysis, the authors searched electronic databases from their inception through February 2017 for all cohort studies that reported incidence of obstetric complications in women diagnosed with endometriosis compared with controls. In most of the 24 studies—which comprised data from 1,924,114 women—endometriosis was diagnosed histologically after surgery. The primary outcome was PTB at < 37 weeks and the random effects model of DerSimonian and Laird was used to produce an odds ratio (OR) with 95% confidence interval (CI).
Risk of PTB was statistically significantly higher in women with endometriosis than in controls (OR 1.63; 95% CI, 1.32-2.01) as was risk of 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). Incidence of gestational hypertension and preeclampsia did not differ between the two groups.