Henrik Falconer, MD

25th annual conference of the European Society of Human Reproduction and  Embryology


 NB: this is the subject of a news briefing by Dr. Henrik Falconer at 09.30 hrs (CEST)  on Wednesday 1 July
 
 Amsterdam, The Netherlands: The largest study to date of endometriosis in  pregnant women has found that the condition is a major risk factor for premature  birth, the 25th annual conference of the European Society of Human Reproduction  and Embryology heard today (Wednesday July 1). Dr. Henrik Falconer, of the  Department of Woman and Child Health, Karolinska Institute, Stockholm, Sweden,  said that his team had found that women with endometriosis also had a higher  risk of other pregnancy complications, as well as being more likely to give  birth through Caesarean section. The research is published on-line in the  journal Human Reproduction today*.
 
 The researchers investigated the association between adverse pregnancy outcome,  assisted reproduction technology (ART), and a previous diagnosis of  endometriosis in 1 442 675 single births to Swedish women. They found 13 090  births among 8922 women diagnosed with endometriosis. Compared with women  without endometriosis, they had a 1.33 greater risk of preterm birth. Women with  endometriosis were also more likely to have difficulty in conceiving and need to  receive ART, which is itself a risk factor for adverse pregnancy outcome.
 
 Among women with endometriosis, 11.9% conceived after ART compared with the 1.4%  of women without endometriosis who used the technique. The risk of preterm birth  associated with endometriosis among women with ART was 1.24, and among women  without ART 1.37. 
 
 “Endometriosis appears to be a risk factor for preterm birth, irrespective of  ART,” said Dr. Falconer. “Our findings indicate that women with endometriosis  may be considered a high risk group and have special care during pregnancy.”
 
 Endometriosis is a chronic inflammatory disease, affecting up to 15% of all  women of reproductive age, in which the endometrial cells that line the uterus  are deposited in other areas. 
 
 Such displacement of endometrial cells can lead to anatomical distortion and  also the release of anti-inflammatory cytokines, signalling molecules used in  communication between cells. Symptoms of endometriosis include severe pelvic  pain, heavy menstrual periods, and nausea. 
 /more
 In addition to an increased risk of preterm birth, the researchers also found  other differences in the pregnancies of women with endometriosis. “Nearly twice  as many women in this group were delivered by Caesarean section,” said Dr.  Falconer. “We observed that among these women the risk of induced preterm birth  was higher than for spontaneous preterm birth. We believe that women with  endometriosis are more frequently scheduled for preterm Caesarean section,  possibly due to placental complications.” 
 
 Women with endometriosis were also more likely to suffer from pre-eclampsia, a  condition that develops in the second or third trimester of pregnancy and  involves the development of high blood pressure and the presence of protein in  the urine. Antepartal bleeding was also found to be more common among women with  endometriosis, the researchers say.
 
 “Because endometriosis is so strongly associated with infertility,” said Dr.  Falconer, “we were not surprised to find that women suffering from it were of  higher maternal age and had fewer children. However, after adjusting for  maternal age and other confounding factors, the strong association between  endometriosis and risky pregnancies still remained. 
 
 “Our research provides clinicians with important information in the search for  the factors associated with premature birth. Given that endometriosis is  relatively common in women of childbearing age, we hope that our results will  lead to pregnant women with this condition receiving extra attention, thus  enabling them to have normal pregnancies and give birth to healthy babies.”
 
 *Full paper published in Human Reproduction. doi:10.1093/humrep/dep186
 
 Abstract no: O-242 Wednesday 11.00 hrs CEST (Hall 3B)

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Articles

The largest study to date of endometriosis in pregnant women has found that the condition is a major risk factor for premature birth, the 25th annual conference of the European Society of Human Reproduction and Embryology heard today (Wednesday July 1).

Henrik Falconer, MD

Articles

Women with Endometriosis Need Special Care During Pregnancy to Avoid Risk of Premature Birth