Findings of a Danish retrospective cohort study show that women with endometriosis are at significantly increased risk for experiencing a variety of adverse pregnancy outcomes.1
According to the authors of the recently published study, the research represents the largest and most detailed study of obstetrical and neonatal complications in women with endometriosis. They stated that its results confirm the findings of previously reported large studies. Considering the magnitude of the complications, the authors recommended increased antenatal surveillance for women with endometriosis.
Risks of obstetrical and neonatal complications among women with endometriosis were analyzed using data from the Danish Health Register and the Danish Medical Birth Register. The study population was comprised of women ages 15 to 49 years old who delivered in Denmark from 1997 through 2013. It included 11,739 women with a diagnosis of endometriosis who gave birth to 19,331 infants. The “unexposed” control cohort included 615,533 women who gave birth to 1,071,920 infants.
Results from multivariate logistic regression analysis adjusting for year of delivery and maternal age showed that compared to controls, women with endometriosis had a statistically significant increased risk for having pre-eclampsia (1.4-fold), severe preeclampsia (1.7-fold), hemorrhage in pregnancy (2.3-fold), placental abruption (2.0-fold), placenta previa (3.9-fold), premature rupture of membranes (1.7-fold), retained placenta (3.1-fold), and hemorrhage after 22 gestational weeks (2.3-fold).
Analyses of neonatal complications showed significantly increased risks of preterm birth before 28 weeks (3.1-fold) and before 34 weeks (2.7-fold), being small for gestational age (1.5-fold), a low Apgar score (1.4-fold), a diagnosis of a malformation within the first year (1.3-fold), and neonatal death (1.8-fold) for infants born to women with endometriosis.