Spotlighting the endometriosis, preeclampsia research gap in Black women, with Calbeth C. Alaribe, DMSc, MPH, PA-C

A scoping review searching for literature examining the association between preeclampsia, eclampsia, and endometriosis specifically among Black women identified no qualifying studies, according to an abstract presented at the 2026 American College of Obstetricians & Gynecologists (ACOG) Annual Clinical & Scientific Meeting.

The review searched 9 databases and PROSPERO from inception through March 2024, including studies of reproductive-age Black women aged 15 to 49 years with laparoscopically diagnosed endometriosis and outcomes of preeclampsia or eclampsia. Of 5 relevant articles identified, none met the inclusion criteria.

Calbeth C. Alaribe, DMSc, MPH, PA-C, CPCHE, OB-GYN hospitalist physician associate and maternal health equity consultant, described the rationale for pursuing the question.

“Endometriosis affects approximately 10% of reproductive-age women, yet Black women are 50% less likely to be diagnosed. On the other hand, preeclampsia and eclampsia are notorious for having the highest rates in Black women in the United States, with Black women having the highest maternal mortality rates from it in comparison to any other ethnic group,” she said.

A gap in race-stratified data

Alaribe noted that emerging evidence suggests hypertensive disorders of pregnancy and endometriosis share overlapping immunologic and vascular pathways, but that the intersection with Black patients remains unexamined.

“Studies that were conducted in the United States actually collected race data but did not stratify results. So the data was absolutely meaningless to us in terms of determining if endometriosis has an impact in the development of preeclampsia and how that impacts Black women,” she said.

She framed the null result as a finding in itself.

“It basically tells us that just because there is no evidence does not mean that there are no risk factors. It just means that there is more presence of neglect,” Alaribe said, adding that without representation in datasets, Black patients are “completely invisible in our data sets.”

Clinical implications

Alaribe emphasized that no guideline currently supports treating endometriosis as a preeclampsia risk factor, given that biological plausibility has not established causation. She suggested clinicians nonetheless approach care proactively.

“If a patient comes in with severe chronic pelvic pain, bad menstrual pain as well, we should start clinically diagnosing them with endometriosis, and then potentially looking at ways that this could further implicate the risk of developing preeclampsia in the future,” she said, citing earlier blood pressure monitoring and maternal-fetal medicine involvement for patients planning pregnancy.

The review's principal limitation is inherent to its result: with no studies meeting inclusion criteria, no conclusions can be drawn about the association itself.

“The findings underscore the urgent need for inclusive, race-conscious research to inform clinical care and reduce maternal health disparities,” Alaribe concluded in the study abstract.

Reference:

Alaribe C. Association between preeclampsia and eclampsia in Black women with endometriosis: A scoping review. Abstract. Presented at: American College of Obstetricians & Gynecologists Annual Clinical & Scientific Meeting. May 1-3, 2026. Washington, D.C.