Endometriosis and Ectopic Pregnancy: A Meta-analysis

Area of Science:

• Reproductive Medicine
• Gynecologic Surgery
• Women's Health

Background:

• Endometriosis is a chronic inflammatory condition affecting women of reproductive age.
• Ectopic pregnancy is a life-threatening condition with significant maternal morbidity.
• The association between endometriosis and ectopic pregnancy risk requires systematic evaluation.

Purpose of the Study:

• To systematically review and meta-analyze the risk of ectopic pregnancy in women with endometriosis.
• To quantify the association between endometriosis and ectopic pregnancy using available cohort and case-control studies.

Main Methods:

• Searched MEDLINE, Embase, CINAHL, and Cochrane Library up to April 2019.
• Included cohort and case-control studies from 1990 onwards, excluding non-English full-text articles.
• Extracted data with independent reviewers and performed random-effects meta-analysis to calculate pooled odds ratios (OR).

Main Results:

• Fifteen studies (10 case-control, 5 cohort) were included in the meta-analysis.
• Case-control studies showed an increased risk of ectopic pregnancy with endometriosis (OR = 2.66).
• High-quality cohort studies (Ottawa-Newcastle score ≥7) also indicated an increased risk (OR = 2.16), despite initial non-significant findings.

Conclusions:

• A possible association exists between endometriosis and an increased risk of ectopic pregnancy.
• High heterogeneity among studies warrants cautious interpretation of the findings.
• Further research is necessary to clarify the pregnancy implications of endometriosis.