[Perinatal outcome of pregnant women with adenomyosis]

Objective: To analyze the effect of pregnancy with adenomyosis on perinatal outcome. Methods: From April 2014 to April 2019, singleton pregnant women complicated with adenomyosis in Peking University Third Hospital was selected and the perinatal outcomes were analyzed retrospectively. Results: The age of patients in the pregnancy with adenomyosis group (study group) was not different from that of the control group (median: 35 vs 34 years old, P>0.05); the body mass index was higher than that of the control group (median: 23.9 vs 21.8 kg/m², P<0.01); the rate of assisted reproductive technology was significantly higher than that of the control group [25.3% (64/253) vs 3.1% (8/257), P<0.01]. Compared with the control group, the gestational age at delivery was significantly lower in the study group (median: 38.0 vs 39.2 weeks, P<0.01); the rates of preterm birth [17.1% (44/257) vs 4.7% (12/257), P<0.01] and preeclampsia [13.7% (35/255) vs 5.8% (15/257), P=0.003] were significantly higher in the study group. The incidence of severe postpartum hemorrhage in the study group was significantly higher than that in the control group [5.8% (14/241) vs 1.2% (3/257), P=0.004]. The incidence of cesarean section was higher in the study group [(57.0% (146/256) vs 31.5% (81/257), P<0.01]. Neonatal weight was lower in the study group than that in the control group (median: 3 140 vs 3 440 g, P<0.01); the incidence of small for gestational age (SGA) was higher in the study group [21.5% (55/256) vs 4.7% (12/257), P<0.01]. There were no significant differences in umbilical artery pH and 1-minute Apgar score between the study group and the control group (all P>0.05). Conclusions: Pregnant women complicated with adenomyosis has low fertility, and most of them need assisted reproductive technology to conceive. The pregnant women with adenomyosis has the poor perinatal outcome, including an increased incedence of preterm birth, preeclampsia, postpartum hemorrhage, cesarean section and SGA, and low newborn weight.