Endometriosis and Adverse Pregnancy Outcomes: A Nationwide Population-Based Study

Area of Science:

• Reproductive Medicine
• Obstetrics and Gynecology
• Clinical Epidemiology

Background:

• Endometriosis is a significant factor contributing to infertility.
• Its known pathophysiology suggests potential adverse effects on pregnancy outcomes.
• Previous research indicates a link between endometriosis and conception difficulties.

Purpose of the Study:

• To investigate the association between endometriosis and adverse pregnancy outcomes following successful conception.
• To compare pregnancy outcomes in women with and without endometriosis.
• To identify specific risks and complications linked to endometriosis during pregnancy.

Main Methods:

• Retrospective cohort study using data from the Korean Health Insurance Review and Assessment Service database.
• Analysis of singleton pregnancy deliveries between January 2014 and October 2019.
• Comparison of clinical characteristics and adverse pregnancy outcomes between endometriosis and non-endometriosis groups.

Main Results:

• Women with endometriosis (2.6% of cohort) experienced significantly more adverse pregnancy outcomes.
• Associated outcomes included preterm labor, preeclampsia, fetal growth restriction, placental complications, hemorrhage, and stillbirth.
• Increased risks for postpartum hemorrhage, blood transfusion, uterine artery embolization, cesarean hysterectomy, and higher cesarean delivery rates were observed in the endometriosis group.

Conclusions:

• Endometriosis is associated with a substantially higher risk of adverse pregnancy outcomes.
• The findings highlight the dual impact of endometriosis on fertility and maternal-fetal health.
• Women with endometriosis require careful monitoring throughout pregnancy due to elevated complication risks.