Association between adenomyosis volume and adverse perinatal outcomes: multicenter cohort study

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Reproductive Health

Background:

• Adenomyosis, a condition where uterine tissue grows into the muscular wall, can impact pregnancy.
• Assessing the severity of adenomyosis through volume measurement is crucial for understanding its potential effects on perinatal outcomes.

Purpose of the Study:

• To evaluate the association between adenomyosis volume, as an indicator of severity, and the risk of adverse perinatal outcomes.
• To determine if increased adenomyosis volume correlates with a higher incidence of pregnancy complications.

Main Methods:

• A multicenter retrospective cohort study involving pregnant women with and without adenomyosis.
• Adenomyosis diagnosis and volume calculation using ultrasound up to 14 weeks gestation.
• Logistic regression analysis to assess the association between adenomyosis and pregnancy complications, with sensitivity analysis for severe cases.

Main Results:

• Women with adenomyosis showed increased risks of preterm birth, spontaneous preterm birth, placenta previa, cervical incompetence, and abnormal fetal presentation.
• Severe adenomyosis (≥757.5 cm³) was associated with significantly higher risks of preterm birth, pre-eclampsia, placenta previa, and cervical incompetence compared to mild adenomyosis.
• The risk of spontaneous preterm birth and abnormal fetal presentation was similar between severe and mild adenomyosis subgroups.

Conclusions:

• Pregnancies complicated by adenomyosis, especially severe cases, are linked to a greater risk of adverse perinatal outcomes.
• Key complications include preterm birth, spontaneous preterm birth, placenta previa, cervical incompetence, and abnormal fetal presentation.
• Adenomyosis volume serves as a valuable marker for predicting pregnancy complication risks.