Pregnancy outcomes of endometrial hyperplasia with or without atypia

Given the proven efficacy of hormonal treatment, more women with endometrial hyperplasia (EH) are choosing to preserve their fertility. Previous studies have focused primarily on the progression of EH to endometrial cancer or pregnancy success rates in these women post-treatment. However, limited research has examined pregnancy outcomes in women with EH. Therefore, we analyzed the association between EH and adverse pregnancy outcomes using Korean National Health Insurance claims data from 2006 to 2023, focusing on women with obstetric outcomes classified using the International Classification of Disease, Tenth Edition. Adverse obstetric outcomes included pregnancy-associated hypertension, gestational diabetes mellitus, placenta previa, placenta accreta, placental abruption, preterm labor, intrauterine growth restriction, uterine rupture, threatened abortion, preterm premature rupture of membranes, polyhydramnios, oligohydramnios, postpartum hemorrhage, and fetal death in utero. Multivariate logistic regression was used to evaluate the association between EH and adverse obstetric outcomes. Among the 199 143 women included in the study, 1655 were diagnosed with EH before pregnancy. After adjusting for age, body mass index, and preexisting conditions, women with EH showed a significantly higher risk of adverse obstetric outcomes. Our findings indicate that EH is a significant risk factor for adverse obstetric outcomes, necessitating obstetric surveillance.