Endometriosis and pregnancy outcome: are pregnancies complicated by endometriosis a high-risk group?
Endometriosis and pregnancy outcome: are pregnancies complicated by endometriosis a high-risk group?
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DOI：
10.1016/j.ejogrb.2013.10.024
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发表时间：
2014-01-01
影响因子：
2.6
通讯作者：
Aoki, Yoichi
中科院分区：
文献类型：
--
作者：
Mekaru, Keiko;Masamoto, Hitoshi;Aoki, Yoichi
目的：据报道，子宫内膜异位症妇女的早产、妊娠高血压（PIH）和小孕龄（SGA）婴儿的发生率增加，但研究人群包括无法获得明确诊断的妇女，以及通过体外受精/胚胎移植（IVF/ET）受孕的妇女，这本身就是不良妊娠结局的危险因素。因此，子宫内膜异位症对妊娠结局的影响缺乏共识。本研究比较了妊娠结局的妇女或没有明确诊断子宫内膜异位症的腹腔镜laparoscopy.Study设计：回顾性比较妊娠结局的108名妇女谁进行了管理分娩后建立的不孕症腹腔镜调查。排除了已知影响妊娠结局因素的女性，如年龄≥ 41岁，通过IVF/ET受孕和多胎分娩。49名研究参与者患有子宫内膜异位症（En+组），59名参与者没有子宫内膜异位症（En组）。结果：两组之间的平均（+/-标准差）年龄（33 +/- 3.8 vs 33.6 +/- 4.1岁），流产史，早产史和妊高征史无显著差异。En+组和En-组分别有26.5%和30.5%的患者采用促排卵治疗不孕症，En+组和En-组分别有30.6%和32.2%的患者采用人工授精治疗不孕症。关于妊娠结局，流产率无显著差异（18.4% vs 18.6%），绒毛膜下血肿（5.0% vs 2.1%），早产（7.5% vs 8.3%），妊高征（15.0% vs 12.5%），剖腹产（32.5% vs 22.9%），分娩时胎龄在En+和En-组之间发现了（38.9 +/- 1.5 vs 38.8 +/- 1.7周）、出生体重（3013.3 +/- 480 vs 2934.5 +/- 639.5 g）和SGA婴儿（2.5% vs 2.1%）。两组均未发生胎盘脱垂。En+组中有1例新生儿为21三体，En-组中有1例妇女为妊娠期糖尿病。结论：子宫内膜异位症可能不会影响妊娠结局，但需要进行大型前瞻性研究。(C)2013爱思唯尔爱尔兰有限公司版权所有。
Objectives: Increased incidence of preterm birth, pregnancy-induced hypertension (PIH) and small-forgestational-age (SGA) babies have been reported in women with endometriosis, but the study populations included women in whom a definitive diagnosis was not attainable, and women who conceived via in vitro fertilization/embryo transfer (IVF/ET), which, in itself, is a risk factor for adverse pregnancy outcome. Thus there is a lack of consensus on the effects of endometriosis on pregnancy outcome. This study compared the pregnancy outcomes of women with or without a definitive diagnosis of endometriosis on laparoscopy.Study design: Retrospective comparison of pregnancy outcomes of 108 women who underwent managed delivery of pregnancies established after laparoscopic investigation of infertility. Women with factors known to affect pregnancy outcome, such as age >= 41 years, conception via IVF/ET and multiple births, were excluded. Forty-nine of the study participants had endometriosis (En+ group) and 59 participants did not have endometriosis (En group).Results: There were no significant differences in mean (+/- standard deviation) age (33 +/- 3.8 vs 33.6 +/- 4.1 years), history of miscarriage, history of preterm birth and history of PIH between the two groups. Ovulation induction was used for infertility treatment in 26.5% of the En+ group and 30.5% of the En- group, and artificial insemination was used in 30.6% of the En+ group and 32.2% of the En- group. Regarding pregnancy outcomes, no significant differences in miscarriage (18.4% vs 18.6%), subchorionic haematoma (5.0% vs 2.1%), preterm birth (7.5% vs 8.3%), PIH (15.0% vs 12.5%), caesarean section (32.5% vs 22.9%), gestational age at delivery (38.9 +/- 1.5 vs 38.8 +/- 1.7 weeks), birth weight (3013.3 +/- 480 vs 2934.5 +/- 639.5 g) and SGA babies (2.5% vs 2.1%) were found between the En+ and En- groups. Placental abruption did not occur in either group. One neonate had trisomy 21 in the En+ group, and one woman had gestational diabetes in the En- group.Conclusion: Endometriosis may not affect pregnancy outcome, but there is a need for a large prospective study. (C) 2013 Elsevier Ireland Ltd. All rights reserved.