Assisted reproductive technology pregnancy complications are significantly associated with endometriosis severity before conception: a retrospective cohort study.
Assisted reproductive technology pregnancy complications are significantly associated with endometriosis severity before conception: a retrospective cohort study.
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DOI：
10.1186/s12958-016-0209-2
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发表时间：
2016-11-03
期刊：
影响因子：
--
通讯作者：
Osuga Y
中科院分区：
文献类型：
--
作者：
Fujii T;Wada-Hiraike O;Nagamatsu T;Harada M;Hirata T;Koga K;Fujii T;Osuga Y
子宫内膜异位症已被证明与妊娠中期至晚期并发症（如早产和前置胎盘）有关，但证据并不一致。我们假设子宫内膜异位症的严重程度可能会影响这些不一致的结果。因此，我们旨在进行一项回顾性队列研究，以阐明子宫内膜异位症的严重程度是否与不良妊娠结局的发生率相关。2000年3月至2014年12月在我院通过辅助生殖技术（ART）实现单胎妊娠的患者（N = 631）纳入分析。其中，92名女性经手术证实患有子宫内膜异位症，512名女性未出现子宫内膜异位症并发症。92例子宫内膜异位症中，10例为修订后的美国生殖医学学会（rASRM） I期和II期，31例为rASRM III期，43例为rASRM IV期；8例未达到rASRM阶段。采用Logistic回归分析计算早产、前置胎盘和小于胎龄的比值比（OR）和95%可信区间（CI）。OR根据年龄、胎次和移植胚胎数量进行调整。首先，我们证实子宫内膜异位症妇女早产和前置胎盘的频率显著增加（早产OR， 2.08; 95% CI, 1.07-3.89，前置胎盘OR， 15.1; 95% CI, 4.40-61.7），而胎龄小的频率则没有显著增加。此外，我们发现，与其他两组相比，rASRM IV期子宫内膜异位症妇女早产和前置胎盘的频率显著增加：rASRM I-III期子宫内膜异位症妇女（早产OR， 7.40; 95% CI, 1.83-50.3；前置胎盘OR， 11.0; 95% CI, 1.75-216.5）和无子宫内膜异位症妇女（早产调整OR， 4.11; 95% CI, 1.88-8.55；前置胎盘调整OR， 39.8; 95% CI, 10.1-189.1）。rASRM I-III型子宫内膜异位症患者与非子宫内膜异位症患者之间无显著差异。我们发现子宫内膜异位症患者早产和前置胎盘的频率明显增加，子宫内膜异位症的严重程度可能对ART妊娠产生不利影响。
Endometriosis has been shown to be associated with second- to third-trimester pregnancy complications such as preterm birth and placenta previa, but the evidence is inconsistent. We hypothesized that endometriosis severity might affect these inconsistent results. Therefore we aimed to conduct a retrospective cohort study to elucidate whether endometriosis severity is associated with the incidence rates of adverse pregnancy outcomes. The patients who achieved singleton pregnancy by assisted reproductive technology (ART) in our facility between March 2000 and December 2014 (N = 631) were included in this analysis. Among them, 92 women demonstrated surgically proven endometriosis, and 512 women were shown to not have endometriosis as a complication. Among the 92 cases of endometriosis, 10 were classified as revised American Society for Reproductive Medicine (rASRM) stage I and II, 31 cases were rASRM stage III, and 43 cases were rASRM stage IV; in 8 cases, the rASRM stage was unavailable. Logistic regression analysis was performed to calculate odds ratios (OR) and 95 % confidence interval (CI) for the rates of preterm birth, placenta previa, and small for gestational age. OR were adjusted by age, parity and the number of transferred embryos. First we confirmed the frequency of preterm birth and placenta previa were significantly increased in women with endometriosis (preterm birth OR, 2.08; 95 % CI, 1.07–3.89, placenta previa OR, 15.1; 95 % CI, 4.40–61.7), while the frequency of small for gestational age was not. Moreover, we found the frequencies of preterm birth and placenta previa were significantly increased in women with rASRM stage IV endometriosis compared to other two groups: women with rASRM stage I-III endometriosis (preterm birth OR, 7.40; 95 % CI, 1.83–50.3; placenta previa OR, 11.0; 95 % CI, 1.75–216.5) and women without endometriosis (preterm birth adjusted OR, 4.11; 95 % CI, 1.88–8.55; placenta previa adjusted OR, 39.8; 95 % CI, 10.1–189.1). There were no significant difference between women with rASRM I-III endometriosis and women without endometriosis. We found that the frequencies of preterm birth and placenta previa were significantly increased in women with endometriosis, and the severity of endometriosis might have an adverse impact on ART pregnancy.
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影响因子：
6.1
作者：
Stephansson, Olof;Kieler, Helle;Falconer, Henrik
通讯作者：
Falconer, Henrik
DOI：
10.1111/j.1447-0756.2007.00619.x
发表时间：
2007-10-01
影响因子：
1.6
作者：
Sumigama, Seiji;Itakura, Atsuo;Kikkawa, Fumitaka
通讯作者：
Kikkawa, Fumitaka
DOI：
10.1016/j.bpobgyn.2006.01.017
发表时间：
2006-08-01
影响因子：
5.5
作者：
Vercellini, Paolo;Vigano, Paola;Fedele, Luigi
通讯作者：
Fedele, Luigi
影响因子：
6.7
作者：
Hayashi, Masako;Nakai, Akihito;Matsuda, Yoshio
通讯作者：
Matsuda, Yoshio
影响因子：
6.1
作者：
Healy, D. L.;Breheny, S.;Baker, H. W. G.
通讯作者：
Baker, H. W. G.