Maria Tølbøll Glavind1, Axel Forman2, Linn Håkonsen Arendt3, Karsten Nielsen4, Tine Brink Henriksen5. 1. Perinatal Epidemiology Research Unit, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark. Electronic address: mariatoelboell@hotmail.com. 2. Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark. 3. Perinatal Epidemiology Research Unit, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark; Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark. 4. Department of Pathology, Aarhus University Hospital, Aarhus, Denmark. 5. Perinatal Epidemiology Research Unit, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
Abstract
OBJECTIVE: To study the association between endometriosis and risk of pre-eclampsia, cesarean section, postpartum hemorrhage, preterm birth, and small for gestational age (SGA), in a large Danish birth cohort, while taking fertility treatment into account. DESIGN: Population-based study. SETTING: Not applicable. PATIENT(S): A total population of 82,793 singleton pregnancies from the Aarhus Birth Cohort (1989 through 2013); 1,213 women had a diagnosis of endometriosis, affecting 1,719 pregnancies. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Pre-eclampsia, cesarean section, postpartum hemorrhage, preterm birth, and SGA. RESULT(S): Endometriosis was associated with an increased risk of preterm birth (adjusted odds ratio [AOR] 1.67, 95% confidence interval [CI] 1.37-2.05), with the risk being highest for very preterm birth (AOR 1.91, 95% CI 1.16-3.15). Compared with unaffected women, women with endometriosis also had an increased risk of pre-eclampsia (AOR 1.37, 95% CI 1.06-1.77) and cesarean section (AOR 1.83, 95% CI 1.60-2.09). Assisted reproductive technology did not explain these findings. No association was found between endometriosis and postpartum hemorrhage or SGA. CONCLUSION(S): Women with endometriosis were at increased risk of pre-eclampsia, preterm birth, and cesarean section, irrespective of use of assisted reproductive technology.
OBJECTIVE: To study the association between endometriosis and risk of pre-eclampsia, cesarean section, postpartum hemorrhage, preterm birth, and small for gestational age (SGA), in a large Danish birth cohort, while taking fertility treatment into account. DESIGN: Population-based study. SETTING: Not applicable. PATIENT(S): A total population of 82,793 singleton pregnancies from the Aarhus Birth Cohort (1989 through 2013); 1,213 women had a diagnosis of endometriosis, affecting 1,719 pregnancies. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Pre-eclampsia, cesarean section, postpartum hemorrhage, preterm birth, and SGA. RESULT(S): Endometriosis was associated with an increased risk of preterm birth (adjusted odds ratio [AOR] 1.67, 95% confidence interval [CI] 1.37-2.05), with the risk being highest for very preterm birth (AOR 1.91, 95% CI 1.16-3.15). Compared with unaffected women, women with endometriosis also had an increased risk of pre-eclampsia (AOR 1.37, 95% CI 1.06-1.77) and cesarean section (AOR 1.83, 95% CI 1.60-2.09). Assisted reproductive technology did not explain these findings. No association was found between endometriosis and postpartum hemorrhage or SGA. CONCLUSION(S): Women with endometriosis were at increased risk of pre-eclampsia, preterm birth, and cesarean section, irrespective of use of assisted reproductive technology.
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