Leslie V Farland1, Jennifer Prescott, Naoko Sasamoto, Deirdre K Tobias, Audrey J Gaskins, Jennifer J Stuart, Daniela A Carusi, Jorge E Chavarro, Andrew W Horne, Janet W Rich-Edwards, Stacey A Missmer. 1. Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona; the Channing Division of Network Medicine, the Department of Obstetrics, Gynecology, and Reproductive Biology, the Division of Preventive Medicine, and the Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, and the Department of Nutrition and the Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; the MRC Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland; and the Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, Michigan.
Abstract
OBJECTIVE: To investigate the relationship between endometriosis and adverse pregnancy outcomes. METHODS: Women between ages 25 and 42 years in 1989 (n=116,429) reported detailed information on pregnancies and reproductive health at baseline and every 2 years thereafter in the Nurses' Health Study II, a cohort study. In 2009, they completed a detailed, pregnancy-focused questionnaire. A total of 196,722 pregnancies were reported. Adverse pregnancy outcomes included spontaneous abortion, ectopic pregnancy, stillbirth, gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (preeclampsia or gestational hypertension), preterm birth, and low birth weight. We estimated the relative risks (RRs) and 95% CIs of adverse pregnancy outcomes comparing pregnancies in women with and without a history of laparoscopically confirmed endometriosis using multivariable log-binomial regression, with generalized estimating equations to account for multiple pregnancies per woman. RESULTS: Endometriosis was associated with a greater risk of pregnancy loss (spontaneous abortion: RR 1.40, 95% CI 1.31-1.49; ectopic pregnancy: RR 1.46, 95% CI 1.19-1.80). Endometriosis was also associated with a greater risk of GDM (RR 1.35, 95% CI 1.11-1.63) and hypertensive disorders of pregnancy (RR 1.30, 95% CI 1.16-1.45). CONCLUSIONS: We observed an association between laparoscopically confirmed endometriosis and several adverse pregnancy outcomes. Future research should focus on the potential biological pathways underlying these relationships to inform screening or preventive interventions.
OBJECTIVE: To investigate the relationship between endometriosis and adverse pregnancy outcomes. METHODS: Women between ages 25 and 42 years in 1989 (n=116,429) reported detailed information on pregnancies and reproductive health at baseline and every 2 years thereafter in the Nurses' Health Study II, a cohort study. In 2009, they completed a detailed, pregnancy-focused questionnaire. A total of 196,722 pregnancies were reported. Adverse pregnancy outcomes included spontaneous abortion, ectopic pregnancy, stillbirth, gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (preeclampsia or gestational hypertension), preterm birth, and low birth weight. We estimated the relative risks (RRs) and 95% CIs of adverse pregnancy outcomes comparing pregnancies in women with and without a history of laparoscopically confirmed endometriosis using multivariable log-binomial regression, with generalized estimating equations to account for multiple pregnancies per woman. RESULTS: Endometriosis was associated with a greater risk of pregnancy loss (spontaneous abortion: RR 1.40, 95% CI 1.31-1.49; ectopic pregnancy: RR 1.46, 95% CI 1.19-1.80). Endometriosis was also associated with a greater risk of GDM (RR 1.35, 95% CI 1.11-1.63) and hypertensive disorders of pregnancy (RR 1.30, 95% CI 1.16-1.45). CONCLUSIONS: We observed an association between laparoscopically confirmed endometriosis and several adverse pregnancy outcomes. Future research should focus on the potential biological pathways underlying these relationships to inform screening or preventive interventions.
Authors: Neil P Johnson; Lone Hummelshoj; G David Adamson; Jörg Keckstein; Hugh S Taylor; Mauricio S Abrao; Deborah Bush; Ludwig Kiesel; Rulla Tamimi; Kathy L Sharpe-Timms; Luk Rombauts; Linda C Giudice Journal: Hum Reprod Date: 2016-12-05 Impact factor: 6.918
Authors: L M Troy; K B Michels; D J Hunter; D Spiegelman; J E Manson; G A Colditz; M J Stampfer; W C Willett Journal: Int J Epidemiol Date: 1996-02 Impact factor: 7.196
Authors: S Lalani; A J Choudhry; B Firth; V Bacal; Mark Walker; S W Wen; S Singh; A Amath; M Hodge; I Chen Journal: Hum Reprod Date: 2018-10-01 Impact factor: 6.918
Authors: Maria C Magnus; Nils-Halvdan Morken; Knut-Arne Wensaas; Allen J Wilcox; Siri E Håberg Journal: PLoS Med Date: 2021-05-10 Impact factor: 11.613
Authors: Leslie V Farland; Judy E Stern; Chia-Ling Liu; Howard J Cabral; Charles C Coddington; Hafsatou Diop; Dmitry Dukhovny; Sunah Hwang; Stacey A Missmer Journal: Am J Obstet Gynecol Date: 2022-01-31 Impact factor: 10.693
Authors: Leslie V Farland; William J Degnan; Holly R Harris; Deirdre K Tobias; Stacey A Missmer Journal: Diabetologia Date: 2021-01-05 Impact factor: 10.122