Berlac Janne Foss, Hartwell Dorthe, Skovlund Charlotte Wessel, Langhoff-Roos Jens, Lidegaard Øjvind
Department of Obstetrics and Gynecology, Hillerød Hospital, Hillerød, Denmark.
Department of Gynecology, Rigshospitalet University Hospital, Copenhagen, Denmark.
Acta Obstet Gynecol Scand. 2017 Jun;96(6):751-760. doi: 10.1111/aogs.13111. Epub 2017 Mar 11.
The objective of this study was to assess obstetrical complications and neonatal outcomes in women with endometriosis as compared with women without endometriosis.
National cohort including all delivering women and their newborns in Denmark 1997-2014. Data were extracted from the Danish Health Register and the Medical Birth Register. Logistic regression analysis provided odds ratios (OR) with 95% confidence intervals (CI). Sub-analyses were made for primiparous women with a singleton pregnancy and for women with endometriosis who underwent gynecological surgery before pregnancy.
In 19 331 deliveries, women with endometriosis had a higher risk of severe preeclampsia (OR 1.7, 95% CI 1.5-2.0), hemorrhage in pregnancy (OR 2.3, 95% CI 2.0-2.5), placental abruption (OR 2.0, 95% CI 1.7-2.3), placenta previa (OR 3.9, 95% CI 3.5-4.3), premature rupture of membranes (OR 1.7, 95% CI 1.5-1.8), and retained placenta (OR 3.1, 95% CI 1.4-6.6). The neonates had increased risks of preterm birth before 28 weeks (OR 3.1, 95% CI 2.7-3.6), being small for gestational age (OR 1.5, 95% CI 1.4-1.6), being diagnosed with congenital malformations (OR 1.3, 95% CI 1.3-1.4), and neonatal death (OR 1.8, 95% CI 1.4-2.1). Results were similar in primiparous women with a singleton pregnancy. Gynecological surgery for endometriosis before pregnancy carried a further increased risk.
Women with endometriosis had a significantly higher risk of several complications, such as preeclampsia and placental complications in pregnancy and at delivery. The newborns had increased risk of being delivered preterm, having congenital malformations, and having a higher neonatal death rate. Pregnant women with endometriosis require increased antenatal surveillance.
本研究的目的是评估患有子宫内膜异位症的女性与未患子宫内膜异位症的女性相比的产科并发症和新生儿结局。
全国队列研究纳入了1997年至2014年丹麦所有分娩的女性及其新生儿。数据从丹麦健康登记册和医疗出生登记册中提取。逻辑回归分析得出比值比（OR）及95%置信区间（CI）。对单胎初产妇以及妊娠前行妇科手术的子宫内膜异位症患者进行了亚组分析。
在19331例分娩中，患有子宫内膜异位症的女性发生严重先兆子痫的风险更高（OR 1.7，95% CI 1.5 - 2.0）、孕期出血（OR 2.3，95% CI 2.0 - 2.5）、胎盘早剥（OR 2.0，95% CI 1.7 - 2.3）、前置胎盘（OR 3.9，95% CI 3.5 - 4.3）、胎膜早破（OR 1.7，95% CI 1.5 - 1.8）以及胎盘残留（OR 3.1，95% CI 1.4 - 6.6）。新生儿在28周前早产的风险增加（OR 3.1，95% CI 2.7 - 3.6）、小于胎龄（OR 1.5，95% CI 1.4 - 1.6）、被诊断为先天性畸形（OR 1.3，95% CI 1.3 - 1.4）以及新生儿死亡（OR 1.8，95% CI 1.4 - 2.1）。单胎初产妇的结果相似。妊娠前行子宫内膜异位症妇科手术会使风险进一步增加。
患有子宫内膜异位症的女性发生多种并发症的风险显著更高，如孕期和分娩时的先兆子痫及胎盘并发症。新生儿早产、患先天性畸形及新生儿死亡率更高的风险增加。患有子宫内膜异位症的孕妇需要加强产前监测。
