Gruber Teresa Mira, Ortlieb Laura, Henrich Wolfgang, Mechsner Sylvia
Department of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Endometriosis Centre Charité, Department of Gynecology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
J Clin Med. 2021 Dec 29;11(1):157. doi: 10.3390/jcm11010157.
Endometriosis (EM), especially deep infiltrating endometriosis (DIE) and adenomyosis (AM), are known to cause pain and sterility in young women. More recently, they have also been described as risk factors for obstetric complications. While the pathophysiology is not yet completely understood, they seem to share a common origin: archimetrosis. Methods: A systematic literature review was conducted to summarize the existing evidence on DIE and AM as risk factors for obstetric complications. Results: Preterm birth, caesarean section delivery (CS) and placental abnormalities are associated with the diagnosis of DIE and AM. Women with AM seem to experience more often hypertensive pregnancy disorders, premature rupture of membranes and their children are born with lower birth weights than in the control groups. However, many of the studies tried to evaluate AM, EM and DIE as separate risk factors. Moreover, often they did not adjust for important confounders such as multiple pregnancies, parity, mode of conception and maternal age. Therefore, prospective studies with larger numbers of cases and appropriate adjustment for confounders are needed to explore the pathophysiology and to prove causality.
子宫内膜异位症（EM），尤其是深部浸润性子宫内膜异位症（DIE）和子宫腺肌病（AM），已知会导致年轻女性疼痛和不孕。最近，它们还被描述为产科并发症的危险因素。虽然其病理生理学尚未完全了解，但它们似乎有一个共同的起源：子宫腺肌症。方法：进行系统的文献综述，以总结关于DIE和AM作为产科并发症危险因素的现有证据。结果：早产、剖宫产分娩（CS）和胎盘异常与DIE和AM的诊断相关。患有AM的女性似乎更常出现妊娠高血压疾病、胎膜早破，并且她们的孩子出生体重低于对照组。然而，许多研究试图将AM、EM和DIE作为单独的危险因素进行评估。此外，它们通常没有对多胎妊娠、产次、受孕方式和产妇年龄等重要混杂因素进行校正。因此，需要进行有大量病例的前瞻性研究并对混杂因素进行适当校正，以探索其病理生理学并证明因果关系。
