Medicine and Health Sciences (Ms. Drummond, Dr. Danesh, Ms. Arseneault, and Drs. Tulandi, Raina, and Suarthana); Department of Obstetrics and Gynecology (Ms. Drummond and Drs. Danesh, Tulandi, Raina, and Suarthana).
Medicine and Health Sciences (Ms. Drummond, Dr. Danesh, Ms. Arseneault, and Drs. Tulandi, Raina, and Suarthana); Faculty of Arts (Ms. Arseneault), and Department of Family Medicine (Ms. Rodrigues), McGill University, Montreal, Quebec, Canada.
J Minim Invasive Gynecol. 2023 Feb;30(2):91-99. doi: 10.1016/j.jmig.2022.11.008. Epub 2022 Nov 18.
To evaluate the association between endometriosis and the risk of preeclampsia and other maternal outcomes in spontaneously conceived women.
PubMed, MEDLINE, Embase, Scopus, Cochrane Library, Web of Science, and Google Scholar were systemically searched for studies published from inception to November 2021 (CRD42020198741). Observational studies published in English or French that investigated the risk of preeclampsia in women with endometriosis who conceived spontaneously were included.
A total of 610 articles were reviewed once duplicates were removed. Inclusion criteria included spontaneous conception and surgical and/or imaging ascertainment of an endometriosis diagnosis. Exclusion criteria included conception using assisted reproductive technologies, multiple pregnancies, chronic hypertension, and unclear diagnoses of endometriosis.
TABULATION, INTEGRATION, AND RESULTS: Data of selected studies were extracted, and analysis was performed on Review Manager, version 5.4. Quality assessment of included studies for potential risk of bias was evaluated using the Newcastle-Ottawa Scale for cohort studies. Three cohort studies of spontaneous pregnancies were included. Endometriosis was associated with an increased risk of preeclampsia (risk ratio [RR] = 1.47, 95% CI 1.13 -1.89, p = .003; I = 0%; n = 3 studies). A sensitivity analysis excluding a study with adenomyosis cases yielded similar risk (RR = 1.44; 95% CI, 1.11-1.87; p = .006; I = 0%; n = 2 studies). Having endometriosis did not significantly increase risk of cesarean delivery (RR = 1.38; 95% CI, 0.99-1.92; p = .06; I = 80%; n = 2 studies) or postpartum hemorrhage (RR = 1.16; 95% CI, 0.46-2.91; p = .76; I = 50%; n = 2 studies).
We detected an increased risk of preeclampsia in women with endometriosis who conceived spontaneously. Endometriosis did not seem to increase the risk of cesarean delivery and postpartum hemorrhage, but the number of studies was limited, and the heterogeneity was high.
评估在自然受孕的女性中，子宫内膜异位症与子痫前期和其他母婴结局风险之间的关联。
系统检索了从建库至 2021 年 11 月发表的 PubMed、MEDLINE、Embase、Scopus、Cochrane 图书馆、Web of Science 和 Google Scholar 中的研究，以评估在自然受孕的子宫内膜异位症女性中子痫前期的风险。
共检索了 610 篇文章，去除重复项后进行了一次审阅。纳入标准包括自然受孕、手术和/或影像学确定子宫内膜异位症诊断。排除标准包括使用辅助生殖技术受孕、多胎妊娠、慢性高血压和不明确的子宫内膜异位症诊断。
对入选研究的数据进行了提取，并使用 Review Manager 版本 5.4 进行了分析。使用纽卡斯尔-渥太华量表对队列研究的潜在偏倚风险进行了纳入研究的质量评估。纳入了 3 项关于自然妊娠的队列研究。子宫内膜异位症与子痫前期风险增加相关（风险比 [RR] = 1.47，95%置信区间 1.13-1.89，p =.003；I = 0%；n = 3 项研究）。敏感性分析排除了一项有子宫腺肌病病例的研究，结果相似（RR = 1.44；95%置信区间，1.11-1.87；p =.006；I = 0%；n = 2 项研究）。患有子宫内膜异位症并不会显著增加剖宫产（RR = 1.38；95%置信区间，0.99-1.92；p =.06；I = 80%；n = 2 项研究）或产后出血（RR = 1.16；95%置信区间，0.46-2.91；p =.76；I = 50%；n = 2 项研究）的风险。
我们发现自然受孕的子宫内膜异位症女性子痫前期风险增加。子宫内膜异位症似乎不会增加剖宫产和产后出血的风险，但研究数量有限，异质性较高。
