College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Department of Obstetrics and Gynecology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; Department of Obstetrics and Gynecology, Almurjan Hospital, Jeddah, Saudi Arabia.
Eur J Obstet Gynecol Reprod Biol. 2024 Jan;292:58-62. doi: 10.1016/j.ejogrb.2023.11.009. Epub 2023 Nov 10.
This study aimed to investigate the relationship between endometriosis and adverse obstetric outcomes using data from the National Inpatient Sample (NIS) database.
The ICD-10 coding system was used to identify codes for endometriosis and obstetric outcomes, and data from the NIS (2016-2019) were analyzed. Descriptive statistics were used to summarize variables, while the chi-square test was used to detect significant differences for categorical variables. Univariate and multivariate regression analyses were conducted to assess the association between endometriosis and obstetric outcomes. On multivariate analysis, adjustment was done for age, race, hospital region, smoking status, and alcohol misuse. Forest plots were used to visualize odds ratios and their 95% confidence intervals.
Overall, 2,854,149 women were included in this analysis, of whom 4,006 women had endometriosis. The post-hoc Bonferroni correction was applied to account for multiple comparisons, and our analyses revealed several statistically significant associations (p < 0.004). Specifically, on univariate analysis, significant associations with endometriosis were identified for ruptured uterus, placenta previa, placental abruption, postpartum hemorrhage, preeclampsia, amniotic fluid abnormality, gestational diabetes, preterm labor, and multiple gestation. On multivariate analysis, significant associations with endometriosis were observed for placenta previa, placental abruption, postpartum hemorrhage, preeclampsia, amniotic fluid abnormality, preterm labor, premature rupture of membranes, and multiple gestation.
The present findings provide important insights into the potential relationship between endometriosis and various adverse obstetric outcomes and may help inform clinical practice and future research. Further studies that use more detailed clinical data and longitudinal designs are needed to solidify the presented conclusions.
本研究旨在利用国家住院患者样本（NIS）数据库的数据，探讨子宫内膜异位症与不良产科结局之间的关系。
使用国际疾病分类第十版编码系统（ICD-10）对子宫内膜异位症和产科结局的代码进行识别，并对 NIS（2016-2019 年）的数据进行分析。采用描述性统计方法总结变量，卡方检验用于检测分类变量的显著差异。采用单变量和多变量回归分析评估子宫内膜异位症与产科结局之间的关联。在多变量分析中，调整了年龄、种族、医院区域、吸烟状况和酒精滥用。使用森林图可视化比值比及其 95%置信区间。
本研究共纳入了 2854149 名女性，其中 4006 名女性患有子宫内膜异位症。为了校正多重比较，我们应用了事后 Bonferroni 校正，分析结果显示存在几个统计学意义上的关联（p<0.004）。具体而言，在单变量分析中，与子宫内膜异位症相关的结局有子宫破裂、前置胎盘、胎盘早剥、产后出血、子痫前期、羊水异常、妊娠期糖尿病、早产和多胎妊娠。在多变量分析中，与子宫内膜异位症相关的结局有前置胎盘、胎盘早剥、产后出血、子痫前期、羊水异常、早产、胎膜早破和多胎妊娠。
本研究结果为子宫内膜异位症与各种不良产科结局之间潜在的关系提供了重要的见解，并可能有助于指导临床实践和未来的研究。需要进一步的研究，使用更详细的临床数据和纵向设计，以巩固本文的结论。
