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子宫内膜异位症与不良妊娠结局:一项病例对照研究。

Endometriosis and adverse pregnancy outcomes: A case-control study.

作者信息

Shahmoradi Fatemeh, Haghighi Ladan, Noori Marziyeh, Derakhshan Roya, Hashemi Neda, Rokhgireh Samaneh

机构信息

Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran.

Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Int J Reprod Biomed. 2024 Aug 5;22(6):473-480. doi: 10.18502/ijrm.v22i6.16798. eCollection 2024 Jun.

Abstract

BACKGROUND

The association between endometriosis and the outcome of pregnancy is one of the interesting topics. Endometriosis-related pain is alleviated with pregnancy; however, it is known to cause adverse outcomes in pregnancy. The main cause is systemic chronic inflammation caused by higher levels of cytokines, growth factors, and angiogenesis factors.

OBJECTIVE

This study aimed to clarify the relationship between endometriosis, deep endometriosis, adenomyosis, surgical treatment, and poor maternal consequences.

MATERIALS AND METHODS

In this case-control study, data from 250 women who gave birth in Hazrat Rasoul Akram hospital, Tehran, Iran from February 2015 to December 2019 was extracted from the hospital information system in January 2020. Participants were divided into 2 groups: 125 women with endometriosis and 125 women without endometriosis. We looked at how endometriosis affected mothers and newborn babies. Data on pregnancy, delivery, and newborns of both groups was extracted.

RESULTS

The mean age of participants was 32.74 4.10 and 31.7 5.53 yr in endometriosis and control group, respectively. In terms of pregnancy complications, placenta previa, placenta accreta, placenta abruption, pre-eclampsia, gestational diabetes mellitus, and postpartum hemorrhage remarkably increased in the endometriosis group compared to the control group. Small for gestational age was significantly higher in rectal endometriosis than women without rectal endometriosis (p = 0.03). The neonatal intensive care unit admission rate was notably higher in infants of the endometriosis group compared to controls (40.7% vs. 24.8%, p = 0.009).

CONCLUSION

Our findings showed women with endometriosis are at a higher risk for important adverse maternal outcomes.

摘要

背景

子宫内膜异位症与妊娠结局之间的关联是一个有趣的话题。与子宫内膜异位症相关的疼痛在妊娠时会减轻;然而,已知它会导致妊娠不良结局。主要原因是细胞因子、生长因子和血管生成因子水平升高引起的全身性慢性炎症。

目的

本研究旨在阐明子宫内膜异位症、深部子宫内膜异位症、子宫腺肌病、手术治疗与不良母体后果之间的关系。

材料与方法

在这项病例对照研究中,2020年1月从伊朗德黑兰哈兹拉特·拉苏勒·阿克拉姆医院的医院信息系统中提取了2015年2月至2019年12月在该医院分娩的250名女性的数据。参与者分为两组:125名患有子宫内膜异位症的女性和125名没有子宫内膜异位症的女性。我们观察了子宫内膜异位症如何影响母亲和新生儿。提取了两组的妊娠、分娩和新生儿数据。

结果

子宫内膜异位症组和对照组参与者的平均年龄分别为32.74±4.10岁和31.7±5.53岁。在妊娠并发症方面,与对照组相比,子宫内膜异位症组前置胎盘、胎盘植入、胎盘早剥、子痫前期、妊娠期糖尿病和产后出血显著增加。直肠子宫内膜异位症患者小于胎龄儿的发生率显著高于无直肠子宫内膜异位症的女性(p = 0.03)。与对照组相比,子宫内膜异位症组婴儿入住新生儿重症监护病房的比例显著更高(40.7%对24.8%,p = 0.009)。

结论

我们的研究结果表明,患有子宫内膜异位症的女性出现重要不良母体结局的风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b1e/11347764/7bb0e7594aa4/ijrb-22-473-g001.jpg

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