Miscarriage on Endometriosis and Adenomyosis in Women by Assisted Reproductive Technology or with Spontaneous Conception: A Systematic Review and Meta-Analysis

Background. In the past several years, there has been an increasing concern on miscarriage caused by endometriosis or adenomyosis. However, the results reported by different studies remain controversial. The present study is aimed at assessing the impact of endometriosis and adenomyosis on miscarriage. Materials and Methods. Searches were carried out in PubMed, Embase, and the Cochrane library for studies published from inception until February 29, 2020. The investigators included studies that evaluated miscarriage risk in pregnant women with endometriosis or adenomyosis by assisted reproductive technology (ART), or with spontaneous conception (SC). Miscarriage (<28 weeks) was the primary outcome. The secondary outcomes were antepartum hemorrhage (APH), postpartum hemorrhage (PPH), preterm birth, low birthweight, placenta praevia, placental abruption, ectopic pregnancy, stillbirth, gestational diabetes, preeclampsia, and intrauterine growth restriction (IUGR). Endnote was used for the study collection, and the data analyses were carried out by two authors using Review Manager version 5.2. Results. Thirty-nine studies, which is comprised of 697,984 women, were included in the present study. Miscarriage risk increased in women with endometriosis in SC (OR: 1.81, 95% CI: 1.44-2.28, I 2 = 96 % ) compared with those without endometriosis, while women with endometriosis who underwent ART had a similar miscarriage risk, when compared to those with tubal infertility (OR: 1.03, 95% CI: 0.92-1.14, I 2 = 0 % ). Compared with those without adenomyosis, women with adenomyosis had an augmented miscarriage risk in ART (OR: 2.81, 95% CI: 1.44-5.47, I 2 = 64 % ). Compared with those without endometriosis, women with endometriosis had higher odds of APH, PPH, preterm birth, stillbirth, and placenta praevia. No difference was observed in the incidence of ectopic pregnancy, placental abruption, pre-eclampsia, gestational diabetes, low birthweight, and IUGR. Conclusion. Women with endometriosis had an augmented miscarriage risk in SC and a similar miscarriage risk during ART. Adenomyosis was associated with miscarriage in pregnant women using ART.

Download Full-text

1332Endometriosis, assisted reproductive technology and adverse pregnancy outcomes: a population based data linkage study

International Journal of Epidemiology ◽

10.1093/ije/dyab168.302 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Ibinabo Ibiebele ◽

Tanya Nippita ◽

Rodney Baber ◽

Siranda Torvaldsen

Keyword(s):

Preterm Birth ◽

Assisted Reproductive Technology ◽

Pregnancy Outcomes ◽

Data Linkage ◽

Reproductive Technology ◽

Linkage Study ◽

Adverse Pregnancy Outcomes ◽

Placenta Praevia ◽

Antepartum Haemorrhage ◽

Adverse Pregnancy

Abstract Background Endometriosis is a chronic inflammatory disease characterised by endometrial tissue outside the uterus – pain and infertility are common symptoms. There is a paucity of data on the association between endometriosis and adverse pregnancy outcomes where the contribution of assisted reproductive technology (ART) use is also considered. This study will examine the association between endometriosis, with and without ART use, on adverse pregnancy outcomes. Methods Population data linkage study of all female NSW residents aged 15-45 years with a singleton birth in 2006-2015. Pregnancies were classified into 4 groups based on endometriosis diagnosis (yes/no) and ART use (yes/no). Multinomial logistic regression was used to estimate the odds of adverse pregnancy outcomes with 99% confidence intervals, adjusting for maternal and pregnancy factors. Outcomes assessed included placenta praevia, antepartum haemorrhage, planned birth (induction of labour or caesarean section) and preterm birth. Results Of 889,101 eligible pregnancies, women with endometriosis were more likely to be older while women who used ART were more likely to be nulliparous, birth in a private hospital and less likely to smoke. Adjusted odds ratios for selected study outcomes are outlined below. Conclusions Endometriosis is associated with increased odds of preterm birth, placenta praevia, antepartum haemorrhage and planned birth. In general, the odds of adverse pregnancy outcomes associated with endometriosis were further increased with ART use. Key messages These findings suggest that women with endometriosis, especially those who achieved pregnancy via ART use, represent a high risk obstetric population requiring appropriate surveillance and management.

Download Full-text

Association Between Endometriosis and Preterm Birth in Women With Spontaneous Conception or Using Assisted Reproductive Technology: A Systematic Review and Meta-Analysis of Cohort Studies

Reproductive Sciences ◽

10.1177/1933719117749760 ◽

2018 ◽

Vol 25 (3) ◽

pp. 311-319 ◽

Cited By ~ 11

Author(s):

Faustino R. Pérez-López ◽

Pablo Villagrasa-Boli ◽

María Muñoz-Olarte ◽

Álex Morera-Grau ◽

Pablo Cruz-Andrés ◽

...

Keyword(s):

Systematic Review ◽

Preterm Birth ◽

Cohort Studies ◽

Assisted Reproductive Technology ◽

Meta Analysis ◽

Reproductive Technology ◽

Spontaneous Conception

Download Full-text

Endometrial endotoxin, assisted reproductive technology, and preterm birth

Fertility and Sterility ◽

10.1016/j.fertnstert.2004.04.036 ◽

2004 ◽

Vol 82 (4) ◽

pp. 793-794

Author(s):

J IAMS

Keyword(s):

Preterm Birth ◽

Assisted Reproductive Technology ◽

Reproductive Technology

Download Full-text

A Clinical Nomogram For Predicting Preterm Birth in Women Who Conceived Through Assisted Reproductive Technology

10.21203/rs.3.rs-1036505/v1 ◽

2021 ◽

Author(s):

Yaduan Lin ◽

Fanchen He ◽

Rui Gao ◽

Ting Liu ◽

Ke Zhao ◽

...

Keyword(s):

Preterm Birth ◽

Assisted Reproductive Technology ◽

Risk Model ◽

Cox Regression ◽

Early Stage ◽

Statistical Significance ◽

Reproductive Technology ◽

Brier Score ◽

Chronic Hypertension ◽

Singleton Pregnancy

Abstract Background: We used prepregnant and gestational characteristics as predictors to develop and validated a nomogram predicting the risk of preterm birth (PTB) in assisted reproductive technology (ART) treated women. Methods: The National Vital Statistics System (NVSS) was queried for singleton ART-treated pregnant women from 2015 to 2019. Multivariable cox regression was used to develop the early (< 32 weeks) or late (< 37 weeks) PTB risk model using both statistical significance and clinical importance criteria for variable selection. The predictive accuracy was assessed, and bootstrapping was used for validation. A nomogram was constructed for the presentation of the final model. Results: ART-treated women who were over 45 years old, black, obese, had a history of cesarean section and PTB, restarting ART within 3 months, prepregnant diabetes, chronic hypertension, gestational diabetes, gestational hypertension, and eclampsia, had the highest risk for late and early-stage PTB. The nomogram with these variables accurately predicted PTB in ART women with a singleton pregnancy. (Brier score:0.121, calibration slope: 0.99, c-index: 0.684). Conclusion: We created a nomogram predicting the risk of early or late PTB in ART women with a singleton pregnancy, which could identify potentially at-risk women who seeking ART treatment and inform appropriate preterm care.

Download Full-text