Purpose To evaluate obstetric outcome in women with endometriosis who conceive naturally and receive standard obstetric care in Italy. Methods Cases were consecutive women with endometriosis managed in eleven Italian referral centers. Controls were women in whom endometriosis was excluded. All women filled in a questionnaire addressing previous natural pregnancies. Marginal logistic regression models were fitted to evaluate the impact of endometriosis on obstetric outcome. A post hoc analysis was performed within the endometriosis group comparing women with severe adenomyosis versus women with absent or mild adenomyosis. Results Three hundred and fifty-five pregnancies in endometriosis group and 741 pregnancies in control group were included. Women with endometriosis had a higher risk of preterm delivery<34 weeks (6.4% vs 2.8%, OR 2.42, 95% CI 1.22–4.82), preterm delivery<37 weeks (17.8% vs 9.7%, OR 1.98, 95% CI 1.23–3.19), and neonatal admission to Intensive Care Unit (14.1% vs 7.0%, OR 2.04, 95% CI 1.23–3.36). At post hoc analysis, women with endometriosis and severe adenomyosis had an increased risk of placenta previa (23.1% vs 1.8%, OR 16.68, 95% CI 3.49–79.71), cesarean delivery (84.6% vs 38.9%, OR 8.03, 95% CI 1.69–38.25) and preterm delivery<34 weeks (23.1% vs 5.7%, OR 5.52, 95% CI 1.38–22.09). Conclusion Women with endometriosis who conceive naturally have increased risk of preterm delivery and neonatal admission to intensive care unit. When severe adenomyosis is coexistent with endometriosis, women may be at increased risk of placenta previa and cesarean delivery.

Impact of endometriosis on obstetric outcome after natural conception. a multicenter Italian study / Berlanda, N; Alio, W; Angioni, S; Bergamini, V; Bonin, C; Boracchi, P; Candiani, M; Centini, G; D'Alterio, M N; Del Forno, S; Donati, A; Dridi, D; Incandela, D; Lazzeri, L; Maiorana, A; Mattei, A; Ottolina, J; Orenti, A; Perandini, A; Perelli, F; Piacenti, I; Pino, I; Porpora, M G; Scaramuzzino, S; Seracchioli, R; Solima, E; Somigliana, E; Venturella, R; Vercellini, P; Viganò, P; Vignali, M; Zullo, F; Zupi, E. - In: ARCHIVES OF GYNECOLOGY AND OBSTETRICS. - ISSN 0932-0067. - 305:1(2022), pp. 149-157. [10.1007/s00404-021-06243-z]

Impact of endometriosis on obstetric outcome after natural conception. a multicenter Italian study

Porpora, M G;Scaramuzzino, S;
2022

Abstract

Purpose To evaluate obstetric outcome in women with endometriosis who conceive naturally and receive standard obstetric care in Italy. Methods Cases were consecutive women with endometriosis managed in eleven Italian referral centers. Controls were women in whom endometriosis was excluded. All women filled in a questionnaire addressing previous natural pregnancies. Marginal logistic regression models were fitted to evaluate the impact of endometriosis on obstetric outcome. A post hoc analysis was performed within the endometriosis group comparing women with severe adenomyosis versus women with absent or mild adenomyosis. Results Three hundred and fifty-five pregnancies in endometriosis group and 741 pregnancies in control group were included. Women with endometriosis had a higher risk of preterm delivery<34 weeks (6.4% vs 2.8%, OR 2.42, 95% CI 1.22–4.82), preterm delivery<37 weeks (17.8% vs 9.7%, OR 1.98, 95% CI 1.23–3.19), and neonatal admission to Intensive Care Unit (14.1% vs 7.0%, OR 2.04, 95% CI 1.23–3.36). At post hoc analysis, women with endometriosis and severe adenomyosis had an increased risk of placenta previa (23.1% vs 1.8%, OR 16.68, 95% CI 3.49–79.71), cesarean delivery (84.6% vs 38.9%, OR 8.03, 95% CI 1.69–38.25) and preterm delivery<34 weeks (23.1% vs 5.7%, OR 5.52, 95% CI 1.38–22.09). Conclusion Women with endometriosis who conceive naturally have increased risk of preterm delivery and neonatal admission to intensive care unit. When severe adenomyosis is coexistent with endometriosis, women may be at increased risk of placenta previa and cesarean delivery.
2022
adenomyosis; cesarean delivery; endometriosis; obstetric complications; placenta; preterm delivery; previa
01 Pubblicazione su rivista::01l Trial clinico
Impact of endometriosis on obstetric outcome after natural conception. a multicenter Italian study / Berlanda, N; Alio, W; Angioni, S; Bergamini, V; Bonin, C; Boracchi, P; Candiani, M; Centini, G; D'Alterio, M N; Del Forno, S; Donati, A; Dridi, D; Incandela, D; Lazzeri, L; Maiorana, A; Mattei, A; Ottolina, J; Orenti, A; Perandini, A; Perelli, F; Piacenti, I; Pino, I; Porpora, M G; Scaramuzzino, S; Seracchioli, R; Solima, E; Somigliana, E; Venturella, R; Vercellini, P; Viganò, P; Vignali, M; Zullo, F; Zupi, E. - In: ARCHIVES OF GYNECOLOGY AND OBSTETRICS. - ISSN 0932-0067. - 305:1(2022), pp. 149-157. [10.1007/s00404-021-06243-z]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1576942
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