{"paper_id":"7325ee02-d103-4cce-abe3-db9bd8de8782","body_text":"Abstract\nEndometriosis is a chronic gynaecological condition characterized by inflammatory and immune abnormalities. Likewise, these dysfunctions are important hallmarks of systemic lupus erythematosus (SLE), a condition that also has a high prevalence among women in reproductive age. Therefore, we conducted a systematic review and meta-analysis to investigate the association between endometriosis and SLE. We searched Medline and Web of Science for articles published from database inception to March 1, 2021. Random-effects meta-analysis was performed to provide a pooled risk ratio (RR). Individual study quality was evaluated following the National Heart, Lung, and Blood Institute Quality Assessment Tools (NHLBI QAT). From the 225 articles identified through our search, five studies—assessing 152,355 women—were included. Included studies presented an overall poor or fair quality rating. We observed a significant association between endometriosis and SLE (RR = 2.47, 95% confidence interval: 1.33–4.59, P < 0.004, I2 = 54%). Sensitivity analyses stratifying articles by study design demonstrated that the association was significant in cross-sectional and case–control studies (RR = 5.07, 95% confidence interval: 1.42–18.11, P < 0.012), as well as in cohort studies (RR = 2.07, 95% confidence interval: 1.02–4.20, P < 0.044). In spite of the limited quality of included studies, our results suggest the existence of an association between endometriosis and SLE. These findings can aid medical assessment of patients with endometriosis, as well as provide further insights to better understand this gynaecological disorder.\nSimilar content being viewed by others\nData Availability\nThe data used in the preparation of the present article will be made available upon reasonable request.\nCode Availability\nThe script used for statistical analyses in the present work will be made available upon reasonable request.\nReferences\nShafrir AL, Farland LV, Shah DK, Harris HR, Kvaskoff M, Zondervan K, et al. Risk for and consequences of endometriosis: a critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol. 2018;51:1–15.\nZondervan KT, Becker CM, Koga K, Missmer SA, Taylor RN, Vigano P. Endometriosis Nat Rev Dis Primers. 2018;4(1):9.\nNnoaham KE, Hummelshoj L, Webster P, d’Hooghe T, de Cicco Nardone F, de Cicco Nardone C, et al. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. 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Dtsch Arztebl Int. 2015;112(25):423–32.\nvan Vollenhoven RF, Mosca M, Bertsias G, Isenberg D, Kuhn A, Lerstrom K, et al. Treat-to-target in systemic lupus erythematosus: recommendations from an international task force. Ann Rheum Dis. 2014;73(6):958–67.\nDunselman GA, Vermeulen N, Becker C, Calhaz-Jorge C, D’Hooghe T, De Bie B, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014;29(3):400–12.\nAcknowledgements\nWe would like to thank Bruna Bellaver from the Universidade Federal do Rio Grande do Sul for helping with the search strategy, as well as for providing orientation regarding the design and conceptualization of the study.\nAuthor information\nAuthors and Affiliations\nContributions\nJPF-S and JSCF designed and conceptualized the study. JPF-S performed the literature search. EEM and JPF-S were responsible for study selection. Data extraction was carried out by LPF and MTP. Quality assessment was performed by JPF-S, EEM, LGC, LPF, and MTP. Data analysis was conducted by JPF-S and JSCF. All authors analysed and interpreted the data, as well as had major contributions for manuscript writing and revised the work regarding intellectual content.\nCorresponding author\nEthics declarations\nEthics Approval\nNot applicable because the present work is a systematic review and meta-analysis.\nConsent to Participate\nNot applicable.\nConsent for Publication\nNot applicable.\nCompeting Interests\nThe authors declare no competing interests.\nSupplementary Information\nBelow is the link to the electronic supplementary material.\nRights and permissions\nAbout this article\nCite this article\nFerrari-Souza, J.P., Pedrotti, M.T., Moretto, E.E. et al. Endometriosis and Systemic Lupus Erythematosus: Systematic Review and Meta-analysis. Reprod. Sci. 30, 997–1005 (2023). https://doi.org/10.1007/s43032-022-01045-3\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s43032-022-01045-3","source_license":"CC0","license_restricted":false}