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

Yangxue Huang, Xianhong Zhao, Yiyuan Chen, Jie Wang, Weilin Zheng, Lixing Cao
BioMed research international · 2020 · vol. 2020(1) , pp. 4381346 · doi:10.1155/2020/4381346 · PMID:33490243 · W3110971725
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Endometriosis increased miscarriage risk in spontaneously conceiving women, while adenomyosis increased miscarriage risk in women undergoing ART.

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Abstract

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.

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Condition tags

mesh:D004715endometriosisadenomyosisinfertility

MeSH descriptors

Abortion, Spontaneous Adenomyosis Endometriosis Abortion, Spontaneous Adenomyosis Endometriosis Female Humans Pregnancy Pregnancy Complications Pregnancy Complications Reproductive Techniques, Assisted Reproductive Techniques, Assisted

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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Cited by (36)

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