Endometriosis and adverse pregnancy outcomes: A case-control study

Fatemeh Shahmoradi, Shahmoradi F, Haghighi L, Ladan Haghighi, Noori M, Marziyeh Noori, Derakhshan R, Roya Derakhshan, Hashemi N, Neda Hashemi, Rokhgireh S, Samaneh Rokhgireh
International journal of reproductive biomedicine · 2024 · vol. 22(6) , pp. 473–480 · doi:10.18502/ijrm.v22i6.16798 · PMID:39205922 · PMC11347764 · W4401272238
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⚙ AI-generated summary by claude@2026-07, 2026-07-08 ⓘ

This case-control study found that women with endometriosis had significantly increased risks of adverse maternal outcomes, including pre-eclampsia and postpartum hemorrhage, and their infants had higher rates of NICU admission.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-08 · read from full text ⓘ

This case-control study extracted data on 250 singleton births (125 women with surgically confirmed endometriosis vs 125 controls without prior endometriosis) from a referral hospital information system in Tehran, Iran, and compared maternal and neonatal outcomes using questionnaires plus medical-record review, with laparoscopic/histologic confirmation of endometriosis in cases. The main finding was that women with endometriosis had higher rates of multiple obstetric complications, including preterm birth, pre-eclampsia, gestational hypertension, GDM, placenta previa, placental abruption, and postpartum hemorrhage, and neonates had higher NICU admission rates; the authors also reported that rectal endometriosis was associated with higher SGA and that among women with adenomyosis within the endometriosis group, PPH incidence was higher than in those without adenomyosis. A key caveat is that the study’s subgroup analyses (e.g., rectal involvement/adenomyosis) can be limited by small numbers and the observational design, and the paper notes uncertainty about mechanisms. This paper is centrally about endometriosis — it evaluates how endometriosis (including deep/rectal disease and adenomyosis comorbidity) relates to adverse pregnancy outcomes.

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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.
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Section

Samaneh Rokhgireh: Designed and directed the project; Neda Hashemi: Wrote the manuscript, was involved in planning, and supervised the work; Fatemeh Shahmoradi: Data collection, draft manuscript preparation; Marziyeh Noori: Data collection, draft manuscript preparation; Roya Derakhshan: Monitored, evaluated, and analyzed the result of the study. Ladan Haghighi: Wrote the manuscript and was involved in planning and supervising the work. All authors approved the final manuscript and take responsibility for the integrity of the data.

Coi Statement

The authors declare that there is no conflict of interest.

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endometriosisadenomyosis

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