Endometriosis and assisted reproductive techniques independently related to mother-child morbidities: a French longitudinal national study

Sylvie Epelboin, Epelboin S, Julie Labrosse, Patricia Fauque, Fauque P, Rachel Levy, Rachel Lévy, Levy R, Gervoise-Boyer MJ, M. Boyer, Marie-José Gervoise-Boyer, A. Devaux, Aviva Devaux, Devaux A, Marianne Bergère, Bergère M, De Vienne C, Claire de Vienne, Philippe Jonveaux, Jonveaux P, De Mouzon J, J. de Mouzon, Jacques de Mouzon, Pessione F, Fabienne Pessione
Reproductive BioMedicine Online · 2020 · vol. 42(3) , pp. 627–633 · doi:10.1016/j.rbmo.2020.11.017 · PMID:33388264 · W3116126765
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This study investigated the independent relationships between endometriosis, assisted reproductive techniques, and mother–child morbidities in a French national cohort.

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Abstract

RESEARCH QUESTION: Does endometriosis increase obstetric and neonatal complications, and does assisted reproductive technology (ART) cause additional risk of maternal or fetal morbidity? DESIGN: A nationwide cohort study (2013-2018) comparing maternal and perinatal morbidities in three groups of single pregnancies: spontaneous pregnancies without endometriosis; spontaneous pregnancies with endometriosis; and ART pregnancies in women with endometriosis. RESULTS: Mean maternal ages were 30.0 (SD = 5.3), 31.7 (SD = 4.8) and 33.1 years (SD = 4.0), for spontaneous conceptions, spontaneous conceptions with endometriosis and ART pregnancies with endometriosis groups, respectively (P < 0.0001). Comparison of spontaneous conceptions with endometriosis and spontaneous conceptions: endometriosis independently increased the risk of venous thrombosis (adjusted OR [aOR] 1.51, P < 0.001), pre-eclampsia (aOR 1.29, P < 0.001), placenta previa (aOR 2.62, P < 0.001), placental abruption (aOR 1.54, P < 0.001), premature birth (aOR 1.37, P < 0.001), small for gestational age (aOR 1.05, P < 0.001) and malformations (aOR 1.06, P = 0.049). Comparison of ART pregnancies with endometriosis and spontaneous conceptions with endometriosis: ART increased the risk of placenta previa (aOR 2.43, 95% CI 2.10 to 2.82, P < 0.001), premature birth (aOR 1.42, 95% CI 1.29 to 1.55, P < 0.001) and small for gestational age (aOR 1.18, 95% CI 1.10 to 1.27, P < 0.001), independently from the effect of endometriosis. Risk of pre-eclampsia, placental abruption or congenital malformations was not increased with ART. CONCLUSION: Endometriosis is an independent risk factor for mother and child morbidities. Maternal morbidity and perinatal morbidity were significantly increased by ART in addition to endometriosis; however, some perinatal and maternal morbidity risks were increasingly linked to pathologies related to infertility.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Pregnancy Complications Reproductive Techniques, Assisted Adult Adult Endometriosis Endometriosis Female Female France France France Humans Humans Infant, Newborn Infant, Newborn Infant, Small for Gestational Age Infant, Small for Gestational Age Longitudinal Studies Longitudinal Studies

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