Systematic review and meta-analysis of adverse pregnancy outcomes with different types of adenomyosis

Xia Ying, Ying Xia, Hongbiao Yu, Yu H
International Journal of Gynecology & Obstetrics · 2025 · vol. 171(3) , pp. 1054–1065 · doi:10.1002/ijgo.70272 · PMID:40459223 · W4410997736
meta-analysis OA: bronze CC0 ⤵ 3 in-corpus citations
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This systematic review and meta-analysis found that diffuse adenomyosis significantly increased the risk of adverse pregnancy outcomes, including preterm birth and hypertensive disorders, compared to focal adenomyosis.

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Abstract

BACKGROUND: Different types of adenomyosis have distinct impacts on various pregnancy outcomes. The influence of diffuse and focal adenomyosis on adverse pregnancy outcomes remains controversial. OBJECTIVE: To examine the effects of diffuse and focal adenomyosis on adverse pregnancy outcomes in women. SEARCH STRATEGY: We conducted searches on PubMed, Embase, Web of Science, and the Cochrane Database for studies published between January 1950 and June 2024. SELECTION CRITERIA: We included observational studies that identified medically confirmed adverse pregnancy outcomes (preterm birth, hypertensive disorders of pregnancy, and fetal growth restriction) as endpoints. DATA COLLECTION AND ANALYSIS: Two researchers independently screened and selected pertinent studies. The methodological quality of these selected studies was assessed using the Newcastle-Ottawa Quality Assessment Form for Case-control and Cohort studies. Data analysis was primarily performed using Stata software. Dichotomous data for all adverse pregnancy outcomes were reported as odds ratios (ORs) with 95% confidence intervals (CIs) and synthesized in a meta-analysis using a fixed-effects model. RESULTS: Five studies (involving 390 women with diffuse adenomyosis and 233 women with focal adenomyosis) were included in the meta-analysis. The analysis indicated that diffuse adenomyosis was significantly associated with an increased risk of adverse pregnancy outcomes (OR 2.59, 95% CI 1.73-3.88; P < 0.001). Women with diffuse adenomyosis had higher odds of experiencing preterm birth(OR1.66, 95% CI1.03-2.67, P = 0.038) and hypertensive disorders of pregnancy (OR 2.23, 95% CI 1.32-3.77; P = 0.002). CONCLUSION: Women with diffuse adenomyosis are more likely to experience preterm birth and hypertensive disorders of pregnancy compared with those with focal adenomyosis.
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Abstract

Background Different types of adenomyosis have distinct impacts on various pregnancy outcomes. The influence of diffuse and focal adenomyosis on adverse pregnancy outcomes remains controversial.

Objective

To examine the effects of diffuse and focal adenomyosis on adverse pregnancy outcomes in women. Search Strategy We conducted searches on PubMed, Embase, Web of Science, and the Cochrane Database for studies published between January 1950 and June 2024. Selection Criteria We included observational studies that identified medically confirmed adverse pregnancy outcomes (preterm birth, hypertensive disorders of pregnancy, and fetal growth restriction) as endpoints. Data Collection and Analysis Two researchers independently screened and selected pertinent studies. The methodological quality of these selected studies was assessed using the Newcastle-Ottawa Quality Assessment Form for Case-control and Cohort studies. Data analysis was primarily performed using Stata software. Dichotomous data for all adverse pregnancy outcomes were reported as odds ratios (ORs) with 95% confidence intervals (CIs) and synthesized in a meta-analysis using a fixed-effects model.

Results

Five studies (involving 390 women with diffuse adenomyosis and 233 women with focal adenomyosis) were included in the meta-analysis. The analysis indicated that diffuse adenomyosis was significantly associated with an increased risk of adverse pregnancy outcomes (OR 2.59, 95% CI 1.73–3.88; P < 0.001). Women with diffuse adenomyosis had higher odds of experiencing preterm birth(OR1.66, 95% CI1.03–2.67, P = 0.038) and hypertensive disorders of pregnancy (OR 2.23, 95% CI 1.32–3.77; P = 0.002).

Conclusion

Women with diffuse adenomyosis are more likely to experience preterm birth and hypertensive disorders of pregnancy compared with those with focal adenomyosis. CONFLICT OF INTEREST STATEMENT The authors have no conflicts of interest. DATA AVAILABILITY STATEMENT The authors declare that the date supporting the findings of this study are available with the paper and its supplementary information files.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis

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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