Obstetric and neonatal outcomes in women with internal and non-internal adenomyosis

Qi Y, Yue Qi, Zhang Y, Yuqing Zhang, Lianting Zhuang, Zhuang L, Liu J, Jinchi Liu, Xianmin Zeng, Zeng X, Da Liu, Liu D, Tiantong Zhu, Zhu T, Ying Huang, Huang Y
Reproductive BioMedicine Online · 2026 · vol. 52(6) , pp. 105501 · doi:10.1016/j.rbmo.2026.105501 · PMID:41980566 · W7125503887
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Women with internal adenomyosis had lower live birth rates and increased risks of miscarriage, preterm birth, and small for gestational age infants compared to those with non-internal adenomyosis.

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Abstract

RESEARCH QUESTION: Is there a relationship between the location of adenomyosis lesions and obstetric and neonatal outcomes? DESIGN: A total of 466 women diagnosed with adenomyosis via transvaginal ultrasound between January 2019 and December 2021 were included. Inclusion criterion was a clinical pregnancy (natural conception or ART) achieved within 2 years after diagnosis; patients were followed up until a definitive pregnancy outcome. Women were divided into internal and non-internal adenomyosis groups based on the location of the adenomyosis lesion. Obstetric and neonatal outcomes were compared. Adjusted ratio ratios (aORs) and 95% confidence intervals were calculated by multivariate analysis. Outcomes were adjusted for age, gravidity, mode of conception, history of hysteroscopy and presence of ovarian endometriosis. RESULTS: A total of 251 women (53.9%) presented with internal adenomyosis compared with women with non-internal adenomyosis (n = 215). The internal adenomyosis group were older (35.0 ± 4.3 versus 34.2 ± 4.3 years, P = 0.029) and had more pregnancies. After adjusting for confounders, the internal adenomyosis group had a lower likelihood of live birth (aOR 0.43, 95% CI 0.29 to 0.64, P < 0.001) and a higher risk of early spontaneous miscarriage (aOR 2.27, 95% CI 1.29 to 4.10, P = 0.005). Among women who had live births, women in the internal adenomyosis group had a higher risk of preterm premature rupture of membranes (aOR 3.06, 95% CI 1.37 to 7.27, P = 0.008) and a small for gestational age infant (aOR 2.73, 95% CI 1.24 to 6.32, P = 0.015). CONCLUSION: Women with internal adenomyosis face a higher risk of adverse obstetric and neonatal outcomes; affected patients should be referred early to a high-risk clinic for intensified surveillance and individualized management to improve maternal and infant outcomes.

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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 (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (42)

Cited by (2)

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organisms 2
noordeloos 2009062 noordeloos 2009062

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