Effect of the mode of delivery on the risk of endometriosis recurrence: a retrospective cohort study
Observational
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This retrospective cohort study investigated how the method of childbirth delivery influences the likelihood of endometriosis returning in patients.
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Abstract
OBJECTIVE: To evaluate the risk of endometriosis recurrence according to the mode of delivery (cesarean section vs. vaginal birth) in patients who had become pregnant with a live birth after surgery for endometriosis.
DESIGN: A retrospective cohort study. A Cox proportional-hazards regression was performed to evaluate the risk factors for endometriosis recurrence at 36 months of follow-up after the last pregnancy.
SETTING: Academic hospital.
PATIENT(S): Patients who have had ≥1 pregnancy with a live birth following conservative surgery for ovarian endometriosis performed from January 2009 to December 2016 at our institution.
INTERVENTION(S): Patients who underwent ≥1 cesarean section after surgery for endometriosis.
MAIN OUTCOME MEASURES: The recurrence rate of endometriosis after live-birth pregnancies obtained after the first surgery for endometriosis.
RESULTS: Patients with a history of ≥1 cesarean section after surgery for endometriosis have a higher risk of endometriosis recurrence than the patients who have had a vaginal birth, with an adjusted hazard ratio of 2.25 (95% confidence interval, 1.27-3.96).
CONCLUSION: A cesarean section after surgery for endometriosis is associated with a twofold high risk of endometriosis recurrence with respect to vaginal birth. A different follow-up approach may be needed in those patients, and avoiding inappropriate indications for cesarean sections in pregnant patients with a history of surgery for endometriosis is necessary.
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Cited by (7)
- Rethinking endometriosis recurrence: from clinical challenge to biological opportunity 2026
- Birth Register for Deep Endometriosis (BiRDeE): first analysis and recommendations 2024
- The dilemma of management of patients with endometrioma and infertility 2024
- Bladder Endometriosis: What do we know and what is left to find out? A narrative review 2024
- Influence of Cesarean Section on Postpartum Fertility and Dysmenorrhea: A Retrospective Cohort Study in Japan 2024
- Geburtsmodus beeinflusst Rezidivrisiko nach Endometrioseoperation 2023
- Homozygous C677T Methylenetetrahydrofolate Reductase (MTHFR) Polymorphism as a Risk Factor for Endometriosis: A Retrospective Case-Control Study 2023
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- europepmc
- last seen: 2026-10-13T06:10:10.580696+00:00
- openalex
- last seen: 2026-06-10T17:14:06.276822+00:00
- pubmed
- last seen: 2026-10-08T21:37:06.835816+00:00
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