Articles
Register for Dr. Henrik Falconer: Women with Endometriosis Need Special Care During Pregnancy to Avoid Risk of Premature Birth
Wednesday 1 July 2009
25th annual conference of the European Society of Human Reproduction and
Embryology
NB: this is the subject of a news briefing by Dr. Henrik Falconer at 09.30 hrs (CEST)
on Wednesday 1 July
Amsterdam, The Netherlands: The largest study to date of endometriosis in
pregnant women has found that the condition is a major risk factor for premature
birth, the 25th annual conference of the European Society of Human Reproduction
and Embryology heard today (Wednesday July 1). Dr. Henrik Falconer, of the
Department of Woman and Child Health, Karolinska Institute, Stockholm, Sweden,
said that his team had found that women with endometriosis also had a higher
risk of other pregnancy complications, as well as being more likely to give
birth through Caesarean section. The research is published on-line in the
journal Human Reproduction today*.
The researchers investigated the association between adverse pregnancy outcome,
assisted reproduction technology (ART), and a previous diagnosis of
endometriosis in 1 442 675 single births to Swedish women. They found 13 090
births among 8922 women diagnosed with endometriosis. Compared with women
without endometriosis, they had a 1.33 greater risk of preterm birth. Women with
endometriosis were also more likely to have difficulty in conceiving and need to
receive ART, which is itself a risk factor for adverse pregnancy outcome.
Among women with endometriosis, 11.9% conceived after ART compared with the 1.4%
of women without endometriosis who used the technique. The risk of preterm birth
associated with endometriosis among women with ART was 1.24, and among women
without ART 1.37.
“Endometriosis appears to be a risk factor for preterm birth, irrespective of
ART,” said Dr. Falconer. “Our findings indicate that women with endometriosis
may be considered a high risk group and have special care during pregnancy.”
Endometriosis is a chronic inflammatory disease, affecting up to 15% of all
women of reproductive age, in which the endometrial cells that line the uterus
are deposited in other areas.
Such displacement of endometrial cells can lead to anatomical distortion and
also the release of anti-inflammatory cytokines, signalling molecules used in
communication between cells. Symptoms of endometriosis include severe pelvic
pain, heavy menstrual periods, and nausea.
/more
In addition to an increased risk of preterm birth, the researchers also found
other differences in the pregnancies of women with endometriosis. “Nearly twice
as many women in this group were delivered by Caesarean section,” said Dr.
Falconer. “We observed that among these women the risk of induced preterm birth
was higher than for spontaneous preterm birth. We believe that women with
endometriosis are more frequently scheduled for preterm Caesarean section,
possibly due to placental complications.”
Women with endometriosis were also more likely to suffer from pre-eclampsia, a
condition that develops in the second or third trimester of pregnancy and
involves the development of high blood pressure and the presence of protein in
the urine. Antepartal bleeding was also found to be more common among women with
endometriosis, the researchers say.
“Because endometriosis is so strongly associated with infertility,” said Dr.
Falconer, “we were not surprised to find that women suffering from it were of
higher maternal age and had fewer children. However, after adjusting for
maternal age and other confounding factors, the strong association between
endometriosis and risky pregnancies still remained.
“Our research provides clinicians with important information in the search for
the factors associated with premature birth. Given that endometriosis is
relatively common in women of childbearing age, we hope that our results will
lead to pregnant women with this condition receiving extra attention, thus
enabling them to have normal pregnancies and give birth to healthy babies.”
*Full paper published in Human Reproduction. doi:10.1093/humrep/dep186
Abstract no: O-242 Wednesday 11.00 hrs CEST (Hall 3B)
Further information:
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Email: peter@vermij.com
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