Endometriosis and assisted reproductive techniques independently related to mother–child morbidities: a French longitudinal national study. Issue 3 (March 2021)

• Record Type: Journal Article
• Authors: Epelboin, Sylvie; Labrosse, Julie; Fauque, Patricia; Levy, Rachel; Gervoise-Boyer, Marie-José; Devaux, Aviva; Bergère, Marianne; de Vienne, Claire; Jonveaux, Philippe; De Mouzon, Jacques; Pessione, Fabienne
• Is Part Of: Reproductive biomedicine online. Volume 42:Issue 3(2021)
• Page Start: 627
• Page End: 633
• Publication Date: 2021-03
• Subjects: Assisted reproductive techniques -- Endometriosis -- Maternal and perinatal morbidity -- Pregnancy induced hypertension disorders -- Premature birth; Human reproductive technology -- Periodicals; Human embryo -- Periodicals; Reproduction -- Periodicals; 616.692
• DOI: 10.1016/j.rbmo.2020.11.017
• Languages: English
• ISSNs: 1472-6483

Abstract

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.