Endometriosis and Adverse Pregnancy Outcomes, controversies debates

Abstract The association between endometriosis and outcome of pregnancy is one of the interesting topics. Patients' pain is alleviated with pregnancy, but it seems that endometriosis causes adverse outcomes in pregnancy. The main accused is systemic chronic inflammation caused by higher level of cytokines, growth factors and angiogenic factors. In this retrospective cohort study, the case group included 125 women with endometriosis who referred to Hazrat-e- Rasool hospital in 2015–2019, and the control group included 125 women without endometriosis who went to the hospital for delivery in 2015–2019. Data on pregnancy, delivery and newborns of the endometriosis and control group was extracted from the hospital information system and the questionnaires were completed. The average age of patients was 32.74 ± 4.10 and 31.7 ± 5.53 years in endometriosis and control group respectively. In terms of pregnancy complications, placenta previa, placenta accreta, placenta abruption pre-eclampsia, GDM and postpartum hemorrhage remarkably increase in the endometriosis group compared to the control group (P < 0.05). In bowel endometriosis SGA was significantly higher than patients without bowel endometriosi. (P < 0.05). Conservative or surgical treatment of rectal endometriosis had no significant effect on pregnancy outcome (P > 0.05). As well as the presence of adenomyosis made pregnancy outcomes significantly unfavorable compared to people without adenomyosis. (P < 0.05). NICU admission rate was notably higher in infants of endometriosis group compared to controls (40.7% vs. 24.8%, P-value 0.009). Infant mortality rate had no significant difference in both groups (P = 0.12). Our findings showed that endometriosis and adenomyosis are related to bad obstetric consequences.