Adverse pregnancy outcomes for women with endometriosis: a systematic review and meta-analysis

Objectives: This study aimed at assessing the adverse outcomes of pregnancy in women with endometriosis. Material and methods: The Cochrane, Embase and PubMed databases were searched for identifying the required studies published before June 2019. Meta-analyses of relative risk (RR) were performed under the random-effects model to estimate the risk of selected adverse outcomes of pregnancy in females with endometriosis. Results: Twenty-eight studies (53,141 women with and 2,355,923 women without endometriosis data) were selected for meta-analysis. Endometriosis bearing females had a significantly higher risk placenta previa (RR 3.92 [95% CI 2.48-6.20]), miscarriage (RR 1.31 [95% CI 1.06-1.61), gestational hypertension (RR 1.30 [95% CI 1.02-1.65]), cesarean section (RR 1.48 [95% CI 1.33-1.65]) and preeclampsia (RR 1.18 [95% CI 1.09-1.28]). The incidence of placental abruption was not statistically significant between the groups (RR 3.62 [95% CI [0.99-13.28]). Conclusions: Women suffering from endometriosis are at higher risks of miscarriage, preterm birth, gestational hypertension, placenta previa, cesarean section, and preeclampsia.