Are you more likely to have a preterm birth if you have endometriosis?

Suffering from endometriosis reduces the chances of getting pregnant, but does this disease also make pregnancy difficult? Will it go on as normal? What is the current data on the risk of preterm birth?

L’endometriosis affects one in ten women of childbearing age in France. It is a chronic disease but what disappears menopause. It is characterized by presence pathological of the uterine tissue (theendometrium) outside the uterine cavity, into nearby organs such as the uterine muscle, theovary at which the peritoneum. It can translate into pains during menstruation or sexual intercourse, pains abdominal or lumbar spine.

Generally considered normal by women, even health professionals who are not sufficiently aware of it pathology, this pain is not always properly taken into account when visiting a doctor and the diagnosis of endometriosis often comes late: up to seven years of diagnostic odyssey! This disease is also a common source ofinfertility.

Since endometriosis is a pathology of the uterine cavity, women who have achieved pregnancy have legitimate questions about the course of their pregnancy. pregnancy. In particular, affected women have a higher risk of a premature birth ? A team conducted a study to answer this question. The results were published in yama on February 8, 2022.

What are the different phenotypes of endometriosis?

Uterine tissue can present three main abnormal sites. This results in three phenotypes clear: superficial isolated peritoneal endometriosis, ovarian endometriosis and deep endometriosis. The second can be paired with the first; the third can be paired with the first two.

How was the study conducted?

The authors conducted a multicenter, prospective study between February 4, 2016 and June 28, 2018. Prospective means that the follow-up period begins with the start date of the study. Multi-centre means that the study was carried out simultaneously at several birth centers, in this case seven, all located in France. Patients expecting multiple children (twin pregnancy), positive for VIHor with a high-risk pregnancy were excluded from the study.

Affected patients had to have a correctly documented diagnosis with imaging studies, a classification of the lesions with confirmation by anatomical pathological examination. Since different endometriosis phenotypes often coexist, patients were assigned to the group with the worst prognosis. For example, if a patient has deep endometriosis and superficial isolated peritoneal endometriosis, she is classified in the deep endometriosis group.

A group of women without endometriosis was also formed. To avoid including affected but undiagnosed individuals in this group, the authors were careful to select patients who had never missed school because of menstrual pain or who had not been prescribed the pill to relieve menstrual pain early on.

Is there a risk of premature birth? Is it dependent on the endometriosis phenotype?

The study involved 1,351 women, 470 of whom had the disease. The results were calculated taking into account the endometriosis phenotype, maternal age, gynecological history, the presence of a overweight before pregnancy. In the group of patients with endometriosis, 34 (7.2%) had one premature birthie 37 weeks agoamenorrhea. In the group of healthy women, 53 (6%) delivered before 37 weeks. These results are not statistically significant. Furthermore, no difference was observed between the different phenotypes. Patients with endometriosis can therefore rest easy on this point.

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