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Adenomyosis and adverse perinatal outcomes: increased risk of second trimester miscarriage, preeclampsia, and placental malposition
Abstract
OBJECTIVE: To evaluate the potential impact of adenomyosis on the pregnancy outcomes by retrospectively investigating adenomyosis-complicated pregnancy cases. METHODS: We performed a retrospective case-control study. Forty-nine singleton pregnancy cases complicated with adenomyosis were included in this study. The controls (n = 245) were singleton pregnant women without adenomyosis and were frequency matched to adenomyosis cases by age, parity, and the need for assisted reproductive technology for this conception. The incidence of obstetrical complications and delivery and neonatal outcomes were examined. RESULTS: Patients in the adenomyosis group were significantly more likely to have a second trimester miscarriage (12.2% versus 1.2%, odds ratio (OR): 11.2, 95% confidence interval (95% CI): 2.2-71.2), preeclampsia (18.3% versus 1.2%, OR: 21.0, 95% CI: 4.8-124.5), placental malposition (14.2% versus 3.2%, OR: 4.9, 95% CI: 1.4-16.3), and preterm delivery (24.4% versus 9.3%, OR: 3.1, 95% CI: 1.2-7.2), compared with the control group. CONCLUSION: Adenomyosis was associated not only with an increased incidence of preterm delivery, as previously reported, but also with an increased risk of second trimester miscarriage, preeclampsia, and placental malposition, which could lead to poor perinatal outcomes.
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“Endometriosis, especially cystic ovarian and deep endometriosis (130, 131), and adenomyosis (132, 133) are associated with abnormal placentation, insufficient physiologic changes in the spiral arteries, and an increased risk of preterm birth, small for gestational age (SGA) babies, and preeclampsia (131).”
From Pathogenesis of endometriosis: The genetic/epigenetic theory (2019) · cites this paper as [133]
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Metadata
- Authors
- Hashimoto, A., Iriyama, T., Sayama, S., Nakayama, T., Komatsu, A., Miyauchi, A., Nishii, O., Nagamatsu, T., Osuga, Y., & Fujii, T.
- Affiliations
- The University of Tokyo (JP)
- Japanese Red Cross Medical Center (JP)
- Teikyo University Hospital, Mizonokuchi (JP)
- Corresponding author
- Iriyama, Takayuki
- Venue
- The Journal of Maternal-Fetal & Neonatal Medicine
- Publisher
- Informa UK Limited
- Published
- 2017-02-09
- Volume
- 31
- Issue
- 3
- Pages
- 364-369
- ISSN
- 1476-4954 (ISSN-L)
- 1476-7058
- OpenAlex
- W2582200713
- Cited by
- 141
- References
- 23
- Citations by year
- 2026: 8 · 2025: 18 · 2024: 16 · 2023: 20 · 2022: 25 · 2021: 15 · 2020: 12 · 2019: 14 · 2018: 9 · 2017: 3
- FWCI
- 12.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Maternal-Fetal & Neonatal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Institutional Repositories DataBase (IRDB) (submittedVersion)
- Funders
- Japan Society for the Promotion of Science (15H04979, 16H05469)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Keywords
- adenomyosis, perinatal outcomes, second-trimester miscarriage, preeclampsia, preterm birth, pregnancy complications, singleton pregnancy
- MeSH terms
- Abortion, Spontaneous, Adult, Female, Humans, Japan, Placenta Previa, Pre-Eclampsia, Pregnancy, Pregnancy Trimester, Second, Retrospective Studies, Reproductive Techniques, Assisted, Premature Birth, Adenomyosis
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