Risk of gestational hypertension-preeclampsia in women with preceding endometriosis: a nationwide population-based study
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OBJECTIVE: To investigate the association between preceding endometriosis and gestational hypertension-preeclampsia (GH-PE). METHODS: In this nationwide population-based longitudinal study, data from 1998-2012 Taiwan National Health Insurance Research Database were used. We used ICD9-CM codes 617.X and 642.X respectively for the diagnoses of endometriosis and GH-PE, which were further confirmed by examining medical records of surgeries, blood pressure and urine protein to ensure the accuracy of the diagnoses. The study excluded women diagnosed with endometriosis at < 15 or > 45 years of age, chronic hypertension, and GH-PE prior to endometriosis. Each pregnant woman with a prior diagnosis of endometriosis was matched to 4 pregnant women without endometriosis by age. Logistic regression analysis was used to calculate odds ratios (ORs) for the risk of GH-PE with adjustment for age, occupation, urbanization, economic status and comorbidities. RESULTS: Among 6,300 women with a prior endometriosis diagnosis who were retrieved from a population of 1,000,000 residents, 2,578 (40.92%) had subsequent pregnancies that were eligible for further analysis and were compared with 10,312 pregnant women without previous endometriosis. GH-PE occurred more in women with prior endometriosis as compared to those without endometriosis (3.88% vs. 1.63%, p<0.0001). Further analysis revealed prior endometriosis was associated with GH-PE (adjusted OR = 2.27; 95% CI:1.76-2.93). For danazol-treated and non-danazol-treated subgroups, the incidences of GH-PE were 3.13% (15/480) and 4.05% (85/2,098), respectively. Although the risk for subsequent GH-PE was lower (adjusted OR = 1.49; 95% CI:0.86-2.56) after receiving danazol treatment than average (adjusted OR = 2.27; 95% CI:1.76-2.93) for women with preceding endometriosis, the reduction of risk was not statistically remarkable for danazol-treated (adjusted OR = 1.49) vs. non-danazol-treated (adjusted OR = 2.48) subgroups (p heterogeneity = 0.12). CONCLUSIONS: Preceding endometriosis is an independent and significant risk factor for the occurrence of GH-PE.
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Endometriosis, especially cystic ovarian and deep endometriosis, and adenomyosis are associated with abnormal placentation, insufficient physiologic changes in the spiral arteries, and an increased risk of preterm birth, small for gestational age babies, and preeclampsia.
“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 [130]
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- Authors
- Pan, M.-L., Chen, L.-R., Tsao, H.-M., & Chen, K.-H.
- Affiliations
- Institute of Information Science, Academia Sinica (TW)
- National Yang Ming Chiao Tung University (TW)
- Tzu Chi University (TW)
- Corresponding author
- Chen, Kuo-Hu
- ORCID
- Chen, Kuo-Hu
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2017-07-17
- Volume
- 12
- Issue
- 7
- Pages
- e0181261
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5513453
- OpenAlex
- W2735830395
- Cited by
- 30
- References
- 39
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 5 · 2022: 4 · 2021: 6 · 2020: 3 · 2019: 1 · 2018: 3 · 2017: 1
- FWCI
- 2.57
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- a grant of the Ministry of Science and Technology Multidisciplinary (health cloud research program: technology development and application of big health data), Taiwan
- a grant of Taipei Tzu-Chi Hospital, Taiwan (TCRD-TPE-105-18)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
- Keywords
- endometriosis, gestational hypertension, preeclampsia, pregnancy complications, endometriosis treatment, maternal health risks, Taiwan National Health Insurance Research Database, matched cohort analysis, urinary protein, blood pressure in pregnancy, maternal comorbidities, socioeconomic status, urbanization, occupation, economic status, comorbidities
- MeSH terms
- Adolescent, Adult, Age Factors, Endometriosis, Female, Humans, Longitudinal Studies, Middle Aged, National Health Programs, Pre-Eclampsia, Pregnancy, Risk Factors, Socioeconomic Factors, Taiwan, Time Factors, Urban Population, Comorbidity, Logistic Models, Odds Ratio, Databases, Factual, Young Adult
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