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- Title
Miscarriage on Endometriosis and Adenomyosis in Women by Assisted Reproductive Technology or with Spontaneous Conception: A Systematic Review and Meta-Analysis.
- Authors
Huang, Yangxue; Zhao, Xianhong; Chen, Yiyuan; Wang, Jie; Zheng, Weilin; Cao, Lixing
- Abstract
Background. In the past several years, there has been an increasing concern on miscarriage caused by endometriosis or adenomyosis. However, the results reported by different studies remain controversial. The present study is aimed at assessing the impact of endometriosis and adenomyosis on miscarriage. Materials and Methods. Searches were carried out in PubMed, Embase, and the Cochrane library for studies published from inception until February 29, 2020. The investigators included studies that evaluated miscarriage risk in pregnant women with endometriosis or adenomyosis by assisted reproductive technology (ART), or with spontaneous conception (SC). Miscarriage (<28 weeks) was the primary outcome. The secondary outcomes were antepartum hemorrhage (APH), postpartum hemorrhage (PPH), preterm birth, low birthweight, placenta praevia, placental abruption, ectopic pregnancy, stillbirth, gestational diabetes, preeclampsia, and intrauterine growth restriction (IUGR). Endnote was used for the study collection, and the data analyses were carried out by two authors using Review Manager version 5.2. Results. Thirty-nine studies, which is comprised of 697,984 women, were included in the present study. Miscarriage risk increased in women with endometriosis in SC (OR: 1.81, 95% CI: 1.44-2.28, I 2 = 96 %) compared with those without endometriosis, while women with endometriosis who underwent ART had a similar miscarriage risk, when compared to those with tubal infertility (OR: 1.03, 95% CI: 0.92-1.14, I 2 = 0 %). Compared with those without adenomyosis, women with adenomyosis had an augmented miscarriage risk in ART (OR: 2.81, 95% CI: 1.44-5.47, I 2 = 64 %). Compared with those without endometriosis, women with endometriosis had higher odds of APH, PPH, preterm birth, stillbirth, and placenta praevia. No difference was observed in the incidence of ectopic pregnancy, placental abruption, pre-eclampsia, gestational diabetes, low birthweight, and IUGR. Conclusion. Women with endometriosis had an augmented miscarriage risk in SC and a similar miscarriage risk during ART. Adenomyosis was associated with miscarriage in pregnant women using ART.
- Subjects
RISK factors in miscarriages; LOW birth weight; CONFIDENCE intervals; GESTATIONAL diabetes; ECTOPIC pregnancy; ENDOMETRIOSIS; FERTILIZATION in vitro; FETAL growth retardation; HEMORRHAGE; HUMAN reproductive technology; PREMATURE infants; INFERTILITY; INFORMATION storage &; retrieval systems; MEDICAL databases; MEDICAL information storage &; retrieval systems; MEDLINE; META-analysis; ONLINE information services; PERINATAL death; PLACENTA praevia; PREECLAMPSIA; PREGNANT women; PUERPERAL disorders; RISK assessment; SYSTEMATIC reviews; DISEASE incidence; DATA analysis software; DESCRIPTIVE statistics; ABRUPTIO placentae; ODDS ratio; PREGNANCY outcomes; DISEASE complications
- Publication
BioMed Research International, 2020, p1
- ISSN
2314-6133
- Publication type
Article
- DOI
10.1155/2020/4381346