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The role of parity in the relationship between endometriosis and pregnancy outcomes

The role of parity in the relationship between endometriosis and pregnancy outcomes
The role of parity in the relationship between endometriosis and pregnancy outcomes
Endometriosis is a chronic and debilitating condition which can affect the entire reproductive life course of women with a potentially detrimental effect on pregnancy. Pregnancy (and increasing parity) can affect endometriosis by modulating disease severity and suppressing symptoms. Multiparous women could be less likely to suffer from endometriosis-related pregnancy complications than primiparous women. We aimed to systematically review the evidence examining the role of parity in the relationship between pregnancy outcomes and endometriosis. A systematic search of MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane Library was performed from inception to May 2022. We searched for experimental and observational studies. Grading of Recommendations, Assessment, Development, and Evaluation was used to assess the quality of evidence with the risk of bias in non-randomised studies of interventions tool incorporated. Eleven studies were included in the meta-analysis. Primiparous women with endometriosis had almost double the risk of hypertensive disorders of pregnancy (OR: 1.99, 95% CI: 1.50–2.63, P < 0.001) compared to multiparous women with endometriosis. Primiparous women with endometriosis were at significantly increased risk of preterm delivery, caesarean delivery, and placenta praevia compared to primiparous women without endometriosis. There were no significant differences in outcomes when multiparous women with endometriosis were compared to multiparous women without endometriosis. There is limited evidence to suggest that primiparous women with endometriosis may be at higher risk of adverse pregnancy outcomes compared to multiparous women. The modulatory role of parity in the pathophysiology of endometriosis and its impact on pregnancy outcomes should be investigated.
2633-8386
Sri Ranjan, Yorain
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Ziauddeen, Nida
8b233a4a-9763-410b-90c7-df5c7d1a26e4
Stuart, Beth
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Alwan, Nisreen
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Cheong, Ying
4efbba2a-3036-4dce-82f1-8b4017952c83
Sri Ranjan, Yorain
855005e1-1139-46a2-a69a-34a35be627fa
Ziauddeen, Nida
8b233a4a-9763-410b-90c7-df5c7d1a26e4
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Alwan, Nisreen
0d37b320-f325-4ed3-ba51-0fe2866d5382
Cheong, Ying
4efbba2a-3036-4dce-82f1-8b4017952c83

Sri Ranjan, Yorain, Ziauddeen, Nida, Stuart, Beth, Alwan, Nisreen and Cheong, Ying (2023) The role of parity in the relationship between endometriosis and pregnancy outcomes. Reproduction and Fertility, 4 (1), [e220070].

Record type: Article

Abstract

Endometriosis is a chronic and debilitating condition which can affect the entire reproductive life course of women with a potentially detrimental effect on pregnancy. Pregnancy (and increasing parity) can affect endometriosis by modulating disease severity and suppressing symptoms. Multiparous women could be less likely to suffer from endometriosis-related pregnancy complications than primiparous women. We aimed to systematically review the evidence examining the role of parity in the relationship between pregnancy outcomes and endometriosis. A systematic search of MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane Library was performed from inception to May 2022. We searched for experimental and observational studies. Grading of Recommendations, Assessment, Development, and Evaluation was used to assess the quality of evidence with the risk of bias in non-randomised studies of interventions tool incorporated. Eleven studies were included in the meta-analysis. Primiparous women with endometriosis had almost double the risk of hypertensive disorders of pregnancy (OR: 1.99, 95% CI: 1.50–2.63, P < 0.001) compared to multiparous women with endometriosis. Primiparous women with endometriosis were at significantly increased risk of preterm delivery, caesarean delivery, and placenta praevia compared to primiparous women without endometriosis. There were no significant differences in outcomes when multiparous women with endometriosis were compared to multiparous women without endometriosis. There is limited evidence to suggest that primiparous women with endometriosis may be at higher risk of adverse pregnancy outcomes compared to multiparous women. The modulatory role of parity in the pathophysiology of endometriosis and its impact on pregnancy outcomes should be investigated.

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Accepted/In Press date: 23 February 2023
e-pub ahead of print date: 23 February 2023
Published date: 28 March 2023

Identifiers

Local EPrints ID: 477110
URI: http://eprints.soton.ac.uk/id/eprint/477110
ISSN: 2633-8386
PURE UUID: 674189c7-8d7a-4c2e-b945-0e772f2adde8
ORCID for Nida Ziauddeen: ORCID iD orcid.org/0000-0002-8964-5029
ORCID for Beth Stuart: ORCID iD orcid.org/0000-0001-5432-7437
ORCID for Nisreen Alwan: ORCID iD orcid.org/0000-0002-4134-8463
ORCID for Ying Cheong: ORCID iD orcid.org/0000-0001-7687-4597

Catalogue record

Date deposited: 26 May 2023 16:48
Last modified: 17 Mar 2024 03:59

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Contributors

Author: Yorain Sri Ranjan
Author: Nida Ziauddeen ORCID iD
Author: Beth Stuart ORCID iD
Author: Nisreen Alwan ORCID iD
Author: Ying Cheong ORCID iD

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