The role of parity in the relationship between endometriosis and pregnancy outcomes: a systematic review and meta-analysis
The role of parity in the relationship between endometriosis and pregnancy outcomes: a systematic review and meta-analysis
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.
endometriosis, multiparous, parity, pregnancy outcomes, primiparous, Parturition, Pregnancy, Pregnancy Outcome/epidemiology, Animals, Endometriosis/complications, Pregnancy Complications/epidemiology, Female, Parity
Ranjan, Yorain Sri
6190507c-a19e-42ac-ada8-2b04299baa5e
Ziauddeen, Nida
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Stuart, Beth
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Alwan, Nisreen A.
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Cheong, Ying
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Ranjan, Yorain Sri
6190507c-a19e-42ac-ada8-2b04299baa5e
Ziauddeen, Nida
3ad67dd8-26ba-498a-af0a-b1174298995b
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Alwan, Nisreen A.
0d37b320-f325-4ed3-ba51-0fe2866d5382
Cheong, Ying
4efbba2a-3036-4dce-82f1-8b4017952c83
Ranjan, Yorain Sri, Ziauddeen, Nida, Stuart, Beth, Alwan, Nisreen A. and Cheong, Ying
(2023)
The role of parity in the relationship between endometriosis and pregnancy outcomes: a systematic review and meta-analysis.
Reproduction and Fertility, 4 (1), [e220070].
(doi:10.1530/RAF-22-0070).
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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raf-RAF-22-0070
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e-pub ahead of print date: 28 March 2023
Keywords:
endometriosis, multiparous, parity, pregnancy outcomes, primiparous, Parturition, Pregnancy, Pregnancy Outcome/epidemiology, Animals, Endometriosis/complications, Pregnancy Complications/epidemiology, Female, Parity
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Local EPrints ID: 483198
URI: http://eprints.soton.ac.uk/id/eprint/483198
ISSN: 2633-8386
PURE UUID: 428cc282-41d3-469a-b18f-d375efc36fb9
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Date deposited: 26 Oct 2023 16:33
Last modified: 18 Mar 2024 03:32
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Yorain Sri Ranjan
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