Endometriosis, Severe Maternal Morbidity, and the Effect of Infertility: Population-Based Cohort Study

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada Pub Date : 2024-06-10 DOI:10.1016/j.jogc.2024.102582

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引用次数: 0

Abstract

This population-based cohort evaluated the association between endometriosis and severe maternal morbidity (SMM), and the mediating effect of infertility and fertility treatment. Included were all singleton deliveries in Ontario between 2006 and 2014. Modified Poisson regression generated adjusted relative risks. Mediation analysis estimated the direct effect of endometriosis and indirect effect through infertility and mode of conception. 787 449 deliveries were included (19 099, 2.4% with endometriosis). SMM occurred in 29.0 per 1000 deliveries among women with endometriosis, in contrast to 18.2 per 1000 deliveries among those without endometriosis—corresponding to an adjusted relative risk of SMM of 1.43 (95% CI 1.31–1.56). Mediation analysis demonstrated that the effect of endometriosis on SMM was independent of infertility or fertility treatment. We conclude that SMM in women with endometriosis appears to be due to the disease itself and not to infertility or related treatments.

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子宫内膜异位症、严重孕产妇发病率和不孕症的影响：基于人口的队列研究。

这项基于人群的队列研究评估了子宫内膜异位症与严重孕产妇发病率（SMM）之间的关系，以及不孕症和生育治疗的中介效应。研究对象包括 2006 年至 2014 年期间安大略省的所有单胎产妇。修正的泊松回归产生了调整后的相对风险（aRR）。中介分析估计了子宫内膜异位症的直接影响以及通过不孕症和受孕方式产生的间接影响。共纳入 787 449 例分娩（19 099 例，2.4% 患有子宫内膜异位症）。患有子宫内膜异位症的妇女每 1000 例分娩中有 29.0 例发生 SMM，而未患有子宫内膜异位症的妇女每 1000 例分娩中有 18.2 例发生 SMM，这相当于 SMM 的调整 RR 为 1.43（95% CI 1.31-1.56）。中介分析表明，子宫内膜异位症对SMM的影响与不孕症或生育治疗无关。我们的结论是，患有子宫内膜异位症的妇女的SMM似乎是由疾病本身引起的，而与不孕症或相关治疗无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of obstetrics and gynaecology Canada OBSTETRICS & GYNECOLOGY-

CiteScore

3.30

自引率

5.60%

发文量

302

审稿时长

32 days

期刊介绍： Journal of Obstetrics and Gynaecology Canada (JOGC) is Canada"s peer-reviewed journal of obstetrics, gynaecology, and women"s health. Each monthly issue contains original research articles, reviews, case reports, commentaries, and editorials on all aspects of reproductive health. JOGC is the original publication source of evidence-based clinical guidelines, committee opinions, and policy statements that derive from standing or ad hoc committees of the Society of Obstetricians and Gynaecologists of Canada. JOGC is included in the National Library of Medicine"s MEDLINE database, and abstracts from JOGC are accessible on PubMed.