Association between adenomyosis volume and adverse perinatal outcomes: multicenter cohort study.

IF 6.1 1区 医学 Q1 ACOUSTICS
X Ni, X Su, Y Shi, P Ru, Y Liu, S Lei, Y Gu, M Liu, T Duan
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引用次数: 0

Abstract

Objective: To assess the association between adenomyosis volume, as a reflection of its severity, and the risk of adverse perinatal outcomes.

Methods: This multicenter retrospective cohort study was conducted at a comprehensive tertiary care institution and a tertiary maternal and child healthcare hospital, which are the main types of hospital providing maternal medical care in China. The study included pregnant women without adenomyosis (non-AD cohort) who delivered between 1 January 2021 and 31 December 2021, and women with pregnancy complicated by adenomyosis (AD cohort) who delivered between 1 January 2020 and 31 December 2022. Adenomyosis was diagnosed and measured using transvaginal or transabdominal ultrasound up to 14 weeks of gestation. The adenomyosis volume (V) was calculated based on the sonographic measurement of three dimensions, using the formula V = (length × width × thickness) × 4/3π. Univariate and multivariate logistic regression analyses were conducted to assess the association between adenomyosis and the risk of pregnancy complications. We also performed a sensitivity analysis among 226 pregnancies complicated by adenomyosis that had volume measurements available and 10 507 pregnancies without adenomyosis, using as a threshold for severe adenomyosis the 3rd quartile of adenomyosis volume.

Results: The study group included 10 507 pregnant women in the non-AD cohort and 321 in the AD cohort. Pregnancies complicated by adenomyosis had an increased risk of preterm birth < 37 weeks of gestation (adjusted odds ratio (aOR), 2.39 (95% CI, 1.65-3.48)), spontaneous preterm birth < 37 weeks of gestation (aOR, 2.57 (95% CI, 1.54-4.28)), placenta previa (aOR, 2.57 (95% CI, 1.41-4.67)), cervical incompetence (aOR, 9.70 (95% CI, 4.00-23.55)) and abnormal fetal presentation (aOR, 2.04 (95% CI, 1.39-3.00)), and there was also a non-significant trend toward increased risk of pre-eclampsia (aOR, 1.64 (95% CI, 0.94-2.85)). Sensitivity analysis revealed there was a greater risk in pregnancies with severe (≥ 757.5 cm3) vs mild adenomyosis of preterm birth < 37 weeks of gestation (aOR, 5.50 (95% CI, 2.80-10.82) vs aOR, 1.73 (95% CI, 0.98-3.05)), pre-eclampsia (aOR, 4.94 (95% CI, 2.11-11.58) vs aOR, 1.03 (95% CI, 0.41-2.58)), placenta previa (aOR, 6.37 (95% CI, 2.39-17.04) vs aOR, 1.58 (95% CI, 0.60-4.19)) and cervical incompetence (aOR, 12.79 (95% CI, 2.87-56.93) vs aOR, 4.97 (95% CI, 1.25-19.77)) compared to pregnancies without adenomyosis. The risk of spontaneous preterm birth < 37 weeks and the risk of abnormal fetal presentation was similar between the two subgroups.

Conclusion: Pregnancies complicated by adenomyosis, particularly those with severe adenomyosis, have an increased risk of pregnancy complications, including preterm birth, spontaneous preterm birth, placenta previa, cervical incompetence and abnormal fetal presentation. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

子宫腺肌症体积与围产期不良预后之间的关系:多中心队列研究。
摘要评估反映子宫腺肌症严重程度的子宫腺肌症体积与围产期不良结局风险之间的关系:这项多中心回顾性队列研究在一家综合性三级医疗机构和一家三级妇幼保健医院进行,这两家医院是中国提供孕产妇医疗服务的主要医院类型。研究对象包括 2021 年 1 月 1 日至 2021 年 12 月 31 日期间分娩的无腺肌症孕妇(非腺肌症队列),以及 2020 年 1 月 1 日至 2022 年 12 月 31 日期间分娩的腺肌症并发症孕妇(腺肌症队列)。腺肌症的诊断和测量采用经阴道或经腹部超声波检查,直至妊娠 14 周。腺肌症的体积(V)是根据超声测量的三个维度计算得出的,计算公式为:V=(长×宽×厚)×4/3π。我们进行了单变量和多变量逻辑回归分析,以评估子宫腺肌症与妊娠并发症风险之间的关系。我们还对 226 例有子宫腺肌症并发症的妊娠和 10 507 例无子宫腺肌症的妊娠进行了敏感性分析,以子宫腺肌症体积的第 3 个四分位数作为严重子宫腺肌症的阈值:研究组包括 10 507 名非子宫腺肌症孕妇和 321 名子宫腺肌症孕妇。与轻度子宫腺肌症相比,子宫腺肌症并发症孕妇的早产风险增加了3%:子宫腺肌症孕妇,尤其是重度子宫腺肌症孕妇,发生妊娠并发症的风险增加,包括早产、自然早产、前置胎盘、宫颈机能不全和胎儿畸形。© 2024 国际妇产科超声学会。
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
CiteScore
12.30
自引率
14.10%
发文量
891
审稿时长
1 months
期刊介绍: Ultrasound in Obstetrics & Gynecology (UOG) is the official journal of the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) and is considered the foremost international peer-reviewed journal in the field. It publishes cutting-edge research that is highly relevant to clinical practice, which includes guidelines, expert commentaries, consensus statements, original articles, and systematic reviews. UOG is widely recognized and included in prominent abstract and indexing databases such as Index Medicus and Current Contents.
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