Maternal and Neonatal Outcomes in Pregnancies with Adenomyosis.

IF 1.7 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Maternal and Child Health Journal Pub Date : 2025-09-01 Epub Date: 2025-07-09 DOI:10.1007/s10995-025-04138-y

Soukaina Hguig, Nicholas Czuzoj-Shulman, Andrea R Spence, Haim Arie Abenhaim

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引用次数: 0

Abstract

Objectives: Adenomyosis is a common gynecologic disease involving the uterus, with its effect on pregnancy being poorly understood. This study aimed to evaluate the associations between adenomyosis and obstetrical and newborn outcomes.

Methods: Using the Healthcare Cost and Utilization Project-National Inpatient Sample from the United States, we conducted a retrospective cohort study of all birth-related admissions from 2016 to 2019. Pregnancies with adenomyosis were identified using the ICD-10 code N80.03, with the remaining pregnancies being the reference group. Then, ICD-10 codes were used to identify obstetrical and neonatal outcomes and multivariable logistic regression models, adjusted for baseline maternal demographics, were used to determine the impact of adenomyosis on these outcomes. Also, in light of the potential detection bias inherent in births by cesarean delivery, adjustment for mode of delivery was included in all regression analyses.

Results: Among the 2,943,532 women who delivered between 2016 and 2019, 1,084 had adenomyosis, for an overall prevalence of 36 cases/100,000 births, which was stable throughout the study period. Adenomyosis in pregnancy was associated with increased frequency of placenta abruptio (adjusted OR 1.7, 95% CI 1.2-2.4), preterm delivery (1.4, 1.2-1.6), preterm premature rupture of membranes (1.3, 1.1-1.6), postpartum hemorrhage (2.7, 2.1-3.3), post-partum transfusion (2.2, 1.6-3.0), disseminated intravascular coagulation (9.3, 4.2-20.9), sepsis (2.7, 1.6-4.5), congenital anomalies (2.0, 1.3-2.8), and intrauterine fetal demise (2.0, 1.0-3.8). Also, these pregnancies had an elevated risk of delivering by cesarean (15.7, 12.7-19.3).

Conclusion: Adenomyosis in pregnancy is associated with adverse obstetric and fetal outcomes. As such, pregnancies in patients with adenomyosis should be considered high-risk and should be delivered in centers capable of managing the potential poor events associated with these pregnancies.

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妊娠子宫腺肌症的孕产妇和新生儿结局。

目的：子宫腺肌症是一种累及子宫的常见妇科疾病，其对妊娠的影响尚不清楚。本研究旨在评估子宫腺肌症与产科和新生儿结局之间的关系。方法：采用美国医疗成本与利用项目-全国住院患者样本，对2016 - 2019年所有与出生相关的住院患者进行回顾性队列研究。使用ICD-10代码N80.03识别患有子宫腺肌症的妊娠，其余妊娠作为参照组。然后，使用ICD-10代码确定产科和新生儿结局，并使用多变量logistic回归模型，调整基线产妇人口统计数据，以确定子宫腺肌症对这些结局的影响。此外，考虑到剖宫产分娩所固有的潜在检测偏差，所有回归分析都包括对分娩方式的调整。结果：在2016年至2019年期间分娩的2,943,532名妇女中，1,084名患有子宫腺肌症，总体患病率为36例/10万例，在整个研究期间保持稳定。妊娠期子宫腺肌症与胎盘早脱（调整OR为1.7,95% CI为1.2-2.4）、早产（1.4,1.2-1.6）、早产早破膜（1.3,1.1-1.6）、产后出血（2.7,2.1-3.3）、产后输血（2.2,1.6-3.0）、弥散性血管内凝血（9.3,4.2-20.9）、败血症（2.7,1.6-4.5）、先天性异常（2.0,1.3-2.8）和宫内死胎（2.0,1.0-3.8）的发生频率增加相关。此外，这些孕妇剖宫产的风险也较高（15.7,12.7-19.3）。结论：妊娠期子宫腺肌症与不良产科及胎儿结局相关。因此，子宫腺肌症患者的妊娠应被认为是高风险的，并应在有能力管理与这些妊娠相关的潜在不良事件的中心分娩。

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

Maternal and Child Health Journal PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

3.20

自引率

4.30%

发文量

271

期刊介绍： Maternal and Child Health Journal is the first exclusive forum to advance the scientific and professional knowledge base of the maternal and child health (MCH) field. This bimonthly provides peer-reviewed papers addressing the following areas of MCH practice, policy, and research: MCH epidemiology, demography, and health status assessment Innovative MCH service initiatives Implementation of MCH programs MCH policy analysis and advocacy MCH professional development. Exploring the full spectrum of the MCH field, Maternal and Child Health Journal is an important tool for practitioners as well as academics in public health, obstetrics, gynecology, prenatal medicine, pediatrics, and neonatology. Sponsors include the Association of Maternal and Child Health Programs (AMCHP), the Association of Teachers of Maternal and Child Health (ATMCH), and CityMatCH.