Systematic Review and Meta-Analysis of Adverse Pregnancy Outcomes After Uterine Adenomyosis Publisher Pubmed



Razavi M¹ ; Malekihajiagha A² ; Sepidarkish M³ ; Rouholamin S⁴ ; Almasihashiani A⁵ ; Rezaeinejad M⁶
Source: International Journal of Gynecology and Obstetrics Published:2019

Abstract

Background: Studies on the impact of adenomyosis and its pregnancy complications have yielded conflicting results. Objective: To determine the likelihood of adverse pregnancy outcomes among women with adenomyosis relative to women without adenomyosis. Search strategy: PubMed, Embase, Scopus, and Web of Science were searched for studies published up to June 15, 2018. Selection criteria: Observational studies with medically confirmed pregnancy outcomes as endpoints. Data collection and analysis: Two researchers independently screened and selected relevant studies. Dichotomous data for all adverse pregnancy outcomes were expressed as an odds ratio (OR) with 95% confidence interval (CI), and combined in a meta-analysis by using a random-effects model. Main results: Six studies (322 cases and 9420 controls) were eligible for inclusion in the meta-analysis. Women with adenomyosis had an increased likelihood of preterm birth (OR, 3.05; 95% CI, 2.08–4.47; P˂0.001), small for gestational age (OR, 3.22; 95% CI, 1.71–6.08; P˂0.001), and pre-eclampsia (OR, 4.35; 95% CI, 1.07–17.72; P=0.042). Conclusion: Adenomyosis seems to have a detrimental impact on pregnancy outcomes, resulting in a higher likelihood of preterm birth, small for gestational age, and pre-eclampsia. © 2019 International Federation of Gynecology and Obstetrics