Reproductive prognosis in endometriosis. A national cohort study
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Reproductive prognosis in endometriosis. A national cohort study. / Hjordt Hansen, Maj V; Dalsgaard, Torur; Hartwell, Dorthe; Skovlund, Charlotte W; Lidegaard, Ojvind.
I: Acta Obstetrica et Gynecologica, Bind 93, Nr. 5, 05.2014, s. 483-489.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Reproductive prognosis in endometriosis.
T2 - A national cohort study
AU - Hjordt Hansen, Maj V
AU - Dalsgaard, Torur
AU - Hartwell, Dorthe
AU - Skovlund, Charlotte W
AU - Lidegaard, Ojvind
N1 - © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.
PY - 2014/5
Y1 - 2014/5
N2 - OBJECTIVE: To assess the reproductive long-term prognosis of women with and without endometriosis, to explore changes over time, and to quantify the contribution of artificial reproductive techniques.DESIGN: Cohort study.SETTING: Denmark 1977-2009.SAMPLE: Data retrieved from four national registries. Among 15-49-year-old women during the period 1977-82, 24 667 were diagnosed with endometriosis and 98 668 (1:4) women without endometriosis were age-matched.METHODS: To assess long-term reproductive prognosis, all pregnancy outcomes were identified among the women with and without endometriosis until the end of 2009. To explore changes over time, the endometriosis cohorts were followed for 15 years from the years 1980, 1986, 1992 and 1998, with the corresponding control cohorts. All pregnancy outcomes were categorized into naturally or artificially conceived pregnancies.MAIN OUTCOME MEASURES: Births, miscarriages, induced abortions, ectopic pregnancies and hydatidiform moles.RESULTS: Compared with women without endometriosis, women with endometriosis had a lowered relative risk for childbirth of 0.93 (95% confidence interval 0.92-0.95), for miscarriages the relative risk was 1.2 (95% confidence interval 1.2-1.3), ectopic pregnancies were almost twice as many (relative risk 1.9, 95% confidence interval 1.8-2.1), while frequencies of induced abortions were equivalent. The chances for childbirth increased over time from 0.82 to 0.92 (p < 0.001) with successive cohorts, but this was restricted to pregnancies from assisted reproduction.CONCLUSION: Women with endometriosis have slightly fewer children, but this lessened over time due to artificially conceived pregnancies. The risk for miscarriages and ectopic pregnancies was increased compared with women without the disease.
AB - OBJECTIVE: To assess the reproductive long-term prognosis of women with and without endometriosis, to explore changes over time, and to quantify the contribution of artificial reproductive techniques.DESIGN: Cohort study.SETTING: Denmark 1977-2009.SAMPLE: Data retrieved from four national registries. Among 15-49-year-old women during the period 1977-82, 24 667 were diagnosed with endometriosis and 98 668 (1:4) women without endometriosis were age-matched.METHODS: To assess long-term reproductive prognosis, all pregnancy outcomes were identified among the women with and without endometriosis until the end of 2009. To explore changes over time, the endometriosis cohorts were followed for 15 years from the years 1980, 1986, 1992 and 1998, with the corresponding control cohorts. All pregnancy outcomes were categorized into naturally or artificially conceived pregnancies.MAIN OUTCOME MEASURES: Births, miscarriages, induced abortions, ectopic pregnancies and hydatidiform moles.RESULTS: Compared with women without endometriosis, women with endometriosis had a lowered relative risk for childbirth of 0.93 (95% confidence interval 0.92-0.95), for miscarriages the relative risk was 1.2 (95% confidence interval 1.2-1.3), ectopic pregnancies were almost twice as many (relative risk 1.9, 95% confidence interval 1.8-2.1), while frequencies of induced abortions were equivalent. The chances for childbirth increased over time from 0.82 to 0.92 (p < 0.001) with successive cohorts, but this was restricted to pregnancies from assisted reproduction.CONCLUSION: Women with endometriosis have slightly fewer children, but this lessened over time due to artificially conceived pregnancies. The risk for miscarriages and ectopic pregnancies was increased compared with women without the disease.
KW - Abortion, Induced
KW - Abortion, Spontaneous
KW - Adolescent
KW - Adult
KW - Case-Control Studies
KW - Denmark
KW - Endometriosis
KW - Female
KW - Humans
KW - Hydatidiform Mole
KW - Live Birth
KW - Middle Aged
KW - Pregnancy
KW - Pregnancy, Ectopic
KW - Prognosis
KW - Reproductive Techniques, Assisted
KW - Time Factors
KW - Uterine Diseases
KW - Young Adult
U2 - 10.1111/aogs.12373
DO - 10.1111/aogs.12373
M3 - Journal article
C2 - 24617701
VL - 93
SP - 483
EP - 489
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
SN - 0001-6349
IS - 5
ER -
ID: 137500059