Are you more likely to have a premature birth if you have endometriosis?

I’endometriosis affects one in ten women of childbearing age in France. It’s a chronic disease but which disappears menopause. It is characterized by the presence pathological of uterine tissue (theendometrium) outside the uterine cavity, into nearby organs such as the uterine muscle, theovary where the peritoneum. It can translate into pains during menstruation or during sexual intercourse, pains abdominal or lumbar.

Generally considered normal by women, even by health professionals who are not sufficiently aware of this pathology, these pains are not always correctly taken into account during medical consultations and the diagnosis of endometriosis is often late: up to seven years of diagnostic wandering! This disease is also a frequent source ofinfertility.

Endometriosis being a pathology affecting the uterine cavity, affected women who have succeeded in getting pregnant will therefore legitimately ask themselves questions about the progress of their pregnancy. pregnancy. In particular, do affected women have a greater risk of having a premature delivery ? A team conducted a study to try to answer this question. The results were published in the jama on February 8, 2022.

What are the different phenotypes of endometriosis?

Uterine tissue can have three main abnormal locations. This results in three phenotypes distinct: superficial isolated peritoneal endometriosis, ovarian endometriosis and deep endometriosis. The second can be coupled to the first; the third can be coupled with the first two.

How was the study conducted?

The authors performed a multicenter, prospective study between February 4, 2016 and June 28, 2018. Prospective means that the follow-up period begins on the start date of the trial. Multicentric means that the study was simultaneously carried out in several maternities, in this case 7, all located in France. Patients expecting several children (twin pregnancy), positive for HIVor having a high-risk pregnancy were excluded from the study.

Affected patients had to have a correctly documented diagnosis with imaging examinations, a classification of lesions with confirmation by anatomo-pathological examination. Because different endometriosis phenotypes often coexist, patients were assigned to the group with the worst prognosis. For example, if a patient has deep endometriosis and isolated superficial peritoneal endometriosis, she is categorized in the deep endometriosis group.

A group of women without endometriosis was also formed. In order to avoid including in this group people affected but not diagnosed, the authors took care to select patients who had never been absent from school because of pain during menstruation or who had not had early prescription of the pill to relieve suffering during menstruation.

Is there a risk of premature delivery? Is it dependent on the endometriosis phenotype?

The study included 1,351 women, 470 of whom had the disease. The results were analyzed taking into account the endometriosis phenotype, the age of the mother, the gynecological history, the presence of a overweight before pregnancy. In the group of patients with endometriosis, 34 (7.2%) had a premature deliveryi.e. before 37 weeks ofamenorrhea. In the group of healthy women, 53 (6%) gave birth before 37 weeks. These results are not statistically significant. Furthermore, no difference was observed between the different phenotypes. Patients with endometriosis can therefore be reassured on this point.