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Premature Birth in Women with Endometriosis: a Systematic Review and Meta-analysis

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Abstract

The objective of this study is to verify the association between endometriosis and preterm birth through systematic review and meta-analysis. Is there an increased risk of premature birth in women with endometriosis compared to women without this diagnosis? The databases searched were PubMed, Medline, and LILACS in order to identify all studies published up to April 2020, using the keywords (prematurity OR preterm birth OR premature birth OR premature labor OR obstetric premature labor OR preterm labor OR premature obstetric labor) AND (endometriosis OR adenomyosis OR endometrioma OR endometriomas). A manual research was also performed through the analysis of theses, book chapters, reference references, guidelines, and reviews. All published prospective cohort studies that reported the prevalence of preterm delivery among women with endometriosis, adenomyosis, or endometrioma were included, comparing it to the control group of women without such diagnoses. The random-effects model, the calculation of relative risk, and the confidence interval of 95% were used to perform the meta-analysis. Three studies involving 10,111 patients were included. Compared to women without endometriosis, women with endometriosis present an increased risk of premature birth (RR: 2.68, 95% CI [1.19; 6.02], I2 = 91%). In the subgroup of women with spontaneous conception, endometriosis is also a risk factor for prematurity (RR: 3.26, 95% CI [2.09; 5.09], I2 = 0%, 2 studies, 682 participants). The evidence presented suggests that women with endometriosis should be alerted to a potential risk of preterm birth. PROSPERO registration number, CRD42020189451

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Data Availability

The data of this article are available with the corresponding author, by email giovanabonuccelli@gmail.com.

Code Availability

Not applicable.

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Funding

This work was supported by the authors.

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Authors and Affiliations

  1. Obstetrics and Gynecology Department, Irmandade da Santa Casa de São Paulo, Rua Doutor Cesário Mota Júnior, 61 - Vila Buarque, SP, 01221020, São Paulo, Brazil

    Giovana Afférri Bonuccelli, Romulo Negrini & Raquel Domingues da Silva Ferreira

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  1. Giovana Afférri Bonuccelli
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  2. Romulo Negrini
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  3. Raquel Domingues da Silva Ferreira
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Contributions

Giovana A. Bonuccelli: conceptualization, methodology, software, formal analysis, validation, writing—original draft preparation.

Romulo Negrini: validation, data curation, writing—reviewing and editing, visualization.

Raquel D. S. Ferreira: writing—reviewing and editing.

Corresponding author

Correspondence to Giovana Afférri Bonuccelli.

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This work was approved by research ethics committee of Hospital Central Santa Casa de Misericórdia de São Paulo.

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The authors and institution agreed with this publication, in with was used only data.

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The authors declare no competing interests.

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Bonuccelli, G.A., Negrini, R. & da Silva Ferreira, R.D. Premature Birth in Women with Endometriosis: a Systematic Review and Meta-analysis. Reprod. Sci. 29, 250–259 (2022). https://doi.org/10.1007/s43032-021-00712-1

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  • DOI: https://doi.org/10.1007/s43032-021-00712-1

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