268 ABSTRACT: Objectives: To investigate the prevalence of adverse obstetric and neonatal outcomes in women with histopathological adenomyosis compared to that of that of the general (Dutch) population Study Design: This retrospective population-based study used two Dutch national databases (Perined, the perinatal registry, and the nationwide pathology databank (PALGA), from 1995-2018) to compare obstetric outcomes in women prior to histopathological adenomyosis diagnosis to the general Dutch population without registered histopathological adenomyosis. Odds Ratios (aOR, 95% CI) were calculated for adverse obstetric outcomes. Outcomes were corrected for: maternal age, parity, ethnicity, year of registered birth, induction of labour, hypertensive disorders in previous pregnancies, multiple gestation and low socioeconomic status. Results: Pregnancy outcomes of 7,925 women with histopathological adenomyosis were compared to 4,615,803 women without registered adenomyosis. When corrected for confounders, women with adenomyosis had an aOR 1.37 (95% CI 1.25-1.50) for hypertensive disorders, an aOR of 1.37 (95% CI 1.25-1.51) for preeclampsia, aOR of 1.15 (95% CI 1.07-1.25) for a small-for-gestational-age infants. Women with adenomyosis had an aOR of 1.54 (95% CI 1.41-1.68) for emergency caesarean delivery, an aOR of 1.24 (95% CI 1.12-1.37) for failure to progress, an aOR of 1.29 (95% CI 1.10-1.48) for placental retention and an aOR of 1.23 (95% CI 1.10-1.38) for postpartum haemorrhage. No increased risk for HELLP, placental abruption, operative vaginal delivery or need for oxytocin stimulation was found. Conclusions: Women with a histopathological diagnosis of adenomyosis show an increased prevalence of hypertensive disorders of pregnancy and smallfor-gestational-age infants, failure to progress in labour and placental retention compared to the general population in prior pregnancies. This suggests uterine (contractile) function in labour and during pregnancy is impaired in women with adenomyosis. Keywords: Adenomyosis; Adverse Obstetric Outcomes; Foetal Growth Restriction; Histopathology; Hypertensive disorders; Neonatal outcomes; Obstetric Complications; Placental abnormalities; Population study; Preeclampsia; Progress of Labour; SGA
RkJQdWJsaXNoZXIy MTk4NDMw