282 Adenomyosis was found to have an increased prevalence of signs of premature labour (including cervical insufficiency, PPROM, and premature contractions) during pregnancy with 2.2% more women in the adenomyosis group diagnosed with premature labour or threatened prematurity compared to the general Dutch population. Likewise, there was a higher incidence (+0.5%) of PPROM and cervical insufficiency (increase of 0.5%; all p<0.001). However, prevalence of cervical insufficiency did not differ statistically significantly. When adjusting for confounders, we found an aOR of 1.47 (95% CI 1.33-1.63) for an episode of premature labour in general, and an aOR 1.41 (95% CI 1.16-1.72) for PPROM. Unexpectedly, women with adenomyosis showed lower prevalence of preterm birth (GA <37wk) with an aOR of 0.76 (95%CI 0.69-0.84) for PTB versus the general Dutch population. There was a significantly (P<0.001) higher prevalence of HDP in the adenomyosis groups versus the general Dutch population. Adenomyosis patients had a higher prevalence of all forms of HDP, including PIH, PE and HELLP/Eclampsia. The aOR for all HDP combined was1.37 (95% CI 1.251.50). Women with adenomyosis showed a higher prevalence of FGR (0.5% more prevalent in the adenomyosis groups, p<0.001) and SGA infants (14.3% versus 10.8% respectively, p<0.001) versus the general Dutch population. An aOR of 1.15 (95% CI 1.07-1.25) was found for an SGA foetus. Women with adenomyosis showed significantly different outcomes with regards to progress of labour and mode of delivery. Women with adenomyosis had an aOR of 1.24 (95% CI 1.12-1.37) for failure to progress in labour in general when corrected for confounders. When stratifying this by stage of labour, specifically failure to progress in the second stage of labour remained statistically significant with an aOR of 1.24 (95% CI 1.12-1.37). Similarly, women with adenomyosis had a higher prevalence of PROM (>24 hours) compared to the general population (aOR 1.35 (95% CI 1.23-1.48). No significantly higher prevalence for need for oxytocin stimulation was found, with similarly insignificant results for failure to progress in the first stage of labour.
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