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Endometriosis Increases the Risk of Placenta Previa in Both IVF Pregnancies and the General Obstetric Population

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Abstract

Is there a relationship between endometriosis and placenta previa (PP)? To investigate if there is a relationship between endometriosis and PP, a retrospective study was carried out, using prospectively recorded data from two different databases from Cruces University Hospital. Two different populations were included in the study. The ART (assisted reproduction techniques) population consisted of 246 cesarean sections (CS), from a total of 1170 deliveries, and the obstetric population consisted of 7045 CS, from a total of 50,298 deliveries. A representative subset from the obstetric population was established selecting 4 CS without PP for each CS with PP. In our ART population, the PP rate was 1.71% among all deliveries and 8.13% among CS. In our general obstetric population, the PP rate was 0.34% among all deliveries and 2.41% among the CS. Among the CS in ART pregnancies, the PP rate was 20% in the women with endometriosis vs 5.47% in women without endometriosis (OR = 4.32; 95% CI = 1.67–11.17), while considering all ART deliveries, the PP rates were 6.43% and 1.07%, respectively (OR = 6.36; 95% CI = 2.59–15.65). In the CS-obstetric population, the rate of PP was 9.61% among women with endometriosis vs 2.19% among women without endometriosis (OR = 4.74; 95% CI = 2.91–7.73). Considering all deliveries, the PP rate was 1.35% among women with endometriosis vs 0.30% in women without endometriosis. Differences persisted when adjusting for age, IVF, multiplicity, and previous deliveries. In the CS-obstetric population with PP, mean surgical time and hospital stay were significantly higher in women with endometriosis. Endometriosis is associated with a higher risk of PP even after adjusting for other parameters.

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Authors and Affiliations

  1. Reproduction Unit, Cruces Hospital, Biocruces Health Research Institute, Vizcaya, Spain

    Eider Gómez-Pereira, Rosario Mendoza, Irantzu Pérez-Ruiz, Fátima Olaso, David García & Roberto Matorras

  2. Obstetrics Service, Cruces Hospital, Biocruces Health Research Institute, Vizcaya, Spain

    Jorge Burgos

  3. Applied Mathematics, Statistics, and Operative Research Department, University of the Basque Country, Biocruces Health Research Institute, Vizcaya, Spain

    Iker Malaina

  4. IVI, IVIRMA, Bilbao, Vizcaya, Spain

    Roberto Matorras

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  1. Eider Gómez-Pereira
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Contributions

E Gómez-Pereira: data collection and management, protocol development, data analysis, and manuscript writing. J Burgos: data collection and manuscript editing. R Mendoza: data collection and manuscript editing. I Pérez-Ruiz: data analysis and manuscript writing and editing. D García: data collection and management and manuscript editing. F Olaso: data collection and management and manuscript editing. I Malaina: data analysis and manuscript editing. R Matorras: protocol and project development and manuscript writing and editing.

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Correspondence to Irantzu Pérez-Ruiz.

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The study project was approved by the Clinical Research Ethics Committee (CEIC) of Cruces University Hospital on 25 February 2020, with CEIC code E20/11.

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Informed consent was obtained from all patients for being included in the study (CEIC E20/11).

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Gómez-Pereira, E., Burgos, J., Mendoza, R. et al. Endometriosis Increases the Risk of Placenta Previa in Both IVF Pregnancies and the General Obstetric Population. Reprod. Sci. 30, 854–864 (2023). https://doi.org/10.1007/s43032-022-01054-2

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