The following is a summary of “Association of Endometriosis and Severe Maternal Morbidity” published in the December 2022 issue of Obstetrics & Gynecology by Lafleur et al.

For a study, researchers sought to determine if endometriosis increases the likelihood of severe maternal morbidity (SMM).

In hospitals in Quebec, Canada, between 1989 and 2019, they performed a population-based retrospective cohort analysis that included 2,412,823 births. Endometriosis was discovered and surgically confirmed. Patients were categorized as having active endometriosis throughout pregnancy, inactive during pregnancy, diagnosed with endometriosis after giving birth, or without endometriosis. The result was SMM, which included a variety of maternal diseases that might have been fatal throughout pregnancy or up to 42 days after birth. They calculated the prevalence of SMM and used log-binomial regression to analyze the connection with endometriosis (risk ratio [RR]; 95% CI).

In comparison to 30.7 of 1,000 patients without endometriosis, 46.2 of 1,000 patients with endometriosis experienced severe maternal morbidity. Endometriosis was linked to a 1.43 times higher incidence of SMM than no exposure (95% CI 1.36-1.51). SMM risk was higher in patients with active endometriosis during pregnancy (RR 1.93; 95% CI 1.76-2.11). The risk of severe preeclampsia and eclampsia, severe bleeding, hysterectomy, cardiac problems, embolism, shock, sepsis, and intensive care unit hospitalization was increased by active endometriosis. Inactive endometriosis had a weaker correlation with these results.

Endometriosis during pregnancy, especially active endometriosis, increases the risk of SMM and may benefit from better monitoring to avoid serious pregnancy issues.