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Hum. Reprod. Advance Access originally published online on May 14, 2009
Human Reproduction 2009 24(9):2348-2352; doi:10.1093/humrep/dep123
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Is there an association between endometriosis and the risk of pre-eclampsia? A population based study

Ruth M. Hadfield1,3, Samantha J. Lain1, Camille H. Raynes-Greenow1, Jonathan M. Morris1,2 and Christine L. Roberts1,2

1 Perinatal Research, Kolling Institute, University of Sydney, B52, Level 2, Royal North Shore Hospital, St Leonard's, NSW 2065, Sydney, Australia 2 Department of Obstetrics & Gynaecology, Royal North Shore Hospital, St Leonard’s, Sydney, Australia

3 Correspondence address. E-mail: rhadfield{at}med.usyd.edu.au

BACKGROUND: An association between endometriosis and reduced risk of pre-eclampsia has recently been reported. Longitudinally-linked electronic hospital records are a valuable resource for investigating such findings in a large, population-based sample. Our aim was to determine whether women with a history of endometriosis were at modified risk for pregnancy hypertension or pre-eclampsia.

METHODS: A population-based, longitudinal study of all women in the Australian state of New South Wales, aged from 15 to 45 years of age with a singleton birth during the period 2000–2005. Endometriosis was identified using ICD-10 codes. Endometriosis subgroups were analysed based on: (i) site of endometriosis (ovary or peritoneum), (ii) multiple (i.e. two or more) sites affected and (iii) infertility. To investigate the association between pregnancy hypertension and endometriosis, number of weeks gestation at birth and maternal age, we used logistic regression.

RESULTS: In the 3239 (1.6%) women with endometriosis diagnosed before their first birth, 352 (10.9%) had a diagnosis of pregnancy hypertension compared with 23 186/205 640 (11.3%) in women with no endometriosis diagnosis (OR 0.96; 95% CI 0.9–1.3). The frequency of pregnancy hypertension and pre-eclampsia was not significantly different in women with more severe endometriosis or endometriosis in conjunction with infertility when compared with those with no endometriosis. After adjusting for maternal age and weeks gestation there was still no altered risk.

CONCLUSIONS: We have found no evidence for an association between endometriosis and subsequent risk of either pregnancy hypertension or pre-eclampsia in this large population-based dataset.

Key words: endometriosis/pregnancy hypertension/pre-eclampsia/epidemiology/population-based research

Submitted on January 7, 2009; resubmitted on March 9, 2009; accepted on April 8, 2009.


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