title: Women with endometriosis at first pregnancy have an increased risk of adverse obstetric outcome.
abstract: OBJECTIVE
  To evaluate pregnancy, delivery and neonatal outcome in singleton primiparous versus multiparous women with/without endometriosis.
  
  
  METHODS
  Multicentric, observational and cohort study on a group of Caucasian pregnant women (n = 2239) interviewed during their hospitalization for delivery in five Italian Gynecologic and Obstetric Units (Siena, Rome, Padua, Varese and Florence).
  
  
  RESULTS
  Primiparous women with endometriosis (n = 219) showed significantly higher risk of small for gestational age fetuses (OR: 2.72, 95% CI 1.46-5.06), gestational diabetes (OR: 2.13, 95% CI 1.32-3.44), preterm premature rupture of membranes (OR: 2.93, 95% CI 1.24-6.87) and preterm birth (OR: 2.24, 95% CI 1.46-3.44), and were hospitalized for a longer period of time (p < 0.0001) comparing with control group (n = 1331). Multiparous women with endometriosis (n = 97) delivered significantly more often small for gestational age fetuses (OR: 2.93, 95% CI 1.28-6.67) than control group (n = 592). Newborns of primiparous women with endometriosis needed more frequently intensive care (p = 0.05) and were hospitalized for a longer period of time (p < 0.0001).
  
  
  CONCLUSIONS
  Women with endometriosis at first pregnancy have an increased risk of impaired obstetric outcome, while a reduced number of complications occur in the successive gestation. Therefore, it is worthy for obstetricians to increase the surveillance in nulliparous women with endometriosis during pregnancy.
authors.affiliation: a Department of Molecular and Developmental Medicine .
authors.forename: Nathalie
authors.initials: N
authors.lastname: Conti
authors.forename: Gabriele
authors.initials: G
authors.lastname: Cevenini
authors.forename: Silvia
authors.initials: S
authors.lastname: Vannuccini
authors.forename: Cinzia
authors.initials: C
authors.lastname: Orlandini
authors.forename: Herbert
authors.initials: H
authors.lastname: Valensise
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Gervasi
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Di Tommaso
authors.forename: Filiberto Maria
authors.initials: FM
authors.lastname: Severi
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D016022:Case-Control Studies; D004715:Endometriosis / Q000453:epidemiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D015337:Multicenter Studies as Topic; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D012307:Risk Factors; D014591:Uterine Diseases / Q000453:epidemiology*
keywords: Endometriosis; gestational diabetes; neonatal complications; pPROM; pregnancy outcome; preterm birth; small for gestational age