title: Adenomyosis and adverse perinatal outcomes: increased risk of second trimester miscarriage, preeclampsia, and placental malposition.
abstract: OBJECTIVE
  To evaluate the potential impact of adenomyosis on the pregnancy outcomes by retrospectively investigating adenomyosis-complicated pregnancy cases.
  
  
  METHODS
  We performed a retrospective case-control study. Forty-nine singleton pregnancy cases complicated with adenomyosis were included in this study. The controls (n = 245) were singleton pregnant women without adenomyosis and were frequency matched to adenomyosis cases by age, parity, and the need for assisted reproductive technology for this conception. The incidence of obstetrical complications and delivery and neonatal outcomes were examined.
  
  
  RESULTS
  Patients in the adenomyosis group were significantly more likely to have a second trimester miscarriage (12.2% versus 1.2%, odds ratio (OR): 11.2, 95% confidence interval (95% CI): 2.2-71.2), preeclampsia (18.3% versus 1.2%, OR: 21.0, 95% CI: 4.8-124.5), placental malposition (14.2% versus 3.2%, OR: 4.9, 95% CI: 1.4-16.3), and preterm delivery (24.4% versus 9.3%, OR: 3.1, 95% CI: 1.2-7.2), compared with the control group.
  
  
  CONCLUSIONS
  Adenomyosis was associated not only with an increased incidence of preterm delivery, as previously reported, but also with an increased risk of second trimester miscarriage, preeclampsia, and placental malposition, which could lead to poor perinatal outcomes.
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Medicine , University of Tokyo , Tokyo , Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Hashimoto
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Medicine , University of Tokyo , Tokyo , Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Iriyama
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Medicine , University of Tokyo , Tokyo , Japan.
authors.forename: Seisuke
authors.initials: S
authors.lastname: Sayama
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Medicine , University of Tokyo , Tokyo , Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakayama
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Medicine , University of Tokyo , Tokyo , Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Komatsu
authors.affiliation: b Department of Obstetrics and Gynecology , Japanese Red Cross Medical Center , Tokyo , Japan.
authors.forename: Akito
authors.initials: A
authors.lastname: Miyauchi
authors.affiliation: c Department of Obstetrics and Gynecology , Mizonokuchi Hospital, Teikyo University School of Medicine , Kanagawa , Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Nishii
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Medicine , University of Tokyo , Tokyo , Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagamatsu
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Medicine , University of Tokyo , Tokyo , Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Osuga
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Medicine , University of Tokyo , Tokyo , Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Fujii
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology / Q000209:etiology*; D062788:Adenomyosis / Q000150:complications*; D000328:Adult; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D010923:Placenta Previa / Q000453:epidemiology / Q000209:etiology; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies
keywords: Adenomyosis; obstetric complication; perinatal outcome; pregnancy