ArticleActa obstetricia et gynecologica Scandinavica2023
The association between uterine adenomyosis and adverse obstetric outcomes: A propensity score-matched analysis.
Article in Acta obstetricia et gynecologica Scandinavica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 15 citations in OpenAlex.
- Temporal evolution of diffusion lacunae into thrombus: A case report with serial MRI and MR-pathologic correlation.Acta radiologica open · 2026Article
- Subtype-specific analysis of factors associated with assisted reproductive technology indication and live birth in patients with adenomyosis: a retrospective study.Archives of gynecology and obstetrics · 2026Article
- Perinatal complications and time to subsequent pregnancy after open, laparoscopic, and hysteroscopic myomectomy: a retrospective cohort study.BMC pregnancy and childbirth · 2026Article
- Adenomyomectomy with preconceptional transabdominal cervicoisthmic cerclage for transvaginal cerclage failure.Frontiers in surgery · 2025Article
- Type and Location of Adenomyosis in Women with Recurrent Pregnancy Loss: A Transvaginal Ultrasonographic Assessment.Reproductive sciences (Thousand Oaks, Calif.) · 2024Observational
- Proposal for targeted, neo-evolutionary-oriented secondary prevention of early-onset endometriosis and adenomyosis. Part II: medical interventions.Human reproduction (Oxford, England) · 2024Article
- The association between uterine adenomyosis and adverse obstetric outcomes: A propensity score-matched analysis.Acta obstetricia et gynecologica Scandinavica · 2023Article
- Multimodality Imaging for Rare Presentation of Placenta Increta in the First Trimester in a Patient with Previous Cesarean Section and Asherman Syndrome.Journal of medical ultrasoundArticle
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
Abstract
introductionThis study examined obstetric outcomes in patients diagnosed with uterine adenomyosis. MATERIAL AND
methodsThis historical cohort study queried the Healthcare Cost and Utilization Project's National Inpatient Sample. The study population was all hospital deliveries in women aged 15-54 years between January 2016 and December 2019. The exposure was a diagnosis of uterine adenomyosis. The main outcome measures were obstetric characteristics, including placenta previa, placenta accreta spectrum, and placental abruption. Secondary outcomes were delivery complications including severe maternal morbidity. Analytic steps to assess these outcomes included (i) a 1-to-N propensity score matching to mitigate and balance prepregnancy confounders to assess obstetric characteristics, followed by (ii) an adjusting model with preselected pregnancy and delivery factors to assess maternal morbidity. Sensitivity analyses were also performed with restricted cohorts to account for prior uterine scar, uterine myoma, and extra-uterine endometriosis.
resultsAfter propensity score matching, 5430 patients with adenomyosis were compared to 21 720 patients without adenomyosis. Adenomyosis was associated with an increased odds of placenta accreta spectrum (adjusted-odds ratio [aOR] 3.07, 95% confidence interval [CI] 2.01-4.70), placenta abruption (aOR 3.21, 95% CI: 2.60-3.98), and placenta previa (aOR 5.08, 95% CI: 4.25-6.06). Delivery at <32 weeks of gestation (aOR 1.48, 95% CI: 1.24-1.77) and cesarean delivery (aOR 7.72, 95% CI: 7.04-8.47) were both increased in women with adenomyosis. Patients in the adenomyosis group were more likely to experience severe maternal morbidity at delivery compared to those in the nonadenomyosis group (aOR 1.86, 95% CI: 1.59-2.16). Results remained robust in the aforementioned several sensitivity analyses.
conclusionsThis national-level analysis suggests that a diagnosis of uterine adenomyosis is associated with an increased risk of placental pathology (placenta accreta spectrum, placenta abruption, and placental previa) and adverse maternal outcomes at delivery.
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