CC BY 4.0 · Rev Bras Ginecol Obstet 2020; 42(04): 200-210
DOI: 10.1055/s-0040-1708885
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Is there an Increased Risk for Unfavorable Obstetric Outcomes in Women with Endometriosis? An Evaluation of Evidences

Existe um risco maior para desfechos obstétricos desfavoráveis em mulheres com endometriose? Uma avaliação das evidências
1  Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
1  Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
1  Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
1  Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
› Author Affiliations
Further Information

Publication History

11 September 2019

21 January 2020

Publication Date:
24 April 2020 (online)



Objective The present study is a systematic review of the literature to assess whether the presence of endometriosis determines or contributes to adverse obstetric outcomes.

Data Sources The present work was carried out at the Hospital Israelita Albert Einstein, São Paulo, state of São Paulo, Brazil, in accordance to the PRISMA methodology for systematic reviews. A review of the literature was performed using PubMed, Web of Science and Scopus databases. The keywords used were: pregnancy outcome, pregnancy complications, obstetrical complications, obstetrics, obstetric outcomes and endometriosis. The survey was further completed by a manually executed review of cross-referenced articles, which was last performed on November 30, 2018.

Selection of studies The survey disclosed a total of 2,468 articles, published from May 1946 to October 2017. A total of 18 studies were selected to be further classified according to their quality and relevance.

Data Collection The Newcastle–Ottawa Quality Assessment Scale was used for classification. Five studies of greater impact and superior evidence quality and 13 studies of moderate evidence quality were selected. We analyzed the studies for the characteristics of their patients plus how endometriosis was diagnosed and their respective obstetric outcomes taking into account their statistical relevance.

Data Synthesis Analyses of the higher impact and better quality studies have shown high incidence of preterm birth and placenta previa in patients with endometriosis.

Conclusion Placenta previa and preterm birth are the most statistically significant outcomes related to endometriosis, as indicated by our systematic review. The present information is useful to alert obstetricians and patients about possible unfavorable obstetric outcomes.


Objetivo Realizar uma revisão sistemática e crítica da literatura de modo a avaliar se a presença de endometriose determina desfechos obstétricos adversos na gestação.

Fonte dos dados O presente estudo foi realizado no Hospital Israelita Albert Einstein, São Paulo, SP, Brasil, de acordo com a metodologia PRISMA para revisões sistemáticas. As bases de dados usadas para a revisão de literatura foram Pubmed, Web of Science e Scopus. As palavras-chave usadas foram: pregnancy outcome, pregnancy complications, obstetrical complications, obstetrics, obstetric outcomes e endometriosis. Uma revisão manual de artigos com referências cruzadas completou a pesquisa, que foi realizada pela última vez em 30 de novembro de 2018.

Seleção dos estudos A pesquisa contou com o total de 2.468 artigos, publicados de maio de 1946 a outubro de 2017. Foram selecionados 18 estudos com base em sua relevância.

Coleta de dados A metodologia Newcastle–Ottawa Quality Assessment Scale foi usada para selecionar 5 estudos cuja evidência era de melhor qualidade e 13 estudos de moderada qualidade de evidência. As características das populações dos estudos foram analisadas, assim como a doença endometriose foi diagnosticada e os respectivos desfechos obstétricos nas pacientes observando-se a relevância estatística dos estudos.

Síntese dos dados A análise dos estudos de maior impacto e de melhor qualidade de evidência mostram que placenta prévia e ocorrência de nascimentos pré-termo são os desfechos obstétricos desfavoráveis de maior incidência em pacientes com endometriose.

Conclusão Placenta prévia e nascimentos pré-termo são os desfechos obstétricos com maior significância estatística relacionados à endometriose. Esta informação é útil para alertar obstetras e pacientes com endometriose para possíveis desfechos obstétricos desfavoráveis.


All of the authors contributed to the conception and design of the present study, to the data collection, or to the analysis and interpretation of data, as well as to the writing of the article or to the critical review of the intellectual content and to the final approval of the version to be published.

Supplementary Material