Risk of gestational hypertension-preeclampsia in women with preceding endometriosis: A nationwide population-based study

• Published in: PloS one Vol. 12; no. 7; p. e0181261
• Main Authors: Pan, Mei-Lien, Chen, Li-Ru, Tsao, Hsiao-Mei, Chen, Kuo-Hu
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 17.07.2017; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Age; Age Factors; Biology and Life Sciences; Blood pressure; Body mass index; Comorbidity; Complications and side effects; Correlation analysis; Databases, Factual; Diabetes; Diagnosis; Endometriosis; Endometriosis - complications; Endometriosis - epidemiology; Female; Gestational hypertension; Growth hormone; Health risks; Heterogeneity; Humans; Hypertension; Information science; Logistic Models; Longitudinal Studies; Medical records; Medicine and Health Sciences; Middle Aged; National Health Programs; Obesity; Odds Ratio; Oxidative stress; Pain; People and Places; Population; Population studies; Population-based studies; Pre-eclampsia; Pre-Eclampsia - epidemiology; Pre-Eclampsia - etiology; Preeclampsia; Pregnancy; Regression analysis; Risk Factors; Social Sciences; Socioeconomic Factors; Studies; Subgroups; Taiwan; Time Factors; Ultrasonic imaging; Urban Population; Urbanization; Urine; Veins & arteries; Womens health; Young Adult; Taiwan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0181261

To investigate the association between preceding endometriosis and gestational hypertension-preeclampsia (GH-PE). In this nationwide population-based longitudinal study, data from 1998-2012 Taiwan National Health Insurance Research Database were used. We used ICD9-CM codes 617.X and 642.X respectively for the diagnoses of endometriosis and GH-PE, which were further confirmed by examining medical records of surgeries, blood pressure and urine protein to ensure the accuracy of the diagnoses. The study excluded women diagnosed with endometriosis at < 15 or > 45 years of age, chronic hypertension, and GH-PE prior to endometriosis. Each pregnant woman with a prior diagnosis of endometriosis was matched to 4 pregnant women without endometriosis by age. Logistic regression analysis was used to calculate odds ratios (ORs) for the risk of GH-PE with adjustment for age, occupation, urbanization, economic status and comorbidities. Among 6,300 women with a prior endometriosis diagnosis who were retrieved from a population of 1,000,000 residents, 2,578 (40.92%) had subsequent pregnancies that were eligible for further analysis and were compared with 10,312 pregnant women without previous endometriosis. GH-PE occurred more in women with prior endometriosis as compared to those without endometriosis (3.88% vs. 1.63%, p<0.0001). Further analysis revealed prior endometriosis was associated with GH-PE (adjusted OR = 2.27; 95% CI:1.76-2.93). For danazol-treated and non-danazol-treated subgroups, the incidences of GH-PE were 3.13% (15/480) and 4.05% (85/2,098), respectively. Although the risk for subsequent GH-PE was lower (adjusted OR = 1.49; 95% CI:0.86-2.56) after receiving danazol treatment than average (adjusted OR = 2.27; 95% CI:1.76-2.93) for women with preceding endometriosis, the reduction of risk was not statistically remarkable for danazol-treated (adjusted OR = 1.49) vs. non-danazol-treated (adjusted OR = 2.48) subgroups (p heterogeneity = 0.12). Preceding endometriosis is an independent and significant risk factor for the occurrence of GH-PE.