Gestational diabetes risk in women with endometriosis

A systematic review was performed to determine whether there is an increased risk of gestational diabetes in pregnant women with endometriosis.

Key Points

Highlights:

• Meta-analysis of 12 studies covering 3,461 pregnancies showed no significant effect for endometriosis on gestational diabetes (GD) risk.

Importance:

• Data regarding GD risk in women with endometriosis have been conflicting with some studies reporting a higher risk while others are indicating a lower risk. A systematic assessment and meta-analysis can shed some light on the GD risk in pregnant women with endometriosis.

What’s done here?

• A systematic literature review and meta-analysis of published and unpublished studies carried out among women with or without endometriosis and pregnancy.

Key results:

• 12 studies were identified with 48,762 pregnancies; 3,461 of which were with endometriosis. Results showed no significant effect of endometriosis on GD risk.
• Secondary outcomes such as gestational age at delivery, NICU admission, and birth weight were statistically similar in women with or without endometriosis.

Limitations of the study:

• A limited number of published studies (12) were available for investigation.
• Other factors such as endometriosis stage, treatment or any of the confounding factors were not taken into account.

Lay Summary

Gestational diabetes (GD) is a common complication in pregnancy with several negative consequences for both mother and baby.  The risk of developing GD increases with maternal age and body mass index (BMI). Women with endometriosis conceive later than fertile women, a fact that may contribute to the increased risk of GD in women with endometriosis. However, studies of GD risk in women with endometriosis have shown contradictory results. Dr. Perez-Lopez et al. from Zaragoza, Spain, carried out a systematic review to determine if there is an increased risk of GD in pregnant women with endometriosis. 

The authors identified 12 studies involving a total of over 48,000 pregnancies, 3,461 of them with endometriosis. Meta-analysis of data from these studies showed no significant risk of GD in women with endometriosis as compared to the control group. There was also no difference in secondary outcomes such as gestational age at delivery, birthweight, NICU admissions in women with or without endometriosis. The type of conception (spontaneous vs. assisted) and the plurality (single vs. multiple pregnancies) did not affect the GD risk.

The authors conclude that further prospective studies are needed to confirm their results as the insufficient number of available published data, and lack of controls for confounding factors of endometriosis in these 12 articles markedly limited their ability to reach a convincing conclusion. The results were recently published in the scientific journal Gynecologic Endocrinology.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29105527