(823) Inflammatory Lesions in Placentas of Endometriosis Patients and Their Relation to Maternal and Neonatal Outcomes

This study aimed to investigate the relationship between endometriosis and placental pathology, aiming to elucidate potential mechanisms behind adverse pregnancy outcomes associated with endometriosis.

Study Design:

This retrospective cohort study analyzed data of patients with endometriosis who delivered at a single tertiary center between 2008-2023. Inclusion criteria were singleton term deliveries with placentas sent for histopathological examination. Maternal characteristics, pregnancy outcomes, and placental histopathology were compared between patients with endometriosis (n=50) and a control group without endometriosis (n=150) matched for maternal and gestational age.

Results:

The demographic characteristics and labor outcomes did not differ significantly between the groups. Patients with endometriosis exhibited higher rates of placental lesions, including placental hemorrhage (10% vs. 2.6%, p=0.045), maternal inflammatory response lesions (16% vs. 6%, p=0.039), fetal inflammatory response lesions (8% vs. 1.3%, p=0.035), chronic villitis (8% vs. 1.3%, p=0.035), and chronic deciduitis (14% vs. 2.6%, p=0.006). Moreover, composite adverse neonatal outcomes were significantly higher in the endometriosis group (16% vs. 4%, p=0.007). Multivariable regression analyses confirmed significant associations between endometriosis and all inflammatory placental lesions, both acute and chronic. Additionally, endometriosis was significantly and independently associated with adverse neonatal outcomes.

Conclusion:

The presence of endometriosis is associated with increased placental pathology and adverse neonatal outcomes. The findings suggest that inflammatory lesions in the placenta may play a significant role in the pregnancy complications observed in women with endometriosis, highlighting the need for targeted monitoring and management strategies in this population.