Endometriosis and gestational diabetes mellitus risk: a systematic review and meta-analysis

Abstract

Objective: To perform a systematic review and meta-analysis regarding endometriosis and the risk of gestational diabetes mellitus (GDM).

Methods: We carried out a search of the following databases: Medline, Embase, Web of Science, Cochrane Library, Scopus, Scielo, Clinicaltrials.gov, the UK Clinical Trials Gateway, and the Australian New Zealand Clinical Trials Registry, from inception through April 28 2017, without language restrictions, in order to evaluate the effect of endometriosis over GDM risk, in women with and without endometriosis. Odds ratios (ORs) and their 95% confidence intervals (CIs) or mean differences (MDs) were calculated as effects. Methodological quality of evidence was assessed with the Newcastle–Ottawa Scale, and heterogeneity among studies with the I² statistic. Random-effects models were used for meta-analyses, and publication bias was assessed with Egger’s test.

Results: We identified 12 studies (10 cohort and two case control studies) with a total of 48,762 pregnancies, including 3,461 with endometriosis. Endometriosis had no significant effect on GDM risk (OR =1.14; 95% CI: 0.86, 1.51; p = .35, I² = 56%, Egger’s test p = .45). Secondary outcomes (gestational age at delivery, birthweight, and Neonatal Intensive Care Unit admission) were statistically similar in women with and without endometriosis.

Conclusions: Better-designed studies are needed to confirm our results.

Chinese abstract

目的：进行关于子宫内膜异位症与妊娠期糖尿病风险的系统回顾和meta分析。

方法：我们对以下数据库进行了检索： Medline、Embase、Web of Science、Cochrane Library、Scopus、Scielo、Clinicaltrials.gov、the UK Clinical Trials Gateway以及the Australian New Zealand Clinical Trials Registry,从起初到2017年4月28日, 没有语言限制, 目的是评估子宫内膜异位症对妊娠期糖尿病风险的影响, 女性有或没有子宫内膜异位症。效果评估其比值比及其95%置信区间或平均差。证据的方法论质量用Newcastle-Ottawa Scale进行评估, 并且研究中的异质性用I²统计数值。Meta分析使用随机效应模型, 并且使用Egger’s检验评估发表偏倚。

结果：我们鉴定出12项研究（10项队列研究和2项病例对照研究）, 共48762名妊娠者, 其中3461名患有子宫内膜异位症。子宫内膜异位症对妊娠期糖尿病风险无有明显的影响（OR =1.14；95%CI：0.86,1.51；p=.35,I²=56%,Egger’s test p=.45）。次要结局（分娩时孕周, 出生儿体重, 进入新生儿重症监护室）在有或无子宫内膜异位症女性中统计学上是相似的。

结论：需要设计更好的研究来证实我们的结果。

Keywords:

• Assisted reproductive technology
• endometriosis
• gestational diabetes mellitus
• infertility
• meta-analysis
• spontaneous conception

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This research did not receive any specific grant or was funded by any commercial or nonprofit organization or public agency.