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How Endometriosis Affects Pregnancy

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April 19, 2017
naturopathic doctor toronto, naturopathic doctor danforth, endometriosis and pregnancy

A recent study has suggested a link between endometriosis and pregnancy complications. This study followed women in Denmark who gave birth to a single child between September 1, 1989 and December 31, 2013. Women who were diagnosed with primary or secondary endometriosis (whether they were diagnosed before or after the pregnancy) were primarily studied. Diagnosis for endometriosis included the gold-standard laparoscopic surgery (small incisions are made within the abdomen to assess the organs for any endometrial tissue, removal of the tissue typically occurs with this surgery).

The outcomes measured were: pre-eclampsia, c-section, postpartum hemorrhage, preterm birth, and small for gestational age.

  • Preterm birth included: very preterm birth (before 32 weeks) and moderate preterm birth (32-36 weeks). Preterm birth was also classified as spontaneous (labour or premature rupture of the membranes) or induced (elective c-section, acute c-section before labour, or induction of labour).

  • Small for gestational age was considered as 2 standard deviations away from the average birth weight for gestational age. 

  • C-section differentiation included acute (less than 8 hours after making this decision to deliver) or planned. 

  • Postpartum hemorrhage was defined as losing 500mL or more of blood within 24 hours of delivery. 

  • Pre-eclampsia was not defined in the paper, however has characteristics of high blood pressure, protein within the urine and fluid retention.  

Overall, 1231 women and 1719 pregnancies were studied over the course of 23 years. The women who had endometriosis also had a higher maternal age and had a greater use of assisted reproductive technology (ART). In women with endometriosis the risk of very preterm birth (before 32 weeks) was higher, and women with endometriosis often chose to have a c-section. Women may have opted for a c-section to further avoid pelvic pain (often associated with birth). Lastly there was an increase risk of pre-eclampsia in women with a diagnosis of endometriosis. 

There was no association between endometriosis and small for gestational age infants or postpartum hemorrhage. 

So what does this mean?

Currently, no one is clear on why adverse pregnancy outcomes are occurring, although inflammation has been suggested as a possibility. Pre-eclapsia is also said to occur as a result of inflammation within the body, and while it’s not curable (aside from delivering the placenta), there are preventative measures that women can take to decrease their risk of pre-eclampsia beginning with nutrition. Look out for a future post on the issue. When it comes to inflammation, there’s a lot that women can do: support and nourish the immune system, consume foods high in antioxidants, decrease foods that are pro-inflammatory (including foods you may be sensitive to).

Similarly, there are ways that women can be supported if they choose to have a planned or an acute c-section. This includes immune support for both mom and baby, as well as conversations around scarring and healing. 

Before beginning any specific diet protocol or taking supplements, speak to a health-care professional like a Naturopathic Doctor or Medical Doctor. 

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Reference

Glavind, Maria Tølbøll et al. “Endometriosis And Pregnancy Complications: A Danish Cohort Study”. N.p., 2017. Print.

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