La endometriosis previa al embarazo reduce el riesgo de sufrir preeclampsia

La endometriosis no aumenta el riesgo de preeclampsia (PE), sino que incluso reduce el riesgo de padecer esa complicación del embarazo.

El equipo del Profesor Ivo Brosens han estudiado y comparado el número de complicaciones en 245 mujeres con esterilidad asociada a endometriosis con 274 mujeres que actuaron como grupo control. Mientras que las mujeres que padecían endometriosis sufren PE en el 0,8%, en cambio las mujeres sin endometriosis sufren la complicación del embarazo en el 5,8%. El cálculo estadístico establece que el riesgo de padecer PE es 5,6 veces más alto en las mujeres con la citada patología pregestacional. Los autores especulan con multiples explicaciones biológicas para comprender la diferencia de riesgo.

Hum Reprod. 2007;22(6):1725-9. Endometriosis is associated with a decreased risk of pre-eclampsia. Brosens IA, De Sutter P, Hamerlynck T, Imeraj L, Yao Z, Cloke B, Brosens JJ, Dhont M.

Leuven Institute for Fertility and Embryology, Leuven, Belgium. BACKGROUND: We postulated that impaired endometrial differentiation in women with pelvic endometriosis predisposes for pre-eclampsia. METHODS: A retrospective case-control study set at the University of Ghent IVF centre. The incidence of pre-eclampsia and pregnancy-induced hypertension (PIH) following the clinical and/or laparoscopic diagnosis of endometriosis-associated infertility (case group; n = 245 pregnancies) was compared with the incidence of these obstetric complications in pregnancies following treatment for male-factor infertility (control group; n = 274 pregnancies). Pregnancy data were obtained by searching electronic databases and postal questionnaires. The case and control groups were matched for age, parity and multiple pregnancies. RESULTS: The incidence of pre-eclampsia was significantly lower in the case group (0.8%) when compared with control group (5.8%) (P = 0.002; odds ratio (OR) = 7.5, 95% confidence interval (CI): 1.7-33.3). Analysis of obstetric outcome in the subgroup of patients with laparoscopic data confirmed the lower risk of pre-eclampsia in the case (1.2%) versus control (7.4%) groups (P = 0.032; OR = 6.6, 95% CI: 1.2-37). PIH occurred in 3.5% and 8.7% of case and control pregnancies, respectively (P = 0.018; OR = 2.6, 95% CI: 1.2-6.0). The odds of developing pre-eclampsia were 5.67 times higher in the control group than in pregnancies following endometriosis-associated infertility. In multiple pregnancies, the odds of developing pre-eclampsia increased 1.93 times per additional child, with or without endometriosis. CONCLUSIONS: We found no evidence that endometriosis predisposes for pre-eclampsia. Instead, the risk of hypertensive disorder in pregnancy is significantly reduced in women with endometriosis-associated infertility.

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