en اندومتریوز و پیامدهای نامطلوب بارداری: یک مطالعه مورد شاهدی Pregnancy Health Original Article Original Article <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">ارتباط بین اندومتریوز و نتیجه بارداری یکی از موضوعات بحث برانگیز است. هرچند درد بیماران با بارداری کاهش می&shy;یابد، اما به نظر می&shy;رسد که اندومتریوز عوارض نامطلوبی در بارداری ایجاد می&shy;کند. متهم اصلی در ایجاد عوارض التهاب مزمن سیستمیک ناشی از سطوح بالاتر سیتوکین&shy;ها، فاکتورهای رشد و عوامل رگ&shy;زایی است.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این مطالعه با هدف روشن کردن رابطه بین اندومتریوز، اندومتریوز عمیق، ادنومیوز، درمان جراحی و پیامدهای نامطلوب مادری انجام شد.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش&shy;ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این مطالعه مورد شاهدی بر روی 250 بیمار حامله مراجعه&shy;کننده به بیمارستان حضرت رسول (ص) طی سال‌های 1394 تا 1398 انجام شد. 125 زن مبتلا به اندومتریوز را مورد بررسی قرار داده و آنها را با یک گروه 125 نفری از زنان سالم و بدون سابقه اندومتریوز مقایسه و تأثیر اندومتریوز بر بارداری و زایمان و نوزادان را بررسی کردیم. اطلاعات مربوط به بیماران از هر دو گروه از سیستم اطلاعات بیمارستان و دیتا رجیستری اندومتریوز مرکز تحقیقات اندومتریوز دانشگاه علوم پزشکی ایران استخراج شد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">میانگین سنی بیماران در گروه اندومتریوز 10/4 </span></span><span lang="FA" style="font-size:10.0pt">&plusmn; </span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">74/32 سال و در گروه شاهد 53/5</span></span><span lang="FA" style="font-size:10.0pt"> &plusmn; </span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">7/31 سال بود. از نظر عوارض حاملگی، جفت سرراهی، جفت آکرتا، جداشدگی جفت، پره&shy;اکلامپسی، دیابت بارداری و خونریزی پس از زایمان در گروه اندومتریوز نسبت به گروه شاهد افزایش چشمگیری داشت. در اندومتریوز روده </span></span><span dir="LTR" style="font-size:10.0pt">SGA</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">به طور معنی&shy;داری بیشتر از بیماران بدون اندومتریوز روده بود (03/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">). میزان پذیرش نوزادان در </span></span><span dir="LTR" style="font-size:10.0pt">NICU</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> در گروه اندومتریوز به طور قابل توجهی بیشتر از گروه شاهد بود (7/40% در مقابل 8/24% و 009/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">).</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه&shy;گیری: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">یافته&shy;های این مطالعه نشان داد که زنان مبتلا به اندومتریوز در معرض خطر بیشتری برای پیامدهای نامطلوب مهم مادری هستند.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span></div> <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Background:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> The association between endometriosis and the outcome of pregnancy is one of the interesting topics. Endometriosis-related pain is alleviated with pregnancy; however, it is known to cause adverse outcomes in pregnancy. The main cause is systemic chronic inflammation caused by higher levels of cytokines, growth factors, and angiogenesis factors. </span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Objective:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> This study aimed to clarify the relationship between endometriosis, deep endometriosis, adenomyosis, surgical treatment, and poor maternal consequences.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span style="background:white"><span new="" roman="" style="font-family:" times="">Materials and Methods</span></span></span></b><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> In this case-control study, data from 250 women who gave birth in Hazrat Rasoul Akram hospital, Tehran, Iran from February 2015 to December 2019 was extracted from the hospital information system in January 2020. Participants were divided into 2 groups: 125 women with endometriosis and 125 women without endometriosis. We looked at how endometriosis affected mothers and newborn babies. Data on pregnancy, delivery, and newborns of both groups was extracted. </span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span style="background:white"><span new="" roman="" style="font-family:" times="">Results</span></span></span></b><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">: </span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">The mean age of participants was 32.74 &plusmn; 4.10 and 31.7 &plusmn; 5.53 yr in endometriosis and control group, respectively. In terms of pregnancy complications, placenta previa, placenta accreta, placenta abruption, pre-eclampsia, gestational diabetes mellitus, and postpartum hemorrhage remarkably increased in the endometriosis group compared to the control group. Small for gestational age was significantly higher in rectal endometriosis than women without rectal endometriosis (p = 0.03). The neonatal intensive care unit admission rate was notably higher in infants of the endometriosis group compared to controls (40.7% vs. 24.8%, p = 0.009). </span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span sans-serif="" style="font-family:Calibri,"><b><span style="font-size:12.0pt"><span style="background:white"><span new="" roman="" style="font-family:" times="">Conclusion</span></span></span></b><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">: </span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Our findings showed women with endometriosis are at a higher risk for important adverse maternal outcomes.</span></span></span></span></span></span></div> اندومتریوز, پیامد بارداری, پره‌اکلامپسی, زایمان زودرس, سزارین, محدودیت رشد جنین. Endometriosis, Pregnancy outcomes, Pre-eclampsia, Preterm birth, Cesarean section, Small for gestational age. 473 480 http://ijrm.ir/browse.php?a_code=A-10-2478-2&slc_lang=en&sid=1 Fatemeh Shahmoradi fati.shahmoradi69@gmail.com 0000-0002-5711-1233 No Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran. Ladan Haghighi dr.ladanhaghighi@yahoo.com 0000-0001-6458-8497 No Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran. Marziyeh Noori noorifiroozeh1988@gmail.com 0000-0002-3368-7553 No Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran. Roya Derakhshan drroyaderakhshangyn@gmail.com 0000-0001-7425-3412 No Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran. Neda Hashemi nedahashemi1363@gmail.com 0000-0002-4124-1316 No Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran. Samaneh Rokhgireh s.rokhgireh@gmail.com 0000-0002-8090-2893 Yes Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran.