Pregnancy and Endometriosis: The Hidden Risk of Gestational Diabetes

Severe endometriosis cases have to be monitored for diabetes risk when they get pregnant.

Key Points

Highlights:

• There is an increased risk of gestational diabetes in women with endometriosis.

Importance:

• The findings highlight the importance of monitoring and managing blood sugar levels in pregnant women with endometriosis to prevent complications.

What's done here:                                       

• Database searches have been performed on PubMed, Medline, Embase, and Scopus through June 2022 using the keywords of "endometriosis" and "gestational diabetes".
• A meta-analysis was conducted on 18 studies including 4,600,885 women, to investigate the association between endometriosis and gestational diabetes risk.
• Different potential modifying factors were considered, including mode of conception, disease localization, and severity.

Key Results:

• The meta-analysis found that endometriosis increases the risk of gestational diabetes during pregnancy.
• The increased risk was seen across different modes of conception (natural conception, assisted reproductive technologies) and also across different disease localizations and severities.
• The increase was significant in natural conception but was not significant in assisted reproductive cycle pregnancies.
• The severity of the disease but not the localization was found to be corraled with the diabetes risk.
• The study highlights the importance of monitoring pregnant women with endometriosis for the development of gestational diabetes and implementing appropriate interventions to manage the condition.

Limitations:

• The study didn't address the underlying mechanism explaining the association between endometriosis and gestational diabetes.
• The authors couldn't collect data on potential confounding factors, such as body mass index and family history of diabetes.

Lay Summary

Getting pregnant with endometriosis may be challenging. Besides, that pregnancy is a high-risk pregnancy.

According to the recent meta-analysis led by Dr.Vigano, the risk of gestational diabetes increases in endometriosis patients. The study performed database searches on PubMed, Medline, Embase, and Scopus through June 2022 using the keywords of "endometriosis" and "gestational diabetes". Analysis was conducted on 18 individual studies including 4,600,885 women, to investigate the association between endometriosis and gestational diabetes risk. Different potential modifying factors were considered, including mode of conception, disease localization, and severity.

The results revealed that women with endometriosis had a higher risk of gestational diabetes compared to those without endometriosis. The overall risk increase was approximately 1.3 times higher. However, the study didn't address the underlying mechanism as to why there is an association between endometriosis and gestational diabetes.

The study also stratified the analysis by several potential modifying factors, including natural or assisted reproductive techniques, pelvic or extrapelvic location of endometriosis, and mild or moderate/severe disease. Regardless of these factors, the association between endometriosis and gestational diabetes remained significant and also significantly increased by the severity of the disease.

In the article that was recently published in "Scientific Reports", the authors conclude that women with endometriosis should be closely monitored for gestational diabetes during pregnancy. As gestational diabetes can have significant short and long-term effects on both mother and baby, proper screening and management of this condition are essential. The study did not specifically evaluate management options for gestational diabetes in women with endometriosis, but prompt care and effective treatment for gestational diabetes can help ensure a healthy outcome for both the mother and baby.

Research Source: https://pubmed.ncbi.nlm.nih.gov/37208452/