Association of Abortion Event With a History of Endometriosis: A Case-Control Study

Background: Endometriosis is a chronic gynecological disorder characterized by the presence of endometriosis-like tissue outside the uterine cavity, leading to pelvic pain, infertility, and other reproductive complications. Emerging evidence suggests a potential association between endometriosis and an increased risk of abortion events. This study aimed to investigate the association between abortion events and a history of endometriosis using a case-control study design. Methods: A case-control study was conducted involving 112 women who experienced abortion (cases) and 131 women with successful pregnancies without abortion (controls). Data were collected from Prof. Dr. Margono Soekarjo General Hospital between September 2022 and September 2024. Data on endometriosis history, demographic factors, reproductive history, and potential confounding factors were collected through medical records. Logistic regression analysis was performed to assess the association between endometriosis and abortion events, adjusting for confounding variables. Bivariate and multivariate logistic regression analyses used odds ratios (ORs) with 95% confidence intervals (CIs). Variables were considered statistically significant if the P value < 0.05 in multivariate analysis. Results: The prevalence of endometriosis was significantly higher in the abortion group (73.2%) compared to the control group (31.3%) with P < 0.001. After adjusting for age, body mass index (BMI), smoking status, and number of previous pregnancies, women with a history of endometriosis had a 2.25-fold increased odds of experiencing an abortion (OR: 2.25; 95% CI: 1.71 - 2.94; P < 0.001). Additionally, severity of endometriosis was positively correlated with the frequency of abortion events (P < 0.001). Conclusion: This study found a significant association between abortion events and a history of endometriosis. Women with endometriosis are at a higher risk of experiencing abortion, emphasizing the need for targeted reproductive counseling and management in this population. Further research is necessary to elucidate the underlying mechanisms and develop strategies to mitigate this risk. J Clin Gynecol Obstet. 2024;13(3):83-89 doi: https://doi.org/10.14740/jcgo1008