{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:22:09Z","timestamp":1788538929277,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T00:00:00Z","timestamp":1730332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100019978","name":"Shanghai Pudong New Area Health Commission","doi-asserted-by":"publisher","award":["PW2021D\u201010"],"award-info":[{"award-number":["PW2021D\u201010"]}],"id":[{"id":"10.13039\/501100019978","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019978","name":"Shanghai Pudong New Area Health Commission","doi-asserted-by":"publisher","award":["PWZzk2022\u201011"],"award-info":[{"award-number":["PWZzk2022\u201011"]}],"id":[{"id":"10.13039\/501100019978","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the association between adenomyosis volume, as a reflection of its severity, and the risk of adverse perinatal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This multicenter retrospective cohort study was conducted at a comprehensive tertiary care institution and a tertiary maternal and child healthcare hospital, which are the main types of hospital providing maternal medical care in China. The study included pregnant women without adenomyosis (non\u2010AD cohort) who delivered between 1 January 2021 and 31 December 2021, and women with pregnancy complicated by adenomyosis (AD cohort) who delivered between 1 January 2020 and 31 December 2022. Adenomyosis was diagnosed and measured using transvaginal or transabdominal ultrasound up to 14\u2009weeks of gestation. The adenomyosis volume (V) was calculated based on the sonographic measurement of three dimensions, using the formula V\u2009=\u2009(length\u2009\u00d7\u2009width\u2009\u00d7\u2009thickness)\u2009\u00d7\u20094\/3\u03c0. Univariate and multivariate logistic regression analyses were conducted to assess the association between adenomyosis and the risk of pregnancy complications. We also performed a sensitivity analysis among 226 pregnancies complicated by adenomyosis that had volume measurements available and 10\u2009507 pregnancies without adenomyosis, using as a threshold for severe adenomyosis the 3<jats:sup>rd<\/jats:sup>\u2009quartile of adenomyosis volume.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study group included 10\u2009507 pregnant women in the non\u2010AD cohort and 321 in the AD cohort. Pregnancies complicated by adenomyosis had an increased risk of preterm birth &lt;\u200937\u2009weeks of gestation (adjusted odds ratio (aOR), 2.39 (95%\u2009CI, 1.65\u20133.48)), spontaneous preterm birth &lt;\u200937\u2009weeks of gestation (aOR, 2.57 (95%\u2009CI, 1.54\u20134.28)), placenta previa (aOR, 2.57 (95%\u2009CI, 1.41\u20134.67)), cervical incompetence (aOR, 9.70 (95%\u2009CI, 4.00\u201323.55)) and abnormal fetal presentation (aOR, 2.04 (95%\u2009CI, 1.39\u20133.00)), and there was also a non\u2010significant trend toward increased risk of pre\u2010eclampsia (aOR, 1.64 (95%\u2009CI, 0.94\u20132.85)). Sensitivity analysis revealed there was a greater risk in pregnancies with severe  (\u2265\u2009757.5\u2009cm<jats:sup>3<\/jats:sup>) <jats:italic>vs<\/jats:italic> mild adenomyosis of preterm birth &lt;\u200937\u2009weeks of gestation (aOR, 5.50 (95%\u2009CI, 2.80\u201310.82) <jats:italic>vs<\/jats:italic> aOR, 1.73 (95%\u2009CI, 0.98\u20133.05)), pre\u2010eclampsia (aOR, 4.94 (95%\u2009CI, 2.11\u201311.58) <jats:italic>vs<\/jats:italic> aOR, 1.03 (95%\u2009CI, 0.41\u20132.58)), placenta previa (aOR, 6.37 (95%\u2009CI, 2.39\u201317.04) <jats:italic>vs<\/jats:italic> aOR, 1.58 (95%\u2009CI, 0.60\u20134.19)) and cervical incompetence (aOR, 12.79 (95%\u2009CI, 2.87\u201356.93) <jats:italic>vs<\/jats:italic> aOR, 4.97 (95%\u2009CI, 1.25\u201319.77)) compared to pregnancies without adenomyosis. The risk of spontaneous preterm birth &lt;\u200937\u2009weeks and the risk of abnormal fetal presentation was similar between the two subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pregnancies complicated by adenomyosis, particularly those with severe adenomyosis, have an increased risk of pregnancy complications, including preterm birth, spontaneous preterm birth, placenta previa, cervical incompetence and abnormal fetal presentation. \u00a9 2024 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.29108","type":"journal-article","created":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T04:38:15Z","timestamp":1730435895000},"page":"678-686","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Association between adenomyosis volume and adverse perinatal outcomes: multicenter cohort study"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2749-3899","authenticated-orcid":false,"given":"X.","family":"Ni","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Shanghai East Hospital, School of Medicine Tongji University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.","family":"Su","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine Tongji University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Wuxi Maternal and Child Health Care Hospital, School of Medicine Jiangnan University  Wuxi Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Ru","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Shanghai East Hospital, School of Medicine Tongji University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6724-9504","authenticated-orcid":false,"given":"Y.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Shanghai East Hospital, School of Medicine Tongji University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Shanghai East Hospital, School of Medicine Tongji University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Wuxi Maternal and Child Health Care Hospital, School 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