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Infectious Diseases

Poster Session 3

(711) Maternal endometriosis: an independent risk factor for long-term infectious morbidity of the offspring

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

    Primary & Presenting Author(s)

  • Dor Marciano, MD,MPH (he/him/his)

    Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
    Metar, HaDarom, Israel

    • Coauthor(s)

  • Gil Gutvirtz, MD

    Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
    Metar, HaDarom, Israel

  • Tamar Wainstock, PhD (she/her/hers)

    Ben Gurion University
    Beer-Sheva, HaDarom, Israel

  • Eyal Sheiner, MD, PhD

    Head of department of Obstetrics and Gynecology B, Soroka University Medical Center
    Soroka University Medical Center
    Beer-Sheva, HaDarom, Israel

Objective: Endometriosis, a debilitating disease characterized by chronic inflammation, is associated with adverse pregnancy outcomes. However, the long-term health implications for offspring born to mothers with endometriosis remain inadequately explored. The maternal immune response in pregnancy is crucial for fetal development and growth, and the pro-inflammatory state of endometriosis may alter fetal immunologic programming. In this study, we aimed to assess an association between fetal exposure to maternal endometriosis and long-term risk of infectious morbidity for the offspring.

Study Design: We conducted a retrospective population-based cohort study, comparing offspring of mothers diagnosed with endometriosis with those of mothers without the diagnosis. We followed the offspring longitudinally, tracking the time to their first diagnosis with an infectious disease made in a community-based clinics or hospitalization. A Kaplan-Meier survival curve was used to compare the cumulative incidence of offspring infectious morbidity between the study groups. A Cox regression model was constructed to evaluate an association between maternal endometriosis and offspring infectious morbidity, adjusting for possible confounders.

Results: A total of 232,476 singleton deliveries were included. 224 deliveries of mothers diagnosed with endometriosis were compared to those without endometriosis. The total infectious morbidity rate was comparable between groups (70.5% vs. 68.0%, p=0.41). However, the Kaplan-Meier survival curve illustrated an elevated cumulative incidence of infectious morbidity in offspring born to mothers with endometriosis (Log-rank< 0.01, Figure). A Cox regression model, adjusted for gestational age, fertility treatments and mode of delivery, found that fetal exposure to maternal endometriosis was an independent risk factor for long-term infectious morbidity of the offspring (adjusted HR=1.17, 95%CI 1.00-1.36, p=0.05, Figure).

Conclusion: Fetal exposure to maternal endometriosis is an independent risk factor for long-term infectious morbidity of the offspring