The association of chronic endometritis with preterm birth

Abstract

ObjectiveTo determine if chronic endometritis (CE) diagnosed by endometrial biopsy (EMB) is associated with preterm birth (PTB) <37 & <35 weeks.Study designA case control design involving three local pathology departments. EMB reports (1992-2002) of women aged 18-45 were identified using SNOMED codes. Reports were dichotomized into those with and those without CE. CE was diagnosed by the presence of plasma cells. Results were forwarded and birth certificates (BC) were linked at the Ohio Department of Health (ODH). Included were women who delivered singletons (1992-2002) within three years of biopsy. Conditions associated with indicated PTB were excluded: cardiac & renal disease, diabetes, preeclampsia, placental abruption and previa. Statistical analysis included logistic regression, Student's t-test, Fisher's Exact, & Chi-square testing where appropriate. P<.05 were significant.Results1603 EMB reports were identified. The ODH linked BC data to 193 reports, 157 of which met inclusion criteria. 26 of the 157 women had CE. Table 1 shows that when compared to normal EMB results, women with CE were more likely to deliver at <35, but not <37 weeks. Testing for confounders and effect modifiers showed these groups to be similar. Infants born <37 weeks were more likely to be African-American (p<0.001), have intrapartum fever, meconium, or fetal distress (p = 0.026), and to require assisted ventilation (p = 0.016).Table 1≥37 weeks N = 137<37 weeks N = 20OR (95% CI)P-valueNo CE11789.3%1410.7%CE2076.6%623.1%2.51 (.86-7.29)0.091≥35 weeks N = 149<35 weeks N = 8No CE12796.9%43.1%CE2284.6%415.4%5.77 (1.3-24.8)0.026 Open table in a new tab ConclusionWhen compared to women with normal biopsy results, women with CE were more likely to deliver at<35, but not<37 weeks. ObjectiveTo determine if chronic endometritis (CE) diagnosed by endometrial biopsy (EMB) is associated with preterm birth (PTB) <37 & <35 weeks. To determine if chronic endometritis (CE) diagnosed by endometrial biopsy (EMB) is associated with preterm birth (PTB) <37 & <35 weeks. Study designA case control design involving three local pathology departments. EMB reports (1992-2002) of women aged 18-45 were identified using SNOMED codes. Reports were dichotomized into those with and those without CE. CE was diagnosed by the presence of plasma cells. Results were forwarded and birth certificates (BC) were linked at the Ohio Department of Health (ODH). Included were women who delivered singletons (1992-2002) within three years of biopsy. Conditions associated with indicated PTB were excluded: cardiac & renal disease, diabetes, preeclampsia, placental abruption and previa. Statistical analysis included logistic regression, Student's t-test, Fisher's Exact, & Chi-square testing where appropriate. P<.05 were significant. A case control design involving three local pathology departments. EMB reports (1992-2002) of women aged 18-45 were identified using SNOMED codes. Reports were dichotomized into those with and those without CE. CE was diagnosed by the presence of plasma cells. Results were forwarded and birth certificates (BC) were linked at the Ohio Department of Health (ODH). Included were women who delivered singletons (1992-2002) within three years of biopsy. Conditions associated with indicated PTB were excluded: cardiac & renal disease, diabetes, preeclampsia, placental abruption and previa. Statistical analysis included logistic regression, Student's t-test, Fisher's Exact, & Chi-square testing where appropriate. P<.05 were significant. Results1603 EMB reports were identified. The ODH linked BC data to 193 reports, 157 of which met inclusion criteria. 26 of the 157 women had CE. Table 1 shows that when compared to normal EMB results, women with CE were more likely to deliver at <35, but not <37 weeks. Testing for confounders and effect modifiers showed these groups to be similar. Infants born <37 weeks were more likely to be African-American (p<0.001), have intrapartum fever, meconium, or fetal distress (p = 0.026), and to require assisted ventilation (p = 0.016).Table 1≥37 weeks N = 137<37 weeks N = 20OR (95% CI)P-valueNo CE11789.3%1410.7%CE2076.6%623.1%2.51 (.86-7.29)0.091≥35 weeks N = 149<35 weeks N = 8No CE12796.9%43.1%CE2284.6%415.4%5.77 (1.3-24.8)0.026 Open table in a new tab 1603 EMB reports were identified. The ODH linked BC data to 193 reports, 157 of which met inclusion criteria. 26 of the 157 women had CE. Table 1 shows that when compared to normal EMB results, women with CE were more likely to deliver at <35, but not <37 weeks. Testing for confounders and effect modifiers showed these groups to be similar. Infants born <37 weeks were more likely to be African-American (p<0.001), have intrapartum fever, meconium, or fetal distress (p = 0.026), and to require assisted ventilation (p = 0.016). ConclusionWhen compared to women with normal biopsy results, women with CE were more likely to deliver at<35, but not<37 weeks. When compared to women with normal biopsy results, women with CE were more likely to deliver at<35, but not<37 weeks.