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| Factors Influencing the Occurrence of Adverse Pregnancy Outcomes and Their Predictive Value in Patients after Laparoscopic Surgery for Endometriosis |
| SHI Shujing, ZHANG Chunyan, PEI Lihua, et al |
| Peace Hospital of Changzhi Medical College, Shanxi Changzhi 046000, China |
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Abstract Objective: To investigate the factors influencing adverse pregnancy outcomes after laparoscopic surgery in patients with endometriosis and their clinical predictive value. Methods: Clinical data were collected and retrospectively from 124 patients with endometriosis (EMS) who underwent laparoscopic surgery at our hospital from December 2019 to December 2022. The patients were divided into two groups based on their pregnancy outcomes within 2 years after surgery: the good outcome group (77 cases) and the adverse outcome group (47 cases). Univariate analysis was used to compare the age, infertility duration, revised American Fertility Society (r-AFS) staging, Endometriosis Fertility Index (EFI), postoperative medication, postoperative anti-Mullerian hormone (AMH), serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and progesterone (P) levels between the two groups. Multivariate Logistic regression was used to analyze the independent influencing factors of adverse pregnancy outcomes after laparoscopic endometriosis. ROC curve analysis was used to evaluate the predictive value of related indicators, and a nomogram prediction model was constructed and assessed. Results: The age and E2 in the poor outcome group were both greater than those in the good outcome group (P<0.05). The levels of EFI, AMH and P in the poor outcome group were all lower than those in the good outcome group (P<0.05). The results of multivariate analysis showed that EFI score, AMH, E2 and P levels were all independent influencing factors for adverse pregnancy outcomes in patients after laparoscopic surgery (P<0.05). The combination of the four (AUC=0.909) had the highest predictive value for adverse pregnancy outcomes in patients after laparoscopic surgery. The nomogram prediction model constructed based on independent influencing factors has good prediction accuracy and high clinical application value. Conclusion: Low EFI scores, low AMH and P levels, and high E2 levels after surgery can be considered as auxiliary indicators for adverse pregnancy outcomes after laparoscopic surgery in patients with endometriosis, and they are independent influencing factors. The combination of these four factors has the highest predictive value.
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2025, Vol. 31 
