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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate professor Mathew Leonardi, McMaster University,
- Second opponent: Professor Oskari Heikinheimo, University of Helsinki,
- Third member and chair of the evaluation committee: Associate professor Tina Tellum, University of Oslo
Chair of the Defence
Associate professor Anja Maria Lyche Brænd, University of Oslo
Principal Supervisor
Professor Tone Kristin Omsland, University of Oslo
Summary
Pregnancy, mental health, and relationship outcomes in women with endometriosis.
Endometriosis is a common, chronic gynaecologic disorder that can cause pain, infertility, and psychological strain. As more women with endometriosis become pregnant and mothers, it is important to clarify whether the disease is linked to pregnancy complications, and how it may affect long‑term maternal mental health and couple relationships.
The aims of this thesis were to examine associations between endometriosis and adverse pregnancy outcomes, postpartum depression, long‑term maternal anxiety and depression, and couple relationship outcomes.
This longitudinal prospective cohort study from Norway compared women with and without endometriosis from early pregnancy to eight years postpartum. The population comprised 99,853 singleton pregnancies enrolled between 1999 and 2008 in the nationwide Norwegian Mother, Father, and Child Cohort Study (MoBa), with recruitment at approximately 15 gestational weeks, linked to the Medical Birth Registry of Norway. Endometriosis was self‑reported in 1,477 pregnancies (1.5%), with the remaining 98,376 classified as unexposed.
Women with endometriosis had higher risks of several pregnancy and birth complications, including antepartum haemorrhage, placenta previa, placental abruption, caesarean section (planned and emergency), postpartum haemorrhage, preterm birth, and stillbirth. Mothers with endometriosis also had a 34% higher risk of postpartum depression. They experienced persistently higher levels of anxiety and depression after childbirth, with increased risks of anxiety (30%) and depression (32%) at eight years postpartum, compared with mothers without endometriosis. However, couple relationship dissolution and satisfaction were similar to those of women without endometriosis.
Clinically, these findings suggest targeted obstetric attentiveness, individualized counselling on delivery planning, and proactive perinatal mental health screening of women with endometriosis.
Additional information
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