Comparison between those who did and did not develop pain during pregnancy
To assess the impact of pain during pregnancy on perinatal outcomes, we compared the maternal backgrounds and pregnancy outcomes between those who did and did not develop pain at the adenomyosis site among 91 pregnancies with adenomyosis, as shown in Table 2. There was no difference in the maternal backgrounds, but those who experienced pain during pregnancy had a significantly higher incidence of PE (41.7% vs. 13.9%; p <0.05). The cesarean section and preterm delivery rates were also significantly higher in those with pain (91.7% vs. 51.9%; p <0.05, and 66.7% vs. 31.7%;p <0.05, respectively), but the rate of spontaneous preterm delivery was not significantly higher in women who experienced pain than that in those who did not (25.0% vs. 11.9%; p =0.19).
To assess whether the extent of inflammation was associated with the onset of PE, we compared the maximum CRP level, which was measured before the onset of PE, among the 12 pregnancies who developed pain during pregnancy. The median maximum CRP level was significantly higher in patients with PE than that in those without PE (5.45 vs. 0.12 mg/dL,p <0.05) (Fig. 2). Among the 5 cases who developed PE, the maximum CRP level preceded the onset of PE as early as 6 days and as late as 47 days, with the median time from the maximum CRP level to the onset of PE being 15 days (IQR: 9-45 days).