Objective To evaluate the association between endometriosis and preterm birth using meta-analysis. Methods CNKI

Chinese biomedical literature database

Wanfang database

VIP database

Pub Med

EMBASE

Web of Science

MEDLINE

and Cochrane Library databases were retrieved electronically to collect relevant literature related to endometriosis and premature delivery. The type of literature study was a cohort study. The search time limit was from database establishment to September 3 2021. After extraction of relevant data from the included articles and quality assessment of the included articles

meta-analysis was performed using Review Manager 5.4 and Stata 12.0. Publication bias was also estimated using funnel plots and Egger tests. Results A total of 8 articles were included

and the studies included in the articles comprised a total of 10 817 Participants（2 266 in the endometriosis group and 8 551 in the control group）. A meta-analysis of the included literature found that women with endometriosis had a higher risk of preterm birth（RR=1.49

95% CI:1.28 to 1.73）. In women who conceived naturally

women with endometriosis had a 1.28-fold increased risk of preterm birth compared with normal women（RR=2.28

95% CI:1.51 to 3.45）. in women who conceived with artificial assisted impregnation

women with endometriosis had a 0.38-fold increased risk of preterm birth compared with normal women（RR=1.38

95% CI:1.18 to 1.62）. Publication bias was estimated for the included articles

and each article in the funnel plot was fundamentally symmetrically distributed around the center line

and the Egger test was not statistically significant（t=-0.44

P=0.676）

suggesting that there was a small possibility of publication bias. Conclusion Women with endometriosis have a higher risk of premature delivery than women without it regardless of the way of conception. This suggests that we need to take more clinical care measures for women with endometriosis during pregnancy to prevent the occurrence of premature delivery to reduce the health damage of premature delivery to women and fetuses.