Influence of early-life factors on the development of endometriosis

Abstract

Objective: Our aim was to study the association between early-life factors and the development of endometriosis.

Methods: This case–control study included 440 women with surgically confirmed endometriosis (cases) and 880 women without endometriosis (controls). Information on early-life factors was ascertained retrospectively by in-person interviews with participants and their mothers. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between endometriosis and maternal and paternal characteristics and foetal and infant exposures were estimated using unconditional logistic regression, adjusting for frequency matching and confounding variables.

Results: We observed that women who were not breastfed as infants had twice the risk of endometriosis compared with women who were breastfed (adjusted OR 2.0; 95% CI 1.6, 4.5). Our data suggested an increased endometriosis risk with neonatal vaginal bleeding (adjusted OR 1.9; 95% CI 1.2, 4.3) and paternal smoking (adjusted OR 1.8; 95% CI 1.1, 4.9). Although the CIs included the null hypothesis value, caesarean section (adjusted OR 1.7; 95% CI 1.0, 3.5) and prematurity (adjusted OR 1.4; 95% CI 0.8, 3.7) were probably associated with the incidence of endometriosis.

Conclusions: Some early-life factors including breastfeeding, neonatal vaginal bleeding and paternal smoking were associated with subsequent, surgically confirmed endometriosis in this cohort of Chinese women.

摘要

目的：我们的目的是探讨早期生活因素与子宫内膜异位症发生的关系。

方法：本篇为病例对照研究包括440例经手术证实的子宫内膜异位症患者（病例组）和880例无子宫内膜异位症患者（对照组）。关于早期生活因素的信息通过对参与者及她们的母亲进行回顾性访谈而确定。使用无条件logistic回归并调整频率匹配和混杂变量, 估计子宫内膜异位症与母亲和父亲的特征、胎儿和婴儿暴露因素之间的关系的调整优势比（ORs）和95%置信区间（CIs）。

结果：我们研究结果显示, 与经母乳喂养女性相比, 婴儿期非母乳喂养的女性患子宫内膜异位症的风险是经母乳喂养女性的两倍（调整到OR 2.0；95%CI 1.6, 4.5）.我们的数据表明新生儿阴道出血增加子宫内膜异位症的风险（调整到OR1.9；95%CI 1.2, 4.3）和父亲吸烟（调整到OR1.8；95%CI 1.0, 3.5）。虽然CIs纳入了原假设值, 剖宫产术（调整到OR1.7；95%CI 1.0, 3.5）以及早产（调整到OR1.4；95%CI 0.8, 3.7）可能与子宫内膜异位症的发生率相关。

结论：在中国女性中, 母乳喂养、新生儿阴道出血和父亲吸烟在内的一些早期生活因素与经手术确诊的子宫内膜异位症相关。

Keywords:

• Breastfeeding
• case–control study
• early life
• endometriosis

Disclosure statement

The authors have no conflict of interest to declare.

Additional information

Funding

This study was supported by 333 Project Foundation of Jiangsu [no. BRA2017146] and the Key Talents Project of Maternal and Child Health in Jiangsu [no. FRC201730].