Influence of early-life factors on the development of endometriosis

Eur J Contracept Reprod Health Care. 2019 Jun;24(3):216-221. doi: 10.1080/13625187.2019.1602723. Epub 2019 May 5.


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.

Keywords: Breastfeeding; case–control study; early life; endometriosis.

MeSH terms

  • Adolescent
  • Adult
  • Breast Feeding / statistics & numerical data*
  • Case-Control Studies
  • Cesarean Section / statistics & numerical data
  • China / epidemiology
  • Endometriosis / epidemiology*
  • Fathers / statistics & numerical data
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Middle Aged
  • Pregnancy
  • Premature Birth / epidemiology
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Smoking / epidemiology
  • Uterine Hemorrhage / epidemiology*
  • Young Adult