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Reproductive history and endometriosis among premenopausal women.
Obstet Gynecol 2004; 104(5 Pt 1):965-74OG

Abstract

OBJECTIVE

To clarify the temporal complexities of the relation between reproductive factors and endometriosis.

METHODS

We analyzed 10 years of prospective data from the Nurses' Health Study II cohort. Information was obtained through questionnaires sent every 2 years to 116,678 women aged 25-42 years when enrolled in 1989. Cox proportional hazards models were used to adjust for age, calendar time, and confounding variables.

RESULTS

During 726,205 woman-years of follow-up, 1,721 cases of laparoscopically confirmed endometriosis were reported among women with no past infertility. Greater incidence was observed among women with an earlier age at menarche (rate ratio of 1.3 comparing menarche at age < 10 to age 12 years; 95% confidence interval [CI] 1.0-1.8; P value, test for trend < .001) and shorter cycle length during late adolescence (rate ratio of 1.3 comparing < 26 days to 26-31 days; 95% CI 1.1-1.5). Time to cycle regularity was not associated with risk. Among parous women, a linear decrease in risk was observed with number of liveborn children (rate ratio of 0.5 comparing > 3 with 2 children; 95% CI 0.4-0.7; P value, test for trend < .001) and lifetime duration of lactation if time since last birth was less than 5 years (rate ratio of 0.2 comparing > 23 months with never; 95% CI 0.1-0.4; P value, test for trend < .001).

CONCLUSION

Hormonal and anatomical changes associated with menstruation and pregnancy may affect the rate of laparoscopically confirmed endometriosis. Within this cohort, risk was greatest among nulliparous women with earlier age at menarche and shorter menstrual cycles. Among parous women, parity and lifetime duration of lactation were associated with decreased risk.

Authors+Show Affiliations

Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115-5804, USA. stacey.missmer@channing.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15516386

Citation

Missmer, Stacey A., et al. "Reproductive History and Endometriosis Among Premenopausal Women." Obstetrics and Gynecology, vol. 104, no. 5 Pt 1, 2004, pp. 965-74.
Missmer SA, Hankinson SE, Spiegelman D, et al. Reproductive history and endometriosis among premenopausal women. Obstet Gynecol. 2004;104(5 Pt 1):965-74.
Missmer, S. A., Hankinson, S. E., Spiegelman, D., Barbieri, R. L., Malspeis, S., Willett, W. C., & Hunter, D. J. (2004). Reproductive history and endometriosis among premenopausal women. Obstetrics and Gynecology, 104(5 Pt 1), pp. 965-74.
Missmer SA, et al. Reproductive History and Endometriosis Among Premenopausal Women. Obstet Gynecol. 2004;104(5 Pt 1):965-74. PubMed PMID: 15516386.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reproductive history and endometriosis among premenopausal women. AU - Missmer,Stacey A, AU - Hankinson,Susan E, AU - Spiegelman,Donna, AU - Barbieri,Robert L, AU - Malspeis,Susan, AU - Willett,Walter C, AU - Hunter,David J, PY - 2004/11/2/pubmed PY - 2004/12/31/medline PY - 2004/11/2/entrez SP - 965 EP - 74 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 104 IS - 5 Pt 1 N2 - OBJECTIVE: To clarify the temporal complexities of the relation between reproductive factors and endometriosis. METHODS: We analyzed 10 years of prospective data from the Nurses' Health Study II cohort. Information was obtained through questionnaires sent every 2 years to 116,678 women aged 25-42 years when enrolled in 1989. Cox proportional hazards models were used to adjust for age, calendar time, and confounding variables. RESULTS: During 726,205 woman-years of follow-up, 1,721 cases of laparoscopically confirmed endometriosis were reported among women with no past infertility. Greater incidence was observed among women with an earlier age at menarche (rate ratio of 1.3 comparing menarche at age < 10 to age 12 years; 95% confidence interval [CI] 1.0-1.8; P value, test for trend < .001) and shorter cycle length during late adolescence (rate ratio of 1.3 comparing < 26 days to 26-31 days; 95% CI 1.1-1.5). Time to cycle regularity was not associated with risk. Among parous women, a linear decrease in risk was observed with number of liveborn children (rate ratio of 0.5 comparing > 3 with 2 children; 95% CI 0.4-0.7; P value, test for trend < .001) and lifetime duration of lactation if time since last birth was less than 5 years (rate ratio of 0.2 comparing > 23 months with never; 95% CI 0.1-0.4; P value, test for trend < .001). CONCLUSION: Hormonal and anatomical changes associated with menstruation and pregnancy may affect the rate of laparoscopically confirmed endometriosis. Within this cohort, risk was greatest among nulliparous women with earlier age at menarche and shorter menstrual cycles. Among parous women, parity and lifetime duration of lactation were associated with decreased risk. SN - 0029-7844 UR - https://www.unboundmedicine.com/medline/citation/15516386/full_citation L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=15516386.ui DB - PRIME DP - Unbound Medicine ER -