Intrauterine exposures and risk of endometriosis.
BACKGROUND
Intrauterine environmental exposures have been adversely associated with male reproductive health in contrast to limited investigation of such exposures and female reproductive health.


METHODS
To address this research gap, a cohort comprising 84 women aged 18-40 years undergoing laparoscopy was recruited prior to surgery and followed through the post-operative period for endometriosis diagnosis. Women were interviewed about environmental exposures and those of their mothers while pregnant with them (use of alcohol, caffeinated beverages and cigarettes). Endometriosis was diagnosed in 32 women from the laparoscopy cohort; 52 women had no endometriosis visualized. Using unconditional logistic regression, odds ratios (OR) and 95% confidence intervals (CIs) were estimated for the intrauterine exposures adjusting for potential confounders.


RESULTS
No significant associations were seen between intrauterine exposure to alcohol or caffeine and a diagnosis of endometriosis. Adjusting for age, significant reductions in odds of an endometriosis diagnosis were observed for intrauterine cigarette exposure both in the absence (OR 0.22, 95% CI 0.06-0.82) or presence (OR 0.05, 95% CI 0.01-0.42) of women's current smoking.


CONCLUSIONS
While speculative, in utero cigarette exposure may be associated with a lower risk of surgically diagnosed adult-onset endometriosis, possibly as a result of alterations in hormonal milieu or pathologic angiogensis.
Buck Louis
Germaine M
GM
Department of Health and Human Services, Epidemiology Branch, National Institute of Child Health & Human Development, Rockville, Maryland 20852, USA. louisg@mail.nih.gov
Hediger
Mary L
ML
Peña
Josefa B
JB
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D002110:Caffeine / Q000008:administration & dosage; D031885:Cimicifuga; D004715:Endometriosis / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D018811:Maternal Exposure / Q000706:statistics & numerical data*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology
D002110:Caffeine