title: Intrauterine exposures and risk of endometriosis.
abstract: 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.
authors.affiliation: Department of Health and Human Services, Epidemiology Branch, National Institute of Child Health & Human Development, Rockville, Maryland 20852, USA. louisg@mail.nih.gov
authors.forename: Germaine M
authors.initials: GM
authors.lastname: Buck Louis
authors.forename: Mary L
authors.initials: ML
authors.lastname: Hediger
authors.forename: Josefa B
authors.initials: JB
authors.lastname: Peña
mesh_terms: 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
chemical_list: D002110:Caffeine