Potential influence of in utero and early neonatal exposures on the later development of endometriosis

Capsule:
Women with endometriosis, in addition to genetic predisposition, are exposed more frequently to preterm birth during intrauterine life and to formula feeding in early postnatal life.

Authors:
Silvia Vannuccini, M.D., Lucia Lazzeri, M.D., Ph.D., Cinzia Orlandini, M.D., Claudia Tosti, M.D., Vicki L. Clifton, Ph.D., Felice Petraglia, M.D., F.R.C.O.G.

Volume 105, Issue 4, Pages 997-1002

Abstract:

Objective:
To investigate the possible correlation between maternal characteristics, in utero and early neonatal life exposures, and the development of endometriosis in adult life.

Design:
Case-control study.

Setting:
University hospital.

Patient(s):
A group of 161 patients with endometriosis and a control group of 230 women undergoing laparoscopy for benign adnexal diseases and free of endometriosis.

Intervention(s):
All women included in the study were requested to answer a series of questions about their mothers’ gestational data and on their own perinatal and early postnatal lives.

Main Outcome Measure(s):
Odds ratio, adjusted odds ratios, and 95% confidence intervals for the associations between maternal characteristics during the patient’s pregnancy, in utero exposure to obstetrical and perinatal complications, and the type of feeding received during the neonatal period with the development of endometriosis in adult life.

Result(s):
Mothers of women with endometriosis were significantly more likely to be affected by endometriosis or uterine fibroids, with a higher incidence of smoking during pregnancy. Women with endometriosis were more frequently born prematurely, with a significantly lower birth weight, and their mothers experienced preeclampsia during their pregnancies more often than control subjects. They were also more frequently formula fed than breast fed in early life. However, only prematurity and formula feeding were retained in the multivariate analysis model.

Conclusion(s):
Among intrauterine and early neonatal exposures, prematurity and formula feeding were risk factors for the development of endometriosis in adult life. Further studies should evaluate the underlying biologic mechanisms.

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