University of Oulu

Rossi, H-R, Nedelec, R, Jarvelin, M-R, Sebert, S, Uimari, O, Piltonen, TT. Body size during adulthood, but not in childhood associates with endometriosis, specifically in the peritoneal subtype– population-based life-course data from birth to late fertile age. Acta Obstet Gynecol Scand. 2021; 100: 1248– 1257.

Body size during adulthood, but not in childhood, associates with endometriosis, specifically in the peritoneal subtype : population-based life-course data from birth to late fertile age

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Author: Rossi, Henna-Riikka1,2; Nedelec, Rozenn3; Järvelin, Marjo-Riitta3,4,5,6;
Organizations: 1Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland
2PEDEGO Research Unit & Medical Research Center, University of Oulu, Oulu, Finland
3Center for Life Course Health Research, University of Oulu, Oulu, Finland
4Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK
5MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, UK
6Department of Life Sciences, College of Health and Life Sciences, Brunel University, London, UK
7Center for Life Curse Health Research, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
Persistent link:
Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2021-09-03


Introduction: Endometriosis is a common gynecological condition causing chronic pain and infertility. Only limited data exist on body size during childhood and adolescence in affected women. A leaner body shape has been associated with endometriosis in adults. However, longitudinal follow-up data from birth to adulthood are lacking. The aim of this study was to assess the association between body size and endometriosis from birth to age 46 years. We also performed in-depth analysis of the endometriosis subtypes.

Material and methods: This was a population-based study including 96% of the children born in Northern Finland in 1966. Endometriosis case identification was based on (a) the World Health Organization’s International Statistical Classification of Diseases code documentation from national hospital discharge registers and (b) self-reported diagnosis. A total of 348 women with endometriosis (203 in subtype analysis) and 3487 women without endometriosis were identified. Pregnancy, birth, and growth data up to adolescence were collected from welfare clinical records. Follow-up data of the Northern Finland Birth Cohort 1966 were collected at ages 14, 31, and 46 years through postal questionnaires and clinical examinations and included height, weight, and waist and hip circumference measurements. The associations between endometriosis and body size were assessed using logistic regression models.

Results: Body sizes in childhood and adolescence were comparable between women developing endometriosis and those not developing endometriosis. On average, the risk for endometriosis was 2% lower for every kilogram of weight (odds ratio [OR] 0.98, 95% CI 0.97–1.00) and 6% lower for every body mass index unit (OR 0.94, 95% CI 0.90–0.99) at age 31. By age 46, a lower risk for peritoneal endometriosis was observed with greater weight (OR 0.95, 95% CI 0.92–0.98), weight gain from age 14 to age 46 years (OR 0.97, 95% CI 0.93–1.00), body mass index (OR 0.90, 95% CI 0.82–0.98), waist circumference (OR 0.95, 95% CI 0.92–0.99), and waist-hip ratio (OR 0.41, 95% CI 0.21–0.78).

Conclusions: This study provides further evidence of the associations between endometriosis and body size and adiposity, specifically in women with peritoneal endometriosis. The associations are evident in adulthood but not in childhood or adolescence.

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Series: Acta obstetricia et gynecologica Scandinavica
ISSN: 0001-6349
ISSN-E: 1600-0412
ISSN-L: 0001-6349
Volume: 100
Issue: 7
Pages: 1248 - 1257
DOI: 10.1111/aogs.14090
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: The study was funded by The Academy of Finland (315921, 321763), Sigrid Jusélius Foundation, The Finnish Medical Association and Ahokkaan Säätiö. NFBC1966 received financial support from University of Oulu Grant no. 65354 and 24000692, Oulu University Hospital Grant no. 2/97, 8/97 and 24301140, Ministry of Health and Social Affairs Grant no. 23/251/97, 160/97, 190/97, National Institute for Health and Welfare, Helsinki Grant no. 54121, Regional Institute of Occupational Health, Oulu, Finland Grant no. 50621, 54231 and ERDF European Regional Development Fund Grant no. 539/2010 A31592.
Academy of Finland Grant Number: 315921
Detailed Information: 315921 (Academy of Finland Funding decision)
321763 (Academy of Finland Funding decision)
Copyright information: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2021 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).