Epidemiologic determinants of endometriosis among Egyptian women: a hospital-based case-control study

Mamdouh HM, Heba Mohamed Mamdouh, Mona Mohamed Mortada, Mortada MM, Kharboush IF, Ibrahim Fahmy Kharboush, Abd-Elateef HA, Hisham Abd-Elfattah Abd-Elateef
The Journal of the Egyptian Public Health Association · 2011 · doi:10.1097/01.EPX.0000395322.91912.56 · PMID:21527837
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This case-control study found nulligravidity, short/irregular cycles, irritable bowel syndrome history, and family history of endometriosis to be associated with increased risk in Egyptian women.

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This hospital-based case–control study examined possible epidemiologic determinants of endometriosis among 110 recently diagnosed Egyptian women and 220 age-matched hospital controls recruited in Alexandria. Logistic regression identified higher odds of endometriosis among nulligravid women, those with short or irregular menstrual cycles, and women reporting irritable bowel syndrome or a family history of endometriosis. The authors noted that epidemiologic research is complicated by challenges in defining endometriosis and selecting appropriate controls; the hospital-based design also limits the study population to women represented in those clinical settings. This paper is centrally about endometriosis — identifying reproductive, menstrual, gastrointestinal, and familial factors associated with its occurrence among Egyptian women.

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Abstract

BACKGROUND: Advances in understanding the epidemiology of endometriosis have lagged behind other diseases because of methodological problems related to disease definition and control selection. AIM: To identify possible risk factors associated with the development of endometriosis among a sample of Egyptian women. MATERIALS AND METHODS: A case-control study was conducted in the University Maternity Hospital and some private hospitals in Alexandria. The sample included 110 cases recently diagnosed with endometriosis and 220 hospital-based, age-matched controls. RESULTS: Using the logistic regression analysis, nulligravidae were four times more likely to develop endometriosis than gravid women [adjusted odds ratio (AOR)=4.0, 95% confidence interval (CI) (2.2-7.6)]. Short cycles were associated with approximately six times increase in risk of endometriosis [AOR=6.1, 95% CI (2.9-12.8)]. Women with irregular cycles were three times more likely to develop endometriosis than women with regular cycles [AOR=3.5, 95% CI (1.89-6.71)]. Similarly, women with a history of irritable bowel syndrome were twice as likely to develop endometriosis [AOR=1.9, 95% CI (1.03-3.87)]. Women who had one or more relatives with endometriosis were 1.2 times more likely to develop endometriosis [AOR=1.2, 95% CI (1.19-1.43)]. CONCLUSION AND RECOMMENDATIONS: Nulliparous and women reporting short and irregular cycles were at a significantly increased risk of developing endometriosis. A weak association between reported family history of endometriosis and history of irritable bowel syndrome and the development of endometriosis was also observed. Designing and implementing health education programs about endometriosis and its related risk factors should be a priority to ensure early diagnosis of the disease.
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Background

Advances in understanding the epidemiology of endometriosis have lagged behind other diseases because of methodological problems related to disease definition and control selection. Aim To identify possible risk factors associated with the development of endometriosis among a sample of Egyptian women.

Materials and methods

A case–control study was conducted in the University Maternity Hospital and some private hospitals in Alexandria. The sample included 110 cases recently diagnosed with endometriosis and 220 hospital-based, age-matched controls.

Results

Using the logistic regression analysis, nulligravidae were four times more likely to develop endometriosis than gravid women [adjusted odds ratio (AOR)=4.0, 95% confidence interval (CI) (2.2–7.6)]. Short cycles were associated with approximately six times increase in risk of endometriosis [AOR=6.1, 95% CI (2.9–12.8)]. Women with irregular cycles were three times more likely to develop endometriosis than women with regular cycles [AOR=3.5, 95% CI (1.89–6.71)]. Similarly, women with a history of irritable bowel syndrome were twice as likely to develop endometriosis [AOR=1.9, 95% CI (1.03–3.87)]. Women who had one or more relatives with endometriosis were 1.2 times more likely to develop endometriosis [AOR=1.2, 95% CI (1.19–1.43)].

Conclusion

and recommendations Nulliparous and women reporting short and irregular cycles were at a significantly increased risk of developing endometriosis. A weak association between reported family history of endometriosis and history of irritable bowel syndrome and the development of endometriosis was also observed. Designing and implementing health education programs about endometriosis and its related risk factors should be a priority to ensure early diagnosis of the disease.

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Condition tags

endometriosisirritable_bowel_syndrome

MeSH descriptors

Endometriosis Endometriosis Odds Ratio Case-Control Studies Female Humans Parity Risk Factors

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