European Journal of Obstetrics & Gynecology and Reproductive Biology 183 (2014) 104–108
Contents lists available at ScienceDirect
European Journal of Obstetrics & Gynecology and Reproductive Biology journal homepage: www.elsevier.com/locate/ejogrb
Leisure and occupational physical activity at different ages and risk of endometriosis E. Garavaglia a, E. Ricci b,*, F. Chiaffarino b, S. Cipriani b, R. Cioffi a, P. Vigano` c, A. Frigerio b, M. Candiani a, F. Parazzini b a b c
Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Milan, Italy Dipartimento di Scienze Cliniche e di Comunita`, Universita` di Milano, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milano, Italy
A R T I C L E I N F O
A B S T R A C T
Article history: Received 12 June 2014 Received in revised form 8 October 2014 Accepted 22 October 2014
Objective: Cohort and case-control studies have suggested that adult physical activity (PA) may lower endometriosis risk and improve symptoms, but evidence is still controversial. To add information on leisure and occupational PA impact, if any, on endometriosis risk, we have analyzed data from a small case-control study conducted in Milan (Italy). Study design: Ninety cases and 90 controls (median age 35 years, range 18–76) were compared. Endometriosis was laparoscopically diagnosed within the year before interview. Information on demographic variables, menstrual and reproductive history, occupational and recreational physical activity was collected. Results: A consistent protective effect emerged between leisure PA and endometriosis risk. For 41 years); according to the Bonferroni’s test [18] the level of significance was set at P < 0.0025. Results Table 1 shows the distribution of cases and controls according to BMI, education, smoking habits, parity, history of miscarriages and lifelong menstrual history. Overweight women (BMI > 25) had endometriosis less frequently than women with BMI 25 (P = 0.07). As expected, women with endometriosis were more educated (P = 0.0005) and less frequently parous than controls (P < 0.0001). On the same line, miscarriage was more frequent, though not significantly, in women with endometriosis (P = 0.32). In our sample, irregular menstrual cycle, days of bleeding and oral contraceptive use were not significantly related to endometriosis, and nor was smoking. Table 2 shows the distribution of cases and controls with corresponding multivariate ORs in relation to the levels of leisure PA at different ages and occupational PA in teenage years and adulthood. In order to avoid biases due to diagnostic delay, we repeated the teenage years PA analysis excluding women aged less than 25 years (5 years delay), but the results did not substantially change. As 33 women were aged less than 30 years, they did not contribute to the PA evaluation in adulthood. The sample for the analysis of occupational and leisure PA in adult age was composed of 74 cases and 73 controls, and according to each subject’s age, it included both current and past PA. Conversely, the early adolescence and teenage years PA analyses regarded past PA for all subjects. A consistent protective effect emerged between leisure PA and endometriosis risk. For
Contents lists available at ScienceDirect
European Journal of Obstetrics & Gynecology and Reproductive Biology journal homepage: www.elsevier.com/locate/ejogrb
Leisure and occupational physical activity at different ages and risk of endometriosis E. Garavaglia a, E. Ricci b,*, F. Chiaffarino b, S. Cipriani b, R. Cioffi a, P. Vigano` c, A. Frigerio b, M. Candiani a, F. Parazzini b a b c
Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, Milan, Italy Dipartimento di Scienze Cliniche e di Comunita`, Universita` di Milano, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milano, Italy
A R T I C L E I N F O
A B S T R A C T
Article history: Received 12 June 2014 Received in revised form 8 October 2014 Accepted 22 October 2014
Objective: Cohort and case-control studies have suggested that adult physical activity (PA) may lower endometriosis risk and improve symptoms, but evidence is still controversial. To add information on leisure and occupational PA impact, if any, on endometriosis risk, we have analyzed data from a small case-control study conducted in Milan (Italy). Study design: Ninety cases and 90 controls (median age 35 years, range 18–76) were compared. Endometriosis was laparoscopically diagnosed within the year before interview. Information on demographic variables, menstrual and reproductive history, occupational and recreational physical activity was collected. Results: A consistent protective effect emerged between leisure PA and endometriosis risk. For 41 years); according to the Bonferroni’s test [18] the level of significance was set at P < 0.0025. Results Table 1 shows the distribution of cases and controls according to BMI, education, smoking habits, parity, history of miscarriages and lifelong menstrual history. Overweight women (BMI > 25) had endometriosis less frequently than women with BMI 25 (P = 0.07). As expected, women with endometriosis were more educated (P = 0.0005) and less frequently parous than controls (P < 0.0001). On the same line, miscarriage was more frequent, though not significantly, in women with endometriosis (P = 0.32). In our sample, irregular menstrual cycle, days of bleeding and oral contraceptive use were not significantly related to endometriosis, and nor was smoking. Table 2 shows the distribution of cases and controls with corresponding multivariate ORs in relation to the levels of leisure PA at different ages and occupational PA in teenage years and adulthood. In order to avoid biases due to diagnostic delay, we repeated the teenage years PA analysis excluding women aged less than 25 years (5 years delay), but the results did not substantially change. As 33 women were aged less than 30 years, they did not contribute to the PA evaluation in adulthood. The sample for the analysis of occupational and leisure PA in adult age was composed of 74 cases and 73 controls, and according to each subject’s age, it included both current and past PA. Conversely, the early adolescence and teenage years PA analyses regarded past PA for all subjects. A consistent protective effect emerged between leisure PA and endometriosis risk. For
