IMPORTANCE While childhood adversity has been extensively studied in relation to various health outcomes, investigation of its association with gynecological conditions remains limited. OBJECTIVE To systematically review studies examining the effect of childhood adversity on the prevalence of three gynecological conditions: endometriosis, fibroids, and polycystic ovary syndrome (PCOS) in the population. EVIDENCE REVIEW Six databases were searched from inception to 12th March 2024. Observational studies of women with exposure to adversity before age 18, and an outcome of endometriosis, fibroids, and/or PCOS were eligible for inclusion. Studies were summarized through a qualitative synthesis. We evaluated the risk of bias using the Newcastle-Ottawa Scale. FINDINGS Seven studies reported on the association between a form of childhood adversity and endometriosis, fibroids, and or PCOS were selected for review. All seven papers received a moderate risk of bias score. Cumulative exposure to childhood adversity was associated with an increased risk of endometriosis and fibroids. Childhood exposure to sexual abuse was associated with an increased risk of endometriosis and fibroids. Exposure to physical abuse in childhood was associated with a greater risk of fibroids. CONCLUSIONS A small number of studies have shown an association between childhood adversity and the development of endometriosis and fibroids in later life. These initial findings warrant further investigation in larger studies using standardized measures.

中文翻译：

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童年逆境和子宫内膜异位症、肌瘤和多囊卵巢综合征的风险：系统评价。


重要性 虽然童年逆境与各种健康结果的关系已被广泛研究，但对其与妇科疾病关联的调查仍然有限。目的 系统回顾童年逆境对人群中子宫内膜异位症、肌瘤和多囊卵巢综合征 （PCOS） 三种妇科疾病患病率影响的研究。证据综述 检索了从建库到 2024 年 3 月 12 日的 6 个数据库。对 18 岁之前暴露于逆境的女性以及子宫内膜异位症、肌瘤和/或 PCOS 结局的观察性研究符合纳入条件。通过定性综合对研究进行总结。我们使用 Newcastle-Ottawa 量表评估偏倚风险。结果 选择七项研究报告了某种形式的儿童逆境与子宫内膜异位症、子宫肌瘤和/或 PCOS 之间的关联。所有 7 篇论文均获得中等偏倚风险评分。累积暴露于童年逆境与子宫内膜异位症和肌瘤风险增加有关。童年时期遭受性虐待与子宫内膜异位症和子宫肌瘤的风险增加有关。童年时期遭受身体虐待与患子宫肌瘤的风险增加有关。结论 少数研究表明，童年逆境与以后生活中子宫内膜异位症和肌瘤的发展之间存在关联。这些初步发现值得在更大规模的研究中使用标准化测量进行进一步调查。