Demakakos, P;
Steptoe, A;
Mishra, GD;
(2022)
Adverse childhood experiences are associated with increased risk of hysterectomy and bilateral oophorectomy: a national retrospective cohort study of women in England.
BJOG: An International Journal of Obstetrics & Gynaecology
10.1111/1471-0528.17088.
(In press).
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Abstract
OBJECTIVE: To examine the associations between adverse childhood experiences (ACE) and the risk of hysterectomy and bilateral oophorectomy in a national sample of women in England. DESIGN: Retrospective cohort study SETTING: A stratified random sample of households across England POPULATION: 2,648 women aged ≥55trueyears in 2007 from the English Longitudinal Study of Ageing (ELSA) were included in the bilateral oophorectomy analyses and 2,622 in the hysterectomy analyses. METHODS: Logistic regression analyses of the associations between categories of the ACE summary score (0, 1, 2, ≥3 ACE), 8 individual ACE, and hysterectomy and bilateral oophorectomy. RESULTS: 615 women had undergone hysterectomy and 259 women bilateral oophorectomy. We found graded associations between the summary ACE score and risk of hysterectomy and bilateral oophorectomy. In the fully adjusted model, compared with women with no ACE, those with ≥3 ACE had double the odds of hysterectomy (OR 2.01; 95% CI 1.30, 3.11) and more than double the odds of bilateral oophorectomy (OR 2.61; 95% CI 1.54, 4.42). The exclusion of women with cancer history made the associations stronger especially in women who underwent hysterectomy at age <40trueyears or bilateral oophorectomy at age ≤44trueyears. Several individual ACE were positively associated with both outcomes. CONCLUSIONS: ACE are associated with increased risk of hysterectomy and bilateral oophorectomy. Individual-level covariates did not explain these associations. Our findings highlight the importance of a life course approach to understanding surgical menopause and add to our knowledge of the societal and public health impact of ACE.
| Type: | Article |
|---|---|
| Title: | Adverse childhood experiences are associated with increased risk of hysterectomy and bilateral oophorectomy: a national retrospective cohort study of women in England |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/1471-0528.17088 |
| Publisher version: | https://doi.org/10.1111/1471-0528.17088 |
| Language: | English |
| Additional information: | This is an open access article under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Adverse childhood experiences, adversity, aging, bilateral oophorectomy, cohort, epidemiology, hysterectomy, life course, observational study, retrospective study, socioeconomic position, surgical menopause |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10142053 |
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