{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:56:43Z","timestamp":1790639803236,"version":"4.1.0"},"reference-count":44,"publisher":"BMJ","issue":"4","funder":[{"name":"Australian NHMRC Principal Research Fellowship"},{"name":"European Union\u2019s Horizon 2020 research and innovation programme"},{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100006636","name":"Swedish Research Council for Health, Working Life and Welfare","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2018,12,9]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Endometriosis is a chronic condition affecting women of reproductive age and is associated with multiple health burdens. Yet, findings regarding its \u2018developmental origins\u2019 are inconsistent. We aimed to investigate the associations of birth characteristics with endometriosis. We also explored potential mediation by adult social and reproductive factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This cohort study consisted of 3406 women born in Uppsala, Sweden, between 1933 and 1972. We used data from archived birth records and endometriosis diagnoses at ages 15\u201350 recorded in the national patient registers. Socioeconomic and reproductive characteristics were obtained from routine registers. HRs were estimated from Cox regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During the follow-up, 111 women have been diagnosed with endometriosis, and most cases are external endometriosis (ie, outside the uterus, n=91). Lower standardised birth weight for gestational age was associated with increased rate of endometriosis (HR 1.35 per standard deviation decrease; 95% CI 1.08 to 1.67). This increased rate was also detected among women with fewer number of live births (HR 2.38; 95% CI 1.40 to 4.07 for one child vs \u22652 children; HR 6.09; 95% CI 3.88 to 9.57 for no child vs \u22652 children) and diagnosed infertility problem (HR 2.00; 95% CI 1.10 to 3.61) prior to endometriosis diagnosis. All the observed associations were stronger for external endometriosis. However, no evidence was found that number of births was the mediator of the inverse association between standardised birth weight and endometriosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study supports the developmental origins theory and suggests that exposure to growth restriction during the fetal period is associated with increased risk of endometriosis during reproductive years.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jech-2018-211811","type":"journal-article","created":{"date-parts":[[2019,1,19]],"date-time":"2019-01-19T17:25:24Z","timestamp":1547918724000},"page":"353-359","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Developmental origins of endometriosis: a Swedish cohort study"],"prefix":"10.1136","volume":"73","author":[{"given":"Menghan","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Allebeck","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gita D","family":"Mishra","sequence":"additional","affiliation":[{"name":"School of Population Health, University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilona","family":"Koupil","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,1,19]]},"reference":[{"key":"2025100308493927000_73.4.353.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1752"},{"key":"2025100308493927000_73.4.353.2","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1038\/nrendo.2013.255","article-title":"Endometriosis: pathogenesis and treatment","volume":"10","author":"Vercellini","year":"2014","journal-title":"Nat Rev Endocrinol"},{"key":"2025100308493927000_73.4.353.3","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/S0140-6736(04)17403-5","article-title":"Endometriosis","volume":"364","author":"Giudice","year":"2004","journal-title":"The Lancet"},{"key":"2025100308493927000_73.4.353.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2015.09.018"},{"key":"2025100308493927000_73.4.353.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0154227","article-title":"Incidence and Estimated Prevalence of Endometriosis and Adenomyosis in Northeast Italy: A Data Linkage Study","volume":"11","author":"Morassutto","year":"2016","journal-title":"PLoS One"},{"key":"2025100308493927000_73.4.353.6","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq143"},{"key":"2025100308493927000_73.4.353.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(98)00540-8"},{"key":"2025100308493927000_73.4.353.8","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmn016"},{"key":"2025100308493927000_73.4.353.9","doi-asserted-by":"publisher","DOI":"10.1093\/molehr\/gap064"},{"key":"2025100308493927000_73.4.353.10","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/31.6.1235"},{"key":"2025100308493927000_73.4.353.11","doi-asserted-by":"publisher","DOI":"10.1079\/PHN2001145"},{"key":"2025100308493927000_73.4.353.12","unstructured":"Barker D . 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