Risk Factors of Adolescent Endometriosis Onset and Recurrence: A Retrospective Study

Area of Science:

• Gynecology
• Reproductive Medicine
• Adolescent Health

Background:

• Endometriosis (EMs) affects adolescents, necessitating identification of specific risk factors for early detection and management.
• Understanding adolescent-specific risk factors for onset and recurrence is crucial for risk stratification and targeted interventions.

Purpose of the Study:

• To identify adolescent-specific risk factors for the onset of endometriosis.
• To determine predictors of postoperative recurrence in adolescent endometriosis patients.

Main Methods:

• Retrospective analysis of 242 adolescents (10-19 years) with laparoscopy-confirmed endometriosis versus 242 controls.
• Multivariable logistic regression for onset risk factors and Cox regression for recurrence predictors.
• Data included clinical variables, laboratory results, and follow-up for recurrence (symptomatic, imaging, or surgical confirmation).

Main Results:

• Independent onset risk factors: dysmenorrhea (aOR 3.61), genital tract malformation (aOR 16.15), and elevated CA125 (aOR 1.02).
• Hyperfibrinogenemia and dyslipidemia were associated with onset.
• Recurrence rate was 25.3%. Predictors: larger ovarian cyst diameter (aHR 1.24), elevated CA125 (aHR 1.01), and shortened activated partial thromboplastin time (APTT) (aHR 0.77), suggesting hypercoagulation.

Conclusions:

• Dysmenorrhea, genital tract malformations, and elevated CA125 are key risk factors for adolescent endometriosis onset.
• Shortened APTT is a novel predictor of postoperative recurrence, indicating hypercoagulability.
• Enhanced screening for high-risk adolescents and intensified postoperative monitoring, especially for those with coagulation abnormalities, are recommended.