Is adiposity across life associated with subsequent hysterectomy risk? Findings from the 1946 British birth cohort study

Abstract

To examine the associations between adiposity at time points from early life onwards and subsequent hysterectomy risk. Prospective birth cohort study. England, Scotland and Wales. Women from the Medical Research Council National Survey of Health and Development study, with complete data on hysterectomy status (n= 1790). Survival analysis methods were used to examine the associations between body mass index at time points across life and subsequent hysterectomy rates. Self-reported hysterectomy with or without oophorectomy. From 20 years onwards, those women who were classified as underweight had lower hysterectomy rates, and from 36 years onwards, those women who were overweight had higher hysterectomy rates than those who were normal weight. Women who were obese in adolescence and early adulthood had lower rates of hysterectomy than those who were normal weight, although numbers categorised as obese at these ages were small. Women who were obese in later adulthood had higher subsequent rates of hysterectomy. Greater increases in weight between ages 36 and 53 years were associated with higher rates of hysterectomy in later adulthood. These results were not explained by parity, age at menarche or socio-economic position. These results suggest that variation in hysterectomy rates may be partially explained by variation in adiposity, and so with the recent changes in levels of overweight and obesity in populations, there may be increasing demand for gynaecological treatments in the future.