Individuals with a history of Cesarean or Induced abortion combined with allergies will significantly increase their risk of endometriosis: A prospective case-control study

Shanshan Mei, Jie Ding, Zhexin Ni, Chaoqin Yu
In: Pakistan Journal of Medical Sciences · 2026 · vol. 42(6) , pp. 1450–1457 · doi:10.12669/pjms.42.6.13847 · W7163640302
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Cesarean section and induced abortion independently increase endometriosis risk, and induced abortion combined with an allergy history significantly elevates the risk of deep infiltrating endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 · read from full text ⓘ

This prospective case-control study from 2018 to 2024 enrolled 1498 endometriosis patients and 452 non-endometriosis controls at Shanghai Changhai Hospital, analyzing whether delivery/abortion methods and allergy history were associated with endometriosis risk using multivariate logistic regression to adjust for confounders. Cesarean section was associated with about a two-fold increase in endometriosis risk (OR 2.043, 95% CI 1.489–2.804), and this association remained significant after excluding scar endometriosis. Induced abortion was also associated with about a two-fold increased risk (OR 2.262, 95% CI 1.529–3.347), and among allergic participants, induced abortion combined with allergy history was linked to a higher likelihood of deep infiltrating endometriosis. This paper is centrally about endometriosis—specifically the association of cesarean section and induced abortion with endometriosis risk and deep infiltrating endometriosis in relation to allergy history.

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Abstract

Objective: To investigate the association between delivery/abortion methods, allergy history, and endometriosis (EM) risk. Methodology: This prospective case-control study was conducted at the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), China, from 2018 to 2024. We enrolled 1498 EM patients and 452 non-EM controls. Associations between clinical variables (delivery modes, abortion, allergy history) and EM incidence were analyzed using multivariate logistic regression to adjust for confounders. Results: Cesarean section increased EM risk approximately 2-fold (OR 2.043, 95% CI: 1.489-2.804); this risk remained significant after excluding scar EM (OR 1.944, 95% CI: 1.414-2.674). Induced abortion also correlated with a 2-fold increased risk of EM (OR 2.262, 95% CI: 1.529-3.347). Furthermore, allergic patients with a history of induced abortion had a significantly higher likelihood of developing deep infiltrating endometriosis (DIE). Conclusion: Cesarean section and induced abortion independently increase EM risk. Moreover, induced abortion combined with an allergy history elevates the risk of developing DIE, highlighting the synergistic effect of surgical trauma and immune status on EM pathogenesis.
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Objective

To investigate the association between delivery/abortion methods, allergy history, and endometriosis (EM) risk. Methodology: This prospective case-control study was conducted at the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), China, from 2018 to 2024. We enrolled 1498 EM patients and 452 non-EM controls. Associations between clinical variables (delivery modes, abortion, allergy history) and EM incidence were analyzed using multivariate logistic regression to adjust for confounders.

Results

Cesarean section increased EM risk approximately 2-fold (OR 2.043, 95% CI: 1.489-2.804); this risk remained significant after excluding scar EM (OR 1.944, 95% CI: 1.414-2.674). Induced abortion also correlated with a 2-fold increased risk of EM (OR 2.262, 95% CI: 1.529-3.347). Furthermore, allergic patients with a history of induced abortion had a significantly higher likelihood of developing deep infiltrating endometriosis (DIE).

Conclusion

Cesarean section and induced abortion independently increase EM risk. Moreover, induced abortion combined with an allergy history elevates the risk of developing DIE, highlighting the synergistic effect of surgical trauma and immune status on EM pathogenesis.

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