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Copenhagen,
Denmark
19 - 22 June 2005
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Asthma
in women with endometriosis
P. Petrera [1], S Ferrero [1], BM Colombo
[2], P Anserini [1], V Remorgida [1], N Ragni
[1]
[1] San Martino Hospital and University
of Genoa Department of Obstetrics and Gynaecology
Genoa, Italy
[2] University of Genoa
Department of Internal Medicine
Genoa, Italy
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Introduction
A previous cross-sectional survey suggested that
asthma is significantly more common in women with
endometriosis than in the general population (Sinaii
et al., 2002). The objective of this study is to
investigate asthma prevalence and severity in women
with and without endometriosis.
Materials and methods
Before laparoscopy, asthma presence was evaluated
in 879 women of reproductive age, undergoing surgery
because of uterine myomas, ovarian cysts, pelvic
pain, dysmenorrhoea, or infertility. In all
cases, diagnosis of bronchial asthma was based on
the American Thoracic Society criteria; briefly,
bronchial asthma was diagnosed as the presence of
symptoms of episodic wheezing, cough and shortness
of breath, responding to bronchodilators and reversible
airflow obstruction, documented in at least one
previous pulmonary function study. Subjects suffering
from asthma were interviewed on demographic, health
characteristics/behaviours, respiratory symptoms
and medication use.
According to the 2002 Global Initiative for Asthma
guidelines, asthma severity was classified in four
categories (intermittent, mild persistent, moderate
persistent, severe persistent). Asthmatic patients
completed the Living with Asthma Questionnaire (LWAQ),
designed to evaluate patient’s subjective
experiences with asthma, including both functional
limitation and distress. Patients were classified
according to the presence of endometriosis; the
diagnosis of endometriosis was always confirmed
by the histological examination of specimens removed
at surgery.
The extent of endometriosis was scored according
to the 1985 revised criteria of the American Fertility
Society (rAFS). None of the patients included in
the control group had previously undergone surgical
treatment for endometriosis. A power calculation
indicated that about 400 patients in each group
would be necessary to detect a significant difference
in asthma prevalence between the two groups, with
a power of 90% at a 0.1% level of significance.
Data were analysed by using Student’s t-test,
Mann–Whitney U test, and 2·2 x2-test.
Results
There were no significant differences in age, smoking
status and other demographic and health characteristics
between patients with endometriosis (n=467) and
controls (n=412). Asthma prevalence was similar
in women with (23/467, 4.9%; 95% CI, 3.1–7.3)
and without endometriosis (22/412, 5.3%;
95% CI, 3.4–8.0; p=0.781). No significant
difference was observed in asthma prevalence among
women with mild (rAFS stage I–II; 8/180, 4.4%)
and severe endometriosis (rAFS stage III–IV;
15/287, 5.2%; p=0.413).
Asthma severity was similar in women with and without
endometriosis, with 12 (52.2%) women with endometriosis
and 13 (59.1%) controls being in the intermittent
(mildest) degree of severity.
No significant difference was observed between women
with and without endometriosis in the LWAQ total
score and in the four constructs of this questionnaire
(avoidance, distress, preoccupation, and activities).
Conclusions
The current study shows that women with endometriosis
do not have an increased risk of having asthma.
Furthermore, no significant difference was observed
in asthma severity between women with and without
endometriosis.
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