Causal Relationship Between Abortion and Endometriosis: A Bidirectional Two-Sample Mendelian Randomization Study

IF 2.4 3区医学 Q3 IMMUNOLOGY

American Journal of Reproductive Immunology Pub Date : 2025-03-03 DOI:10.1111/aji.70064

Yan Huang, Deyu Zhang, Yingfang Zhou, Chao Peng

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引用次数: 0

Abstract

Problem

The relationship between abortion and endometriosis (EMS) has been inconsistent in previous observational studies and remains controversial. We intended to examine the causal relationship between abortion and EMS.

Methods of Study

We conducted a Mendelian randomization (MR) analysis using genome-wide association study (GWAS) summary statistics, drawing data from the FinnGen database and the UK Biobank. The primary analysis utilized the random-effects inverse variance weighted (IVW) approach, complemented by weighted median, weighted mode, and MR–Egger methods. Comprehensive sensitivity analyses were conducted, encompassing the Cochran's Q statistic for assessing heterogeneity and MR-PRESSO to detect pleiotropy. Additionally, Leave-One-Out (LOO) analysis was conducted to confirm the stability of our results.

Results

The IVW method revealed no statistically significant causal association between various types of abortion and EMS. Specifically, the odds ratios (ORs) were as follows: medical abortion (OR 0.96, 95% CI: 0.78–1.18, p = 0.72), spontaneous abortion (OR 0.99, 95% CI: 0.81–1.21, p = 0.92), and other types of abortions (OR 1.01, 95% CI: 0.99–1.03, p = 0.36), indicating no significant effects on the risk of EMS. Similarly, analysis in the reverse direction showed no significant causal effects of EMS on the likelihood of experiencing any type of abortion, with ORs for medical abortion (0.97, 95% CI: 0.91–1.03, p = 0.33), spontaneous abortion (0.98, 95% CI: 0.92–1.04, p = 0.50), and other abortions (1.30, 95% CI: 0.76–2.23, p = 0.34). Sensitivity analyses supported these findings, demonstrating no evidence of horizontal pleiotropy or significant heterogeneity.

Conclusion

Our MR results do not support a causal relationship between abortion and EMS.

查看原文本刊更多论文

流产与子宫内膜异位症的因果关系：一项双向双样本孟德尔随机研究

流产与子宫内膜异位症（EMS）之间的关系在以往的观察性研究中一直不一致，并且仍然存在争议。我们打算检查流产和EMS之间的因果关系。研究方法我们利用全基因组关联研究（GWAS）汇总统计数据进行了孟德尔随机化（MR）分析，数据来自FinnGen数据库和UK Biobank。初步分析采用随机效应反方差加权（IVW）方法，辅以加权中位数、加权模式和MR-Egger方法。进行了综合敏感性分析，包括评估异质性的Cochran's Q统计量和检测多效性的MR-PRESSO。此外，还进行了留一（LOO）分析，以确认我们结果的稳定性。结果IVW方法显示各种流产类型与EMS之间无统计学意义的因果关系。具体而言，优势比（OR）如下：药物流产（OR 0.96, 95% CI: 0.78-1.18, p = 0.72）、自然流产（OR 0.99, 95% CI: 0.81-1.21, p = 0.92）和其他类型流产（OR 1.01, 95% CI: 0.99 - 1.03, p = 0.36），表明对EMS风险无显著影响。同样，反向分析显示EMS对发生任何类型流产的可能性没有显著的因果影响，药物流产（0.97,95% CI: 0.91-1.03, p = 0.33）、自然流产（0.98,95% CI: 0.92-1.04, p = 0.50）和其他流产（1.30,95% CI: 0.76-2.23, p = 0.34）的or。敏感性分析支持这些发现，没有显示水平多效性或显著异质性的证据。结论我们的MR结果不支持流产和EMS之间的因果关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Reproductive Immunology 医学-免疫学

CiteScore

6.20

自引率

5.60%

发文量

314

审稿时长

2 months

期刊介绍： The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.