ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2026
Impact of adverse childhood experiences on health-related quality of life in Australian women with endometriosis: a population-based cohort study.
Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo examine the associations between adverse childhood experiences (ACEs) and health-related quality of life (HRQoL) among Australian women with endometriosis.
methodsThis population-based cohort study included 1,120 women with endometriosis born in 1973–78 and 1989–95, using data from the Australian Longitudinal Study on Women’s Health and its sub-study, the Genetic variants, Early Life exposures, and Longitudinal Endometriosis symptoms Study. HRQoL was assessed using the Endometriosis Health Profile-30, and ACEs were measured using a validated 21-item questionnaire. Ordinal logistic regression models were used for analyses.
resultsWomen who experienced ACEs were more likely to be diagnosed with endometriosis than those who did not. Among women with endometriosis, a clear dose-response relationship was observed, with higher cumulative ACE scores and greater trauma severity associated with progressively poorer HRQoL across all domains. In the 1973–78 cohort, the strongest associations between cumulative ACEs and HRQoL were observed in the domains of social support, self-image, and emotional well-being, with adjusted odds ratios (95% CIs) of 1.41 (1.24, 1.58), 1.41 (1.24, 1.60), and 1.30 (1.15, 1.46), respectively. Women reporting very/extremely traumatic experiences also had significantly worse outcomes across all domains, particularly for social support 4.42 (2.36, 8.28), emotional well-being 4.38 (2.36, 8.12), and self-image 3.29 (1.77, 6.11). Psychological abuse, physical abuse, and household mental illness were consistently associated with poorer HRQoL, particularly in the social support domain. Similar patterns were observed in the 1989–95 cohort, though with some domain-specific variations.
conclusionChildhood adversity significantly impairs HRQoL in women with endometriosis, particularly psychological abuse, physical abuse, and household mental illness. These findings highlight the need for trauma-informed care in endometriosis management, with careful consideration of the limitations of routine ACE screening.
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