• Birth cohort study;
  • body mass index;
  • hysterectomy;
  • life course

Objective  To examine the associations between adiposity at time points from early life onwards and subsequent hysterectomy risk.

Design  Prospective birth cohort study.

Setting  England, Scotland and Wales.

Population  Women from the Medical Research Council National Survey of Health and Development study, with complete data on hysterectomy status (n= 1790).

Methods  Survival analysis methods were used to examine the associations between body mass index at time points across life and subsequent hysterectomy rates.

Main outcome measure  Self-reported hysterectomy with or without oophorectomy.

Results  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.

Conclusions  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.