Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood
Spectrum of symptoms in women diagnosed with endometriosis during adolescence vs adulthood
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DOI：
10.1016/j.ajog.2017.12.007
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发表时间：
2018-03-01
影响因子：
9.8
通讯作者：
Missmer, Stacey A.
中科院分区：
文献类型：
--
作者：
DiVasta, Amy D.;Vitonis, Allison F.;Missmer, Stacey A.
背景：子宫内膜异位症的症状通常在年轻时开始，症状发作和诊断之间的时间可能是几年。目前尚不清楚青少年所经历的症状是否与成人不同。更好的了解可以缩短诊断过程中往往很长时间的延误。目的：本研究的目的是进一步阐明与成人相比，青少年的症状表现，以确定是否存在差异，基于手术诊断时的年龄可能影响诊断时间。研究设计：本研究是一项横断面研究，纳入患有子宫内膜异位症的青少年和妇女纵向队列。以人群为基础的队列从2个三级保健中心和周围社区招募。参与者包括手术确诊子宫内膜异位症的青少年（18岁诊断，n = 107），她们被纳入了“女性健康研究：从青春期到成年期”。参与者完成了世界子宫内膜异位症研究基金会子宫内膜异位症表型和生物银行协调项目标准临床问卷的扩展版本，包括月经史、相关症状和疼痛等项目。卡方检验或费雪精确检验应用于分类数据；连续数据采用Wilcoxon秩和检验。结果：大多数参与者（90%）经历了中度至重度的月经疼痛。诊断前平均看了3位医生，不论发病年龄（范围0-25岁）。青少年从症状到诊断的平均时间为2年，成人为5年(P
BACKGROUND: Endometriosis symptoms often start at a young age, and the time between symptom onset and endometriosis diagnosis can be several years. It is not clear whether the symptoms that are experienced by adolescents differ from adults. Better understanding may shorten the often lengthy delay in diagnosis.OBJECTIVE: The purpose of the study was to further elucidate the symptom presentation of adolescents as compared with adults to determine whether differences existed, based on age at surgical diagnosis that could impact time to diagnosis.STUDY DESIGN: This investigation was a cross-sectional study at enrollment within a longitudinal cohort of adolescents and women with endometriosis. The population-based cohort was recruited from 2 tertiary care centers and the surrounding communities. Participants included adolescents (diagnosed at 18 years old; n = 107) with surgically confirmed endometriosis who were enrolled into The Women's Health Study: From Adolescence to Adulthood. Participants completed an expanded version of the World Endometriosis Research Foundation Endometriosis Phenome and Bio-banking Harmonization Project standard clinical questionnaire that included items regarding menstrual history, associated symptoms, and pain. Chi-square or Fisher's exact tests were applied to categoric data; Wilcoxon rank sum tests were applied to continuous data.RESULTS: Most participants (90%) experienced moderate-severe menstrual pain. On average, 3 doctors were seen before diagnosis, regardless of age at presentation (range, 0-25 years). Time from symptoms to diagnosis averaged 2 years for adolescents and 5 years for adults (P