Natural menopause among women below 50 years in India: A population-based study.
Natural menopause among women below 50 years in India: A population-based study.
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DOI：
10.4103/0971-5916.198676
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发表时间：
2016-09
期刊：
影响因子：
--
通讯作者：
Stones W
中科院分区：
文献类型：
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作者：
Pallikadavath S;Ogollah R;Singh A;Dean T;Dewey A;Stones W
更年期自然发生的年龄可能反映了营养和环境情况以及遗传因素。在这项研究中，我们审查了自然绝经作为印度和一些主要邦人口一级妇女健康的标志。使用了2007-2008年期间进行的印度地区一级家庭调查的数据，涵盖了643 944名15-49岁的已婚妇女;年龄较大的妇女不包括在这项调查中。由于在调查时并非所有该年龄组的妇女都已自然绝经，因此采用考克斯比例风险回归模型获得报告自然绝经妇女的中位年龄，不包括那些接受子宫切除术的妇女。估计了可能影响自然绝经年龄<40岁的关键社会经济和生殖变量的风险比（HR）。总体而言，约有1.5%的妇女在40岁之前绝经。在国家数据集中，与自然绝经年龄显著相关的因素包括婚姻破裂或丧偶、贫穷、穆斯林宗教信仰、“在册种姓”地位、没有接受过教育、居住在农村、从未使用过避孕药、没有做过绝育手术或堕胎、生育率低和居住在西部地区。在分别审查的五个选定国家的数据中，这些关联的强度各不相同。注意到自然绝经与社会文化、计划生育和人口统计变量之间的联系。最重要的是，这与贫穷有关，需要进一步调查因果关系。更年期提前的妇女比例可能是妇女健康的一个有用的总体指标。关于绝育对卵巢功能可能的晚期影响，数据令人放心。
The age at which menopause naturally occurs may reflect nutritional and environmental circumstances as well as genetic factors. In this study we examined natural menopause as a marker of women's health at the population level in India and in some major States. Data from the Indian District Level Household Survey (DLHS) carried out during 2007-2008 covering 643,944 ever-married women aged 15-49 yr were used; women of older ages were not included in this survey. Since not all women in this age group had achieved natural menopause at the time of survey, Cox proportional hazard regression models were employed to obtain the median age of women reporting a natural menopause, excluding those who underwent hysterectomy. Hazard ratios (HRs) were estimated for key socio-economic and reproductive variables that could potentially affect the age at natural menopause <40 yr. Overall, menopause prior to age 40 was reported by approximately 1.5 per cent of women. In the national data set, significant associations with age at natural menopause were identified with marriage breakdown or widowhood, poverty, Muslim religious affiliation, ‘scheduled caste’ status, not having received schooling, rural residence, having never used contraceptive pills, not been sterilized or had an abortion, low parity and residence in the western region. Within data from five selected States examined separately, the strength of these associations varied. Associations of natural menopause with sociocultural, family planning and demographic variables were noted. Most importantly, there was an association with poverty that would require further investigation as to causality. The proportion of women experiencing early menopause may represent a useful overall indicator of women's health. The data are reassuring with regard to possible late effects of sterilization on ovarian function.