Reproductive factors, hormonal contraception, and risk of uterine leiomyomata in African-American women: A prospective study
Reproductive factors, hormonal contraception, and risk of uterine leiomyomata in African-American women: A prospective study
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DOI：
10.1093/aje/kwh016
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发表时间：
2004-01-15
影响因子：
5
通讯作者：
Rosenberg, L
中科院分区：
文献类型：
--
作者：
Wise, LA;Palmer, JR;Rosenberg, L
作者在一项针对美国黑人女性的前瞻性队列研究中评估了子宫平滑肌瘤与生殖因素和激素避孕的相关性。从1997年3月至2001年3月，作者随访了22,895名绝经前子宫完整且既往未自我报告诊断为子宫平滑肌瘤的妇女。作者使用年龄和时间分层的考克斯回归模型来估计自我报告的子宫平滑肌瘤的发病率比，经超声或子宫切除术证实，与选定的生殖和激素因素相关。在76，711人年的随访中，自我报告了2，279例超声或子宫切除术证实的子宫平滑肌瘤新病例。校正年龄、体重指数、吸烟、饮酒和其他生殖协变量后，超声或子宫切除术证实的平滑肌瘤的风险与初潮年龄、产次和首次生育年龄呈负相关，与上次生育后的年数呈正相关。超重或肥胖似乎减弱了产次与子宫肌瘤之间的负相关性。目前使用孕激素注射剂与风险呈负相关。其他形式的激素避孕没有观察到一致的模式。生育史是绝经前美国黑人妇女发生平滑肌瘤风险的重要决定因素。仅注射孕激素可降低风险。
The authors assessed the risk of uterine leiomyomata in relation to reproductive factors and hormonal contraception in a prospective cohort study of US Black women. From March 1997 through March 2001, the authors followed 22,895 premenopausal women with intact uteri and no prior self-reported diagnosis of uterine leiomyomata. The authors used age- and time-stratified Cox regression models to estimate incidence rate ratios for self-reported uterine leiomyomata, confirmed by ultrasound or hysterectomy, in association with selected reproductive and hormonal factors. During 76,711 person-years of follow-up, 2,279 new cases of ultrasound- or hysterectomy-confirmed uterine leiomyomata were self-reported. After adjustment for age, body mass index, smoking, alcohol intake, and other reproductive covariates, the risk of ultrasound- or hysterectomy-confirmed leiomyomata was inversely associated with age at menarche, parity, and age at first birth and positively associated with years since last birth. Overweight or obesity appeared to attenuate the inverse association between parity and uterine leiomyomata. Current use of progestin-only injectables was inversely associated with risk. No consistent patterns were observed for other forms of hormonal contraception. Reproductive history is an important determinant of leiomyomata risk in premenopausal US Black women. Progestin-only injectables may reduce risk.