Association of spontaneous abortion with all cause and cause specific premature mortality: prospective cohort study.
Association of spontaneous abortion with all cause and cause specific premature mortality: prospective cohort study.
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DOI：
10.1136/bmj.n530
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发表时间：
2021-03-24
期刊：
影响因子：
--
通讯作者：
Chavarro JE
中科院分区：
文献类型：
--
作者：
Wang YX;Mínguez-Alarcón L;Gaskins AJ;Missmer SA;Rich-Edwards JW;Manson JE;Pan A;Chavarro JE
调查自然流产与各种原因和引起特定过早死亡(70岁前死亡)的风险之间的关系。前瞻性队列研究。护士健康研究II(1993-2017)，美国。参加护士健康研究的101名 681曾怀孕的女护士II.通过两年一次的问卷调查，确定妊娠6个月以下的终身自然流产的发生情况。根据自然流产的发生情况，用时间依赖的COX比例风险模型估计所有原因和原因特定过早死亡的危险比和95%可信区间。在24年的随访中，记录到2936人过早死亡，其中1346人死于癌症，269人死于心血管疾病。有自然流产史和无自然流产史的妇女的粗全因死亡率相当(两组均为1.24/1000人年)，但经历过3次或更多自然流产的妇女(每1000人年1.47人)和在24岁之前首次自然流产的妇女(每1000人年1.69人)的粗全因死亡率更高。相应的年龄调整危险比分别为1.02(95%可信区间0.94~1.11)、1.39(1.03~1.86)和1.27(1.11~1.46)。在调整了混杂因素和更新的饮食和生活方式因素后，自然流产的发生与随访期间过早死亡的风险比1.19(95%可信区间1.08~1.30)相关。与反复自然流产(三次或三次以上自然流产的危险比为1.59，95%可信区间为1.17-2.15；两次为1.23，1.00-1.50；一次为1.16，1.05-1.28与无流产相比)，以及妇女生殖生活早期发生的自然流产(≤23岁为1.32，1.14-1.53；24-29岁为1.16，1.01-1.33；年龄为30岁的≥与无年龄组相比分别为1.12、0.98和1.28)。当评估特定原因的死亡率时，自然流产与过早死亡在心血管疾病死亡中的关联性最强(1.48，1.09至1.99)。自然流产与癌症过早死亡无关(1.08，0.94~1.24)。自然流产与过早死亡的风险增加有关，特别是死于心血管疾病。
To investigate the association of spontaneous abortion with the risk of all cause and cause specific premature mortality (death before the age of 70). Prospective cohort study. The Nurses’ Health Study II (1993-2017), United States. 101 681 ever gravid female nurses participating in the Nurses’ Health Study II. Lifetime occurrence of spontaneous abortion in pregnancies lasting less than 6 months, determined by biennial questionnaires. Hazard ratios and 95% confidence intervals for all cause and cause specific premature death according to the occurrence of spontaneous abortion, estimated with time dependent Cox proportional hazards models. During 24 years of follow-up, 2936 premature deaths were recorded, including 1346 deaths from cancer and 269 from cardiovascular disease. Crude all cause mortality rates were comparable for women with and without a history of spontaneous abortion (1.24 per 1000 person years in both groups) but were higher for women experiencing three or more spontaneous abortions (1.47 per 1000 person years) and for women reporting their first spontaneous abortion before the age of 24 (1.69 per 1000 person years). The corresponding age adjusted hazard ratios for all cause premature death during follow-up were 1.02 (95% confidence interval 0.94 to 1.11), 1.39 (1.03 to 1.86), and 1.27 (1.11 to 1.46), respectively. After adjusting for confounding factors and updated dietary and lifestyle factors, the occurrence of spontaneous abortion was associated with a hazard ratio of 1.19 (95% confidence interval 1.08 to 1.30) for premature mortality during follow-up. The association was stronger for recurrent spontaneous abortions (hazard ratio 1.59, 95% confidence interval 1.17 to 2.15 for three or more spontaneous abortions; 1.23, 1.00 to 1.50 for two; and 1.16, 1.05 to 1.28 for one compared with none), and for spontaneous abortions occurring early in a woman’s reproductive life (1.32, 1.14 to 1.53 for age ≤23; 1.16, 1.01 to 1.33 for ages 24-29; and 1.12, 0.98 to 1.28 for age ≥30 compared with none). When cause specific mortality was evaluated, the association of spontaneous abortion with premature death was strongest for deaths from cardiovascular disease (1.48, 1.09 to 1.99). Spontaneous abortion was not related to premature death from cancer (1.08, 0.94 to 1.24). Spontaneous abortion was associated with an increased risk of premature mortality, particularly death from cardiovascular disease.
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影响因子：
6.5
作者：
Maino, Alberto;Siegerink, Bob;Rosendaal, Frits R.
通讯作者：
Rosendaal, Frits R.
DOI：
10.1034/j.1600-0412.2000.079006471.x
发表时间：
2000-06-01
影响因子：
4.3
作者：
Kristensen, P;Irgens, LM
通讯作者：
Irgens, LM
影响因子：
37.8
作者：
Parikh NI;Jeppson RP;Berger JS;Eaton CB;Kroenke CH;LeBlanc ES;Lewis CE;Loucks EB;Parker DR;Rillamas-Sun E;Ryckman KK;Waring ME;Schenken RS;Johnson KC;Edstedt-Bonamy AK;Allison MA;Howard BV
通讯作者：
Howard BV
影响因子：
13.6
作者：
Kharazmi, Elham;Lukanova, Annekatrin;Kaaks, Rudolf
通讯作者：
Kaaks, Rudolf
影响因子：
37.8
作者：
Ranthe, Mattis Flyvholm;Andersen, Elisabeth A. Wreford;Boyd, Heather A.
通讯作者：
Boyd, Heather A.