REPRODUCTIVE/CONTRACEPTIVE RISK FACTORS & ENDOMETRIOSIS

在美国，子宫内膜异位症影响了高达10%的育龄妇女。 慢性盆腔疼痛，痛经，以及可能增加的风险 不孕不育。尽管这种疾病已被确认为一项顶级研究 由美国国立卫生研究院优先考虑，病因仍在 确定的风险因素不确定，而且几乎没有可更改的风险因素。过去时 流行病学研究一直没有得出结论。 生殖或避孕史对儿童发育的影响 子宫内膜异位症。对这些风险因素的大多数研究都受到以下因素的限制 使用在不孕症手术中发现的病例，因为这些妇女可能是 所有子宫内膜异位症患者在生殖和生殖方面都是不典型的 避孕史。我们提出了一项基于人群的病例对照研究 所有育龄妇女中子宫内膜异位症的发病率 在华盛顿州西部的HMO注册，以检验这一假说 自然流产和人工流产可能会增加患上 子宫内膜异位症，考虑到可能的激素和免疫学因素 影响。子宫内膜异位症与迟发性子宫内膜异位症的关系 生育和各种类型的避孕措施将作为 井。普吉特团体卫生合作社所有18-44岁的参保者 经手术诊断为子宫内膜异位症的声音(GHC)，以及部分 仅经体检或超声检查确诊的 1996年8月至2001年4月30日期间，将确定并邀请L 参与(所有种族约750名妇女)。案件将会是 使用计算机化的记录选择，并经医疗人员核实合格 唱片。从计算机化的注册文件中随机选择的控件 将根据年龄和初级保健诊所地区的病例进行频率匹配。 数据将通过面谈的方式从病例和对照中获得，以及 人体测量；并与GHC计算机化药房连接 数据库。受试者将接受关于他们的生殖和 避孕史；包括自然流产和人工流产， 死产、活产、使用激素避孕药、宫内 器械和绝育程序；月经史；不孕症 病史；以及子宫内膜异位症的其他危险因素。

Endometriosis affects up to 10% of women of reproductive age in the U.S. with chronic pelvic pain, dysmenorrhea, and probable increased risk of infertility. Although the disease has been identified as a top research priority by the National Institutes of Health, the etiology is still uncertain, and few modifiable risk factors have been identified. Past epidemiologic research has been inconclusive about the impact of reproductive or contraceptive history on the development of endometriosis. Most studies of these risk factors have been limited by using cases identified at infertility surgery, as these women may be atypical of all endometriosis cases in terms of reproductive and contraceptive history. We propose a population-based case-control study of endometriosis among the entire population of reproductive-age women enrolled in an HMO in western Washington State to test the hypothesis that spontaneous abortion and induced abortion may increase risk of endometriosis, taking into account possible hormonal and immunological influences. The associations between endometriosis and delayed childbearing and various types of contraception will be investigated as well. All 18-44 year old enrollees of Group Health Cooperative of Puget Sound (GHC) diagnosed with endometriosis by surgery, and a portion of those diagnosed by physical examination or ultrasound examination alone between August l, 1996 and April 30, 2001 will be identified and invited to participate (approximately 750 women of all races). Cases will be selected using computerized records, and eligibility verified by medical records. Controls randomly selected from computerized enrollment files will be frequency matched to cases on age and primary care clinic region. Data will be obtained from cases and controls by in-person interview, and anthropometric measurement; and linked with the GHC computerized pharmacy database. Subjects will be interviewed regarding their reproductive and contraceptive histories; including spontaneous and induced abortions, stillbirths, livebirths, use of hormonal contraceptives, intrauterine devices, and sterilization procedures; menstrual history; infertility history; and other risk factors for endometriosis.