美国印第安女性宫颈上皮内瘤变的避孕及生殖风险因素

Contraceptive and reproductive risk factors for cervical intraepithelial neoplasia in American Indian women.

作者信息

Schiff M, Miller J, Masuk M, van Asselt King L, Altobelli K K, Wheeler C M, Becker T M

机构信息

University of New Mexico School of Medicine, 2211 Lomas, NE Albuquerque, NM 87131, USA.

出版信息

Int J Epidemiol. 2000 Dec;29(6):983-90. doi: 10.1093/ije/29.6.983.

DOI:10.1093/ije/29.6.983

PMID:11101538

Abstract

OBJECTIVES

To evaluate contraceptive and reproductive risk factors for cervical intraepithelial neoplasia (CIN) in southwestern American Indian women.

METHODS

We conducted a clinic-based case-control study. Cases were American Indian women with biopsy-proven CIN I, CIN II or CIN III. Controls were from the same clinics and had normal cervical epithelium. All subjects underwent structured interviews focused on contraceptive and reproductive factors. Laboratory assays included polymerase chain reaction (PCR)-based tests for cervical human papillomavirus (HPV) infection.

RESULTS

We enrolled 628 women in the study. The strongest risk factors for CIN II/III included HPV infection (adjusted odds ratio [OR] = 7.9, 95% CI : 4.7-13.2), and low income (OR = 3.1, 95% CI : 1.7-5.7). The use of an intrauterine device (IUD) ever (OR = 3.0, 95% CI : 1.4-6.1) and currently (OR = 4.1, 95% CI : 1.1-14.6), and > or = 3 vaginal deliveries (OR = 5.2, 95% CI : 2.4-11.1) were associated with CIN II/III. History of infertility was also associated with CIN II/III (OR = 2.1, 95% CI : 1.0-4.2).

CONCLUSIONS

The data suggest that history of infertility, IUD use and vaginal deliveries were associated with CIN among American Indian women.

摘要

目的

评估美国西南部印第安女性中宫颈上皮内瘤变（CIN）的避孕及生殖风险因素。

方法

我们开展了一项基于门诊的病例对照研究。病例为经活检证实为CIN I、CIN II或CIN III的美国印第安女性。对照来自相同门诊且宫颈上皮正常。所有受试者均接受了聚焦于避孕及生殖因素的结构化访谈。实验室检测包括基于聚合酶链反应（PCR）的宫颈人乳头瘤病毒（HPV）感染检测。

结果

我们纳入了628名女性参与研究。CIN II/III的最强风险因素包括HPV感染（校正比值比[OR]=7.9，95%可信区间[CI]：4.7-13.2）以及低收入（OR=3.1，95%CI：1.7-5.7）。曾使用宫内节育器（IUD）（OR=3.0，95%CI：1.4-6.1）及当前正在使用（OR=4.1，95%CI：1.1-14.6），以及≥3次阴道分娩（OR=5.2，95%CI：2.4-11.1）均与CIN II/III相关。不孕史也与CIN II/III相关（OR=2.1，�5%CI：1.0-4.2）。