Okamoto K, Horisawa R, Kawamura T, Asai A, Ogino M, Takagi T, Ohno Y
Department of Public Health, Aichi Prefectural College of Nursing and Health, Nagoya, Japan.
Stroke. 2001 Dec 1;32(12):2841-4. doi: 10.1161/hs1201.099383.
We sought to examine the relationship between menstrual and reproductive factors and the risk of subarachnoid hemorrhage (SAH), using a case-control study.
Cases consisted of a consecutive series of 124 women patients with first spontaneous SAH aged 30 to 79 years and confirmed aneurysm(s) by angiography and/or CT scan. Hospital and community controls subjects were identified, matched to each case by age (+/-2 years).
Increased SAH risk was associated with (1) earlier age at menarche (adjusted odds ratio [OR]=3.24 for age <13 years compared with age >/=13 years; 95% CI, 1.25 to 4.03) and (2) nulligravidity (adjusted OR=4.23; 95% CI, 1.05 to 7.56). No significant association of SAH risk was found with regularity of menstrual cycle, age at pregnancy, age at first birth, and number of births. The greatest risk was for the combined effect of nulligravidity and earlier menarche (<13 years) (adjusted OR=6.37; 95% CI, 1.12 to 36.2).
The combined effect of several variables related to menstrual and reproductive history may exert a greater influence on risk of SAH compared with a single menstrual or reproductive variable.
我们采用病例对照研究，旨在探讨月经和生殖因素与蛛网膜下腔出血（SAH）风险之间的关系。
病例包括连续的124例年龄在30至79岁之间首次发生自发性SAH且经血管造影和/或CT扫描确诊有动脉瘤的女性患者。确定了医院和社区对照对象，并按年龄（±2岁）与每个病例进行匹配。
SAH风险增加与以下因素相关：（1）月经初潮年龄较早（月经初潮年龄<13岁与≥13岁相比，调整后的优势比[OR]=3.24；95%可信区间[CI]，1.25至4.03）；（2）未孕（调整后的OR=4.23；95%CI，1.05至7.56）。未发现SAH风险与月经周期规律、怀孕年龄、首次生育年龄及生育次数之间存在显著关联。未孕且月经初潮较早（<13岁）的联合效应风险最大（调整后的OR=6.37；95%CI，1.12至36.2）。
与单一月经或生殖变量相比，与月经和生殖史相关的几个变量的联合效应可能对SAH风险产生更大影响。
