Silman A J
ACR Epidemiology Research Unit, University of Manchester, United Kingdom.
Am J Reprod Immunol. 1992 Oct-Dec;28(3-4):228-30. doi: 10.1111/j.1600-0897.1992.tb00799.x.
Rheumatoid arthritis (RA) is one of a number of autoimmune diseases with a marked female excess in incidence, particularly during the reproductive years. It is of interest to investigate whether reproductive factors are important in determining susceptibility to RA. However, difficulties in dating the pathological onset of the disease can make it difficult to distinguish between the reproductive influence history on disease and the influence of (subclinical) disease on reproduction. In women with RA compared to controls, there is no excess of being unmarried. Most but not all studies, show an increase in nulliparity, whereas parity rates in fertile RA women are unchanged. There is an increased rate of onset postpartum, particularly in the first three months after delivery. There is no unifying biological explanation for these epidemiological findings, and it is likely that the apparently obvious link between reproductive experience and pregnancy is complex.
类风湿关节炎（RA）是众多自身免疫性疾病之一，其发病率女性明显高于男性，尤其是在生育年龄段。研究生殖因素在决定RA易感性方面是否重要很有意义。然而，确定该疾病病理发病时间存在困难，这使得区分生殖因素对疾病的影响历史与（亚临床）疾病对生殖的影响变得困难。与对照组相比，患RA的女性未婚比例并无过高。大多数但并非所有研究表明，未生育比例有所增加，而有生育能力的RA女性的生育比例未变。产后发病几率增加，尤其是在分娩后的头三个月。对于这些流行病学发现，尚无统一的生物学解释，而且生殖经历与怀孕之间看似明显的联系可能很复杂。
