Gierach Gretchen L, Modugno Francesmary, Ness Roberta B
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh Cancer Institute, University of Pittsburgh, Pittsburgh, PA, USA.
Am J Epidemiol. 2005 Mar 1;161(5):452-61. doi: 10.1093/aje/kwi069.
While the protective nature of parity with respect to ovarian cancer has been well documented, whether a history of incomplete pregnancy affects ovarian cancer risk is uncertain. Data collected from 739 epithelial ovarian cancer cases and 1,313 community controls in the Delaware Valley from 1994 to 1998 were used to evaluate the relation between gestational length and timing of first induced or spontaneous abortion and ovarian cancer risk. Incomplete pregnancy was not associated with ovarian cancer among nulliparous women or among ever-pregnant women either before or after adjustment for relevant confounders (for nulliparous women, odds ratio (OR) = 1.12, 95% confidence interval (CI): 0.66, 1.89; for ever-pregnant women, OR = 0.95, 95% CI: 0.76, 1.18). Among unigravid women, one full-term pregnancy was more protective than an incomplete pregnancy (adjusted OR = 0.29, 95% CI: 0.15, 0.57). These results were independent of the type of pregnancy loss. Among ever-pregnant women, a spontaneous abortion before a first birth provided significant protection (adjusted OR = 0.47, 95% CI: 0.30, 0.75), while no significant effect was found for an induced abortion prior to a first birth (adjusted OR = 0.80, 95% CI: 0.44, 1.47). These data do not support an independent association between incomplete pregnancies, either spontaneous or induced, and ovarian cancer risk.
虽然怀孕次数对卵巢癌的保护作用已有充分记录,但不完全妊娠史是否会影响卵巢癌风险尚不确定。1994年至1998年期间,从特拉华河谷的739例上皮性卵巢癌病例和1313名社区对照中收集的数据,用于评估妊娠时长以及首次人工流产或自然流产时间与卵巢癌风险之间的关系。在未生育女性或曾经怀孕的女性中,无论是否对相关混杂因素进行调整,不完全妊娠与卵巢癌均无关联(未生育女性的比值比(OR)=1.12,95%置信区间(CI):0.66,1.89;曾经怀孕的女性,OR = 0.95,95% CI:0.76,1.18)。在单胎妊娠女性中,一次足月妊娠比不完全妊娠更具保护作用(调整后OR = 0.29,95% CI:0.15,0.57)。这些结果与流产类型无关。在曾经怀孕的女性中,首次分娩前的自然流产提供了显著的保护作用(调整后OR = 0.47,95% CI:0.30,0.75),而首次分娩前的人工流产未发现显著影响(调整后OR = 0.80,95% CI:0.44,1.47)。这些数据不支持自然或人工的不完全妊娠与卵巢癌风险之间存在独立关联。