Yang Juan, Savitz David A, Dole Nancy, Hartmann Katherine E, Herring Amy H, Olshan Andrew F, Thorp John M
Department of Epidemiology, School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Paediatr Perinat Epidemiol. 2005 Jul;19(4):276-83. doi: 10.1111/j.1365-3016.2005.00655.x.
This study evaluates maternal age, race, cigarette smoking, prior spontaneous abortion, prior induced abortion, and prior preterm birth in relation to vaginal bleeding during the first two trimesters of pregnancy. Information on vaginal bleeding and predictors came from the Pregnancy, Infection, and Nutrition Study, which enrolled 2806 pregnant women at 24-29 weeks' gestation during 1995-2000 in central North Carolina, USA. Generalised estimating equations were applied to take into account repeated episodes of vaginal bleeding during pregnancy. Women with advanced maternal age and passive smoking exposure were more likely to experience more intense vaginal bleeding during pregnancy, as were women with prior preterm birth. More intense bleeding was also more likely to be reported among women with multiple prior spontaneous abortions or multiple prior induced abortions, but not among women with a single prior spontaneous or induced abortion. The combination of prior spontaneous and induced abortion showed a dose-response association with the occurrence of vaginal bleeding during pregnancy.
本研究评估了孕妇年龄、种族、吸烟情况、既往自然流产史、既往人工流产史以及既往早产史与妊娠前两期阴道出血的关系。关于阴道出血及预测因素的信息来自妊娠、感染与营养研究，该研究于1995年至2000年在美国北卡罗来纳州中部招募了2806名妊娠24 - 29周的孕妇。应用广义估计方程来考虑孕期阴道出血的反复情况。高龄孕妇和被动吸烟的孕妇在孕期更有可能经历更严重的阴道出血，既往有早产史的孕妇也是如此。在有多次既往自然流产或多次既往人工流产史的女性中，报告有更严重出血的可能性也更高，但在仅有一次既往自然流产或人工流产史的女性中并非如此。既往自然流产和人工流产的合并情况与孕期阴道出血的发生呈剂量反应关系。
