Juang Chi-Mou, Chou Pesus, Yen Ming-Shien, Twu Nae-Fong, Horng Huann-Cheng, Hsu Wei-Lun
Department of Obstetrics and Gynecology, Veterans General Hospital, Taipei, Taiwan.
Am J Perinatol. 2007 Jan;24(1):11-6. doi: 10.1055/s-2006-954959. Epub 2006 Nov 8.
Little is known about the mechanism and biochemical pathway of preterm delivery. Some drugs used to treat preterm labor are also useful for the treatment of primary dysmenorrhea. This study attempted to evaluate the association between primary dysmenorrhea and preterm delivery from an epidemiological perspective. A nested case-control study was conducted; 329 singleton preterm delivery cases were investigated, in aggregate and in subgroups (spontaneous preterm labor and preterm premature rupture of membranes). Concurrently, 329 singleton gravid women with term delivery served as controls. Medical charts and records provided information about the maternal history of dysmenorrhea, index pregnancy outcome, and demographic characteristics. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using the multiple logistic regression method. Gravid women with a history of primary dysmenorrhea had no more risk of preterm delivery than those without a history of primary dysmenorrhea (adjusted OR, 1.16; 95% CI, 0.95 to 2.19; p=0.37). However, for subgroup analysis, gravid women with severe primary dysmenorrhea were associated with an adjusted 2.73-fold risk of spontaneous preterm delivery (95% CI, 1.49 to 4.95; p=0.02), and with an adjusted 1.51-fold risk of preterm premature rupture of membranes (95% CI, 0.68 to 3.22; p=0.31). Severe primary dysmenorrhea is associated with an increased risk of spontaneous preterm delivery. A common pathophysiologic pathway may exist between these two disorders. Further in-depth biochemical and molecular studies are necessary to explore this phenomenon.
关于早产的机制和生化途径，人们了解甚少。一些用于治疗早产的药物对原发性痛经的治疗也有效。本研究试图从流行病学角度评估原发性痛经与早产之间的关联。进行了一项巢式病例对照研究；共调查了329例单胎早产病例，包括总体情况及亚组情况（自发性早产和胎膜早破早产）。同时，选取329例单胎足月分娩的孕妇作为对照。病历和记录提供了有关痛经的母亲病史、本次妊娠结局及人口统计学特征的信息。采用多元逻辑回归方法计算调整后的优势比（OR）和95%置信区间（CI）。有原发性痛经病史的孕妇发生早产的风险并不高于无原发性痛经病史的孕妇（调整后的OR为1.16；95%CI为0.95至2.19；p = 0.37）。然而，亚组分析显示，患有严重原发性痛经的孕妇发生自发性早产的调整后风险增加2.73倍（95%CI为1.49至4.95；p = 0.02），发生胎膜早破早产的调整后风险增加1.51倍（95%CI为0.68至3.22；p = 0.31）。严重原发性痛经与自发性早产风险增加有关。这两种疾病之间可能存在共同的病理生理途径。有必要进行进一步深入的生化和分子研究来探究这一现象。
