Daling J R, Weiss N S, Schwartz S M, Stergachis A, Wang S P, Foy H, Chu J, McKnight B, Grayston J T
Department of Epidemiology, University of Washington, Seattle.
Epidemiology. 1991 Jan;2(1):40-8. doi: 10.1097/00001648-199101000-00007.
To explore the possible association between vaginal douching and tubal pregnancy, we interviewed 273 women who were diagnosed with tubal pregnancy at Group Health Cooperative between September 31, 1981 and October 1, 1986. Their responses were compared with responses of a random sample of 722 female members of Group Health Cooperative who were assumed to be at risk of becoming pregnant at the time the cases conceived. After adjusting for differences between cases and controls with regard to other measured risk factors, we found a modest increase in risk associated with having douched more than two times per year in the past (RR = 1.3, 95% CI: 0.9-1.8). Among women who had more than one sexual partner during their lifetime, however, the risk for those who had douched more than twice per year was somewhat higher (RR = 1.6, 95% CI: 1.1-2.3). There was an indication that women who had been exposed to Chlamydia trachomatis, as indicated by elevated antibody titers, may further increase their risk for tubal pregnancy by douching (RR = 2.4, 95% CI: 0.8-7.3). The associations found in other studies between douching and pelvic inflammatory disease, and between pelvic inflammatory disease and subsequent tubal pregnancy, argue that a relation between douching and tubal pregnancy might be anticipated. Our results offer further support for this hypothesis.
为了探究阴道灌洗与输卵管妊娠之间可能存在的关联，我们对1981年9月31日至1986年10月1日期间在健康合作组织被诊断为输卵管妊娠的273名女性进行了访谈。将她们的回答与健康合作组织722名女性成员的随机样本的回答进行了比较，这些女性成员在病例受孕时被认为有怀孕风险。在对病例和对照在其他测量的风险因素方面的差异进行调整后，我们发现过去每年灌洗超过两次会使风险适度增加（相对风险RR = 1.3，95%置信区间CI：0.9 - 1.8）。然而，在一生中拥有多个性伴侣的女性中，每年灌洗超过两次的女性的风险略高（RR = 1.6，95% CI：1.1 - 2.3）。有迹象表明，抗体滴度升高表明曾接触沙眼衣原体的女性，灌洗可能会进一步增加她们患输卵管妊娠的风险（RR = 2.4，95% CI：0.8 - 7.3）。其他研究发现的灌洗与盆腔炎之间以及盆腔炎与随后的输卵管妊娠之间的关联表明，灌洗与输卵管妊娠之间可能存在关联。我们的结果为这一假设提供了进一步的支持。
