Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Fertil Steril. 2010 Dec;94(7):2703-7. doi: 10.1016/j.fertnstert.2010.04.065. Epub 2010 Jun 8.
To evaluate whether menstrual and reproductive characteristics may influence development of uterine leiomyomata since sex steroid hormones have been hypothesized to play a role in their development.
A prospective cohort study (Nurses' Health Study II).
Participants were identified from 14 states and followed for 14 years.
PATIENT(S): A cohort of 116,609 female registered nurses ages 25-42 at baseline.
INTERVENTION(S): We obtained data on uterine leiomyomata incidence and exposures through biennial questionnaires. We calculated hazard ratios and 95% confidence intervals adjusted for known and suspected risk factors.
MAIN OUTCOME MEASURE(S): Uterine leiomyomata confirmed by ultrasound or hysterectomy.
RESULT(S): During 1,163,439 person-years of follow-up, 9,847 self-reported cases of hysterectomy- or ultrasound-confirmed uterine leiomyomata were reported. We observed a lower incidence of uterine leiomyomata with later age at menarche, longer menstrual cycles, parity, later age at first and last birth, shorter time since last birth, and breastfeeding.
CONCLUSION(S): Hormonal and anatomical changes associated with menstruation and pregnancy may influence uterine leiomyomata incidence.
评估月经和生殖特征是否会影响子宫肌瘤的发展，因为性激素被认为在其发展中起作用。
前瞻性队列研究（护士健康研究 II）。
参与者来自 14 个州，随访 14 年。
116609 名年龄在 25-42 岁的女性注册护士在基线时的队列。
我们通过每两年一次的问卷调查获得子宫肌瘤发病和暴露情况的数据。我们计算了调整已知和疑似危险因素后的风险比和 95%置信区间。
通过超声或子宫切除术证实的子宫肌瘤。
在 1163439 人年的随访期间，报告了 9847 例经自我报告的超声或子宫切除术证实的子宫肌瘤病例。我们观察到，月经初潮年龄较晚、月经周期较长、生育次数较多、首次和末次生育年龄较晚、最近一次分娩后时间较短以及母乳喂养时间较长的患者，子宫肌瘤的发病率较低。
与月经和妊娠相关的激素和解剖变化可能会影响子宫肌瘤的发病率。
