Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Am J Obstet Gynecol. 2011 Nov;205(5):476.e1-8. doi: 10.1016/j.ajog.2011.06.002. Epub 2011 Jun 12.
The purpose of this prospective study was to study the association between rotating nightshift work and endometriosis risk within the Nurses' Health Study II.
We found 89,400 women without diagnosed endometriosis at baseline; the 2062 laparoscopically confirmed cases that were documented during 16 years of follow-up evaluation formed our study population.
Overall, there was no association between rotating nightshift work and risk of endometriosis. When the cases were categorized by infertility status, risk was elevated among women with concurrent infertility and ≥5 years of rotating nightshift work (rate ratio, 1.71; 95% confidence interval, 1.18-2.49; P(trend) = .005), compared with women with no rotating nightshift work. In contrast, there was no association among women without reported infertility (P(heterogeneity) = .003).
Women who work rotating nightshifts for ≥5 years may have a modestly elevated risk of endometriosis if concurrently infertile. However, the relation between shiftwork, endometriosis, and infertility is complex, and the potential for bias because of a healthy or infertile worker effect must be considered.
本前瞻性研究旨在探讨护士健康研究 II 中轮班夜班工作与子宫内膜异位症风险之间的关联。
我们发现基线时无诊断为子宫内膜异位症的 89400 名女性；在 16 年的随访评估中，有 2062 例经腹腔镜确诊的病例构成了我们的研究人群。
总体而言，轮班夜班工作与子宫内膜异位症风险之间没有关联。当根据不孕状况对病例进行分类时，同时患有不孕和≥5 年轮班夜班工作的女性风险升高（比率比，1.71；95%置信区间，1.18-2.49；P（趋势）=.005），与没有轮班夜班工作的女性相比。相比之下，无报告不孕的女性之间没有关联（P（异质性）=.003）。
如果同时患有不孕，轮班夜班工作≥5 年的女性可能会略微增加子宫内膜异位症的风险。然而，轮班工作、子宫内膜异位症和不孕之间的关系很复杂，必须考虑到由于健康或不孕工人效应而存在的潜在偏倚。
