Chow J M, Yonekura M L, Richwald G A, Greenland S, Sweet R L, Schachter J
School of Public Health, University of California, Los Angeles.
JAMA. 1990 Jun 20;263(23):3164-7.
We performed a case-control study of the association of past exposure to Chlamydia trachomatis and ectopic pregnancy with 306 case patients with an ectopic pregnancy and 266 pregnant patients who served as controls. The geometric mean antichlamydial antibody titer among cases was 75 +/- 10.2 vs 13 +/- 11.0 among controls. The matched-pair odds ratio for ectopic pregnancy and IgG titer of 1:64 or greater to C trachomatis was 3.0 (95% confidence interval, 2.1 to 4.4). Adjusting for age at first intercourse, total lifetime partners, douching, history of infertility, and parity yielded a relative risk of 2.4 (95% confidence interval, 1.5 to 3.3). Current douching remained an independent risk factor after controlling for chlamydial exposure, with an adjusted relative risk of 2.1 (95% confidence interval, 1.3 to 3.5). The population attributable fraction for chlamydial infection was 0.47 and that for douching was 0.45. The results stress the need for control of C trachomatis infections and for further study of specific douching behaviors as risk factors for ectopic pregnancy.
我们开展了一项病例对照研究，以探讨既往沙眼衣原体暴露与异位妊娠之间的关联，研究对象包括306例异位妊娠病例患者和266例作为对照的妊娠患者。病例组抗衣原体抗体几何平均滴度为75±10.2，而对照组为13±11.0。异位妊娠与沙眼衣原体IgG滴度为1:64或更高的匹配对比值比为3.0（95%置信区间为2.1至4.4）。对首次性交年龄、终生性伴侣总数、灌洗、不孕史和产次进行校正后，相对风险为2.4（95%置信区间为1.5至3.3）。在控制衣原体暴露后，当前灌洗仍是一个独立的风险因素，校正后的相对风险为2.1（95%置信区间为1.3至3.5）。衣原体感染的人群归因分数为0.47，灌洗的人群归因分数为0.45。研究结果强调了控制沙眼衣原体感染的必要性，以及进一步研究特定灌洗行为作为异位妊娠风险因素的必要性。
