Moore Kristen R, Cole Stephen R, Dittmer Dirk P, Schoenbach Victor J, Smith Jennifer S, Baird Donna D
1 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.
2 Epidemiology Branch, National Institute of Environmental Health Sciences , National Institutes of Health, Research Triangle Park, North Carolina.
J Womens Health (Larchmt). 2015 Jun;24(6):489-95. doi: 10.1089/jwh.2014.5051. Epub 2015 Apr 22.
For decades, it has been hypothesized that reproductive tract infections (RTIs) are risk factors for uterine fibroids. However, only two recent studies have been conducted. We aimed to investigate the relationship between RTIs and fibroids in a large study using ultrasound screening for fibroids.
We used cross-sectional enrollment data from African American women ages 23-34 years with no previous fibroid diagnosis. RTI history was measured by self-report and fibroid status by standardized ultrasound. Secondary fibroid outcomes were size, number, and total volume. Age- and multivariable-adjusted logistic regression were used to estimate odds ratios (ORs).
In total, 1,656 women were included; 22% had fibroids. Bacterial vaginosis (BV) was associated with a 21% increased odds of fibroids [aOR 1.21, 95% confidence interval (CI) 0.93-1.58]. Chlamydia infection and pelvic inflammatory disease were associated with a 38% (aOR 0.62, 95% CI 0.40-0.97) and a 46% (aOR 0.54, 95% CI 0.25-1.17) reduced odds of having two or more fibroids, respectively. Those with a previous BV diagnosis had a 47% increased odds of having 2 or more fibroids (aOR 1.47, 95% CI 0.98-2.21) and a 41% increased odds of having a larger total fibroid volume (aOR 1.41, 95% CI 0.98-2.04).
Our study was the first to explore the relationship between RTIs and fibroid size, number, and total volume. There appeared to be no strong associations between self-reported RTIs and fibroids. Studies using serology, a biochemical measure of past infection, are needed to better investigate associations between RTIs and fibroids.
数十年来，一直有人提出生殖道感染（RTIs）是子宫肌瘤的危险因素。然而，近期仅开展了两项研究。我们旨在通过一项针对子宫肌瘤的大型超声筛查研究，调查RTIs与子宫肌瘤之间的关系。
我们使用了年龄在23 - 34岁、既往未诊断出子宫肌瘤的非裔美国女性的横断面登记数据。通过自我报告测量RTI病史，通过标准化超声测量子宫肌瘤状态。次要的子宫肌瘤结局指标为大小、数量和总体积。采用年龄和多变量调整的逻辑回归来估计优势比（ORs）。
总共纳入了1656名女性；22%患有子宫肌瘤。细菌性阴道病（BV）与子宫肌瘤的患病几率增加21%相关 [调整后优势比（aOR）为1.21，95%置信区间（CI）为0.93 - 1.58]。衣原体感染和盆腔炎分别与有两个或更多子宫肌瘤的几率降低38%（aOR为0.62，95% CI为0.40 - 0.97）和46%（aOR为0.54，95% CI为0.25 - 1.17）相关。既往诊断为BV的女性有两个或更多子宫肌瘤的几率增加47%（aOR为1.47，95% CI为0.98 - 2.21），子宫肌瘤总体积更大的几率增加41%（aOR为1.41，95% CI为0.98 - 2.04）。
我们的研究首次探讨了RTIs与子宫肌瘤大小、数量和总体积之间的关系。自我报告的RTIs与子宫肌瘤之间似乎没有很强的关联。需要使用血清学（一种过去感染的生化测量方法）进行研究，以更好地调查RTIs与子宫肌瘤之间的关联。
