Kessous Roy, Davidson Ehud, Meirovitz Mihai, Sergienko Ruslan, Sheiner Eyal
aDepartment of Obstetrics and Gynecology bClalit Health Services (Southern District), Soroka University Medical Center, Faculty of Health Sciences cDepartment of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Eur J Cancer Prev. 2017 Mar;26(2):151-155. doi: 10.1097/CEJ.0000000000000228.
The aim of this study was to investigate the association between a history of prepregnancy obesity and a woman's future long-term risk for the development of female malignancies. A population-based study compared the incidence of long-term female malignancies in a cohort of consecutive women with and without a diagnosis of prepregnancy obesity. Deliveries occurred between the years 1988 and 2013, with a mean follow-up duration of 11.6 years. Women with known malignancies before the index pregnancy and known genetic predisposition for malignancy were excluded from the study. Female malignancies were divided according to specific type (ovary, uterine, breast, and uterine cervix). A Kaplan-Meier survival curve was used to estimate the cumulative incidence of malignancies. A Cox proportional hazards model was used to estimate the adjusted hazard ratios for female malignancy. During the study period, 106 251 deliveries fulfilled the inclusion criteria; 2.2% (n=2360) occurred in patients with a history of prepregnancy obesity. During the follow-up period, patients with prepregnancy obesity had a significantly increased risk for hospitalization because of female malignancies as a group and specifically ovarian and breast cancer. Using a Kaplan-Meier survival curve, patients with a previous diagnosis of prepregnancy obesity had a significantly higher cumulative incidence of female malignancies. Using a Cox proportional hazards model, adjusted for confounders such as gestational diabetes mellitus and maternal age, prepregnancy obesity remained independently associated with long-term risk for female malignancies (adjusted hazard ratio: 1.4; 95% confidence interval: 1.1-1.9; P=0.045). Prepregnancy obesity is an independent risk factor for long-term female malignancies such as ovarian and breast cancer.
本研究的目的是调查孕前肥胖史与女性未来发生恶性肿瘤的长期风险之间的关联。一项基于人群的研究比较了一组连续的有或无孕前肥胖诊断的女性中女性长期恶性肿瘤的发病率。分娩发生在1988年至2013年之间，平均随访时间为11.6年。研究排除了在本次妊娠前已知患有恶性肿瘤以及已知有恶性肿瘤遗传易感性的女性。女性恶性肿瘤根据特定类型（卵巢、子宫、乳腺和子宫颈）进行分类。采用Kaplan-Meier生存曲线来估计恶性肿瘤的累积发病率。使用Cox比例风险模型来估计女性恶性肿瘤的调整风险比。在研究期间，106251例分娩符合纳入标准；2.2%（n = 2360）发生在有孕前肥胖史的患者中。在随访期间，孕前肥胖患者因女性恶性肿瘤（作为一个整体），特别是卵巢癌和乳腺癌而住院的风险显著增加。使用Kaplan-Meier生存曲线，既往诊断为孕前肥胖的患者女性恶性肿瘤的累积发病率显著更高。使用Cox比例风险模型，在调整了妊娠期糖尿病和母亲年龄等混杂因素后，孕前肥胖仍然与女性恶性肿瘤的长期风险独立相关（调整风险比：1.4；95%置信区间：1.1 - 1.9；P = 0.045）。孕前肥胖是卵巢癌和乳腺癌等女性长期恶性肿瘤的独立危险因素。
