Kessous Roy, Walfisch Asnat, Meirovitz Mihai, Davidson Ehud, Sergienko Ruslan, Sheiner Eyal
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, Beer Sheva, 84101, Israel.
Faculty of Health Sciences, Soroka University Medical Center, Clalit Health Services (Southern District), Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Arch Gynecol Obstet. 2017 Jan;295(1):205-210. doi: 10.1007/s00404-016-4198-3. Epub 2016 Sep 10.
To investigate whether an association exists between preterm delivery and a future risk for female malignancies.
A population-based study compared the incidence of long-term female malignancies in a cohort of women with and without a history of PTD. Deliveries occurred between the years 1988-2013, with a mean follow-up duration of 12 years. We excluded women with known genetic predisposition or malignancies prior to the index pregnancy. Malignancies investigated included ovarian, uterine, breast and cervix. Cumulative incidence was assessed using a Kaplan-Meier survival curve. A Cox proportional hazards model was used to estimate the adjusted hazard ratios (HR) for female malignancy.
During the study period, 105,033 women met the inclusion criteria; 16.8 % (n = 17,596) of the patients delivered preterm. Patients with a history of PTD did not have an increased risk of later being diagnosed with female malignancies. The results remained insignificant in a sub-analysis based on malignancy type, early PTD, induced vs. spontaneous, and number of episodes per patient. Kaplan-Meier cumulative incidence was similar between the groups, and the adjusted HR was not significant (1.04, 95 % CI 0.88-1.22; p = 0.665).
A history of PTD does not appear to elevate the risk for subsequent long-term female malignancies.
探讨早产与未来女性患恶性肿瘤风险之间是否存在关联。
一项基于人群的研究比较了有早产史和无早产史的女性队列中远期女性恶性肿瘤的发病率。分娩发生在1988年至2013年之间，平均随访时间为12年。我们排除了在本次妊娠前已知有遗传易感性或患恶性肿瘤的女性。所研究的恶性肿瘤包括卵巢癌、子宫癌、乳腺癌和宫颈癌。使用Kaplan-Meier生存曲线评估累积发病率。采用Cox比例风险模型来估计女性恶性肿瘤的调整风险比（HR）。
在研究期间，105,033名女性符合纳入标准；16.8%（n = 17,596）的患者早产。有早产史的患者后来被诊断为女性恶性肿瘤的风险并未增加。在基于恶性肿瘤类型、早期早产、引产与自然分娩以及每位患者的发作次数的亚分析中，结果仍然不显著。两组之间的Kaplan-Meier累积发病率相似，调整后的HR不显著（1.04，95%CI 0.88 - 1.22；p = 0.665）。
早产史似乎并未增加后续远期女性患恶性肿瘤的风险。
