Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand.
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
BJOG. 2018 Nov;125(12):1532-1539. doi: 10.1111/1471-0528.15247. Epub 2018 May 21.
To estimate the prevalence of pelvic pain and model associations with potential demographic, obstetric, gynaecological and psychosocial determinants.
DESIGN, SETTING AND SAMPLE: A cohort study of women born between 1972 and 1973 in Dunedin, New Zealand, most recently assessed when aged 38 years (95% of survivors retained); 429 women were eligible for analysis.
Women self-completed reproductive health questionnaires at ages 21, 26, 32 and 38 years, with questions on dysmenorrhoea at ages 13 and 15, and on all pelvic pain at age 38. Prevalence and 95% confidence intervals (CI) were calculated and Poisson regression used to model associations.
The prevalence of pain and adjusted relative risks (ARR) for potential explanatory factors.
Over half (54.5%, 95% CI 49.7-59.3%) of women experienced pelvic pain in the past 12 months at age 38. Dysmenorrhoea was reported by 46.2% (41.3-51.3%), dyspareunia by 11.6% (8.7-15.2%) and other pelvic pain (OPP) by 17.3% (13.8-21.2%). After adjusting for multiple factors, pregnancy (ARR 0.60, 95% CI 0.32-1.13) and childbirth (ARR 0.52, 95% CI 0.25-1.09) were borderline protective for dyspareunia and OPP, respectively. However, childbirth was not associated with dysmenorrhoea (ARR 0.97, 95% CI 0.74-1.28). Dysmenorrhoea and dyspareunia were strongly associated, and both were associated with endometriosis.
Our data confirm that female pelvic pain is common, and suggest common gynaecological and obstetric causal pathways, but there was no strong evidence supporting a benefit of childbirth for dysmenorrhoea. Further research on obstetric events and pelvic pain is needed, with both being common experiences.
Pelvic pain was common at age 38, especially dysmenorrhoea (46.2%), and no improvement was detected following childbirth.
估计盆腔疼痛的流行率，并建立与潜在人口统计学、产科、妇科和心理社会决定因素的关联模型。
设计、地点和样本：这是一项对 1972 年至 1973 年期间在新西兰达尼丁出生的女性进行的队列研究，最近一次评估是在她们 38 岁时（95%的幸存者保留）；共有 429 名女性符合分析条件。
女性在 21、26、32 和 38 岁时自行完成生殖健康问卷，在 13 岁和 15 岁时询问痛经情况，并在 38 岁时询问所有盆腔疼痛情况。计算了疼痛的流行率和 95%置信区间（CI），并使用泊松回归来建立关联模型。
疼痛的流行率和潜在解释因素的调整相对风险（ARR）。
超过一半（54.5%，95%CI 49.7-59.3%）的女性在 38 岁时在过去 12 个月内经历过盆腔疼痛。报告痛经的占 46.2%（41.3-51.3%），性交痛占 11.6%（8.7-15.2%），其他盆腔疼痛（OPP）占 17.3%（13.8-21.2%）。调整多种因素后，妊娠（ARR 0.60，95%CI 0.32-1.13）和分娩（ARR 0.52，95%CI 0.25-1.09）对性交痛和 OPP 分别具有边缘保护作用。然而，分娩与痛经无关（ARR 0.97，95%CI 0.74-1.28）。痛经和性交痛密切相关，两者均与子宫内膜异位症有关。
我们的数据证实，女性盆腔疼痛很常见，并且提示存在共同的妇科和产科因果途径，但没有强有力的证据支持分娩对痛经有益。需要进一步研究产科事件和盆腔疼痛，因为它们都是常见的经历。
盆腔疼痛在 38 岁时很常见，尤其是痛经（46.2%），而且分娩后没有改善。
