1 Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
2 Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China.
Reprod Sci. 2019 Aug;26(8):1158-1167. doi: 10.1177/1933719118820469. Epub 2019 Jan 22.
This study aimed to investigate potential factors, especially early-life exposures, associated with endometrioma (OMA) and/or deep infiltrating endometriosis (DIE) in Chinese women.
This is a subgroup analyses of the FEELING study, which was a case-control study that investigated the clinical, lifestyle, and environmental factors associated with OMA and/or DIE in China, Russia, and France. In this subgroup analysis, the data for the Chinese participants were further analyzed using logistic regression model.
All women (N = 546) had fully completed the questionnaire. The mean age of the participants was 31.8 (range: 18-41) years. Univariable analysis showed that noncyclic chronic pelvic pain, dysmenorrhea intensity class, and whether breastfed during infancy were distributed differently between patients with OMA or DIE and those with no endometriosis (non-EM) or superficial peritoneal endometriosis (SUP; < .05). Multivariable analysis revealed that not having been breastfed was a protective factor against OMA and DIE (odds ratio [OR] = 0.33, 95% confidence interval [CI]: 0.16-0.69). Further analysis indicated not having been breastfed was a protective factor for DIE compared with non-EM (OR = 0.13, 95% CI: 0.02-0.88) and with OMA + SUP (OR = 0.19, 95% CI: 0.04-0.85) but was not a protective factor for OMA compared with non-EM (OR = 0.66, 95% CI: 0.32-1.36) and with SUP (OR = 0.63, 95% CI: 0.31-1.30).
This is the first study suggesting that not having been breastfed might protect against DIE in Chinese women.
本研究旨在探究中国女性的卵巢子宫内膜异位囊肿(OMA)和/或深部浸润型子宫内膜异位症(DIE)相关的潜在因素,尤其是生命早期暴露因素。
这是 FEELING 研究的亚组分析,该研究是一项病例对照研究,在中国、俄罗斯和法国调查了与 OMA 和/或 DIE 相关的临床、生活方式和环境因素。在这个亚组分析中,进一步使用逻辑回归模型分析中国参与者的数据。
所有女性(N=546)均完成了问卷。参与者的平均年龄为 31.8(范围:18-41)岁。单变量分析显示,非周期性慢性盆腔痛、痛经强度分级和婴儿期是否母乳喂养在 OMA 或 DIE 患者与无子宫内膜异位症(非-EM)或浅表腹膜子宫内膜异位症(SUP)患者之间存在差异(<0.05)。多变量分析显示,未母乳喂养是 OMA 和 DIE 的保护因素(比值比[OR] = 0.33,95%置信区间[CI]:0.16-0.69)。进一步分析表明,与非-EM 相比,未母乳喂养是 DIE 的保护因素(OR = 0.13,95%CI:0.02-0.88)和 OMA+SUP(OR = 0.19,95%CI:0.04-0.85),但不是 OMA 的保护因素与非-EM(OR = 0.66,95%CI:0.32-1.36)和 SUP(OR = 0.63,95%CI:0.31-1.30)。
这是第一项表明中国女性未母乳喂养可能对 DIE 具有保护作用的研究。