非裔美国系统性红斑狼疮女性与健康女性的不孕比较：一项初步研究。

Infertility Among African American Women With Systemic Lupus Erythematosus Compared to Healthy Women: A Pilot Study.

机构信息

Rollins School of Public Health, Emory University, Atlanta, Georgia.

Rollins School of Public Health, and Emory University School of Medicine, Atlanta, Georgia.

出版信息

Arthritis Care Res (Hoboken). 2020 Sep;72(9):1275-1281. doi: 10.1002/acr.24022.

DOI:10.1002/acr.24022

PMID:31282105

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6946885/

Abstract

OBJECTIVE

Some treatments for systemic lupus erythematosus (SLE) can cause infertility, but the effect of SLE itself on fertility, particularly in African American women, is less clear. We undertook this study to examine infertility experiences in African American women with SLE compared to healthy women.

METHODS

We enrolled women ages 22-40 years living in the Atlanta metropolitan area who were diagnosed with SLE after age 17 years. Women who had ever been treated with cyclophosphamide or who had a hysterectomy were excluded. African American women ages 22-40 years who were from the same area and recruited from a marketing list were used for comparison. Women were interviewed about their reproductive histories and goals. Periods of infertility were identified as times when women had regular, unprotected sex for ≥12 months without conceiving after 20 years of age. We separately considered any period of infertility and periods of infertility when attempting pregnancy. We used Cox proportional hazards regression to examine the association between SLE and time to infertility. Models were adjusted for age, nulliparity, and smoking. An age-matched analysis was also conducted to examine periods of infertility occurring after SLE diagnosis.

RESULTS

Our sample included 75 women with SLE and 154 women without SLE. SLE was associated with any infertility (adjusted hazard ratio [HR ] 2.08 [95% confidence interval (95% CI) 1.38-3.15]), but less so with infertility when attempting pregnancy (HR 1.30 [95% CI 0.62-2.71]). The matched analysis generated similar point estimates.

CONCLUSION

Women with SLE may be more likely to experience episodes of infertility, but this may not translate to an inability to meet reproductive goals.

摘要

目的

某些治疗系统性红斑狼疮 (SLE) 的方法可能会导致不孕，但 SLE 本身对生育能力的影响，尤其是在非裔美国女性中，尚不明确。我们进行这项研究是为了调查非裔美国 SLE 女性与健康女性相比的不孕经历。

方法

我们招募了居住在亚特兰大都会区、17 岁后被诊断为 SLE 的 22-40 岁女性。排除了曾接受环磷酰胺治疗或已行子宫切除术的女性。我们还招募了来自同一地区、年龄在 22-40 岁之间的非裔美国女性作为对照。对这些女性进行了有关生育史和生育目标的访谈。不孕期被定义为女性在 20 岁以后，有规律、无保护的性行为≥12 个月而未怀孕的时期。我们分别考虑了所有不孕时期和试图怀孕时的不孕时期。我们使用 Cox 比例风险回归来检查 SLE 与不孕时间之间的关联。模型调整了年龄、未产和吸烟因素。还进行了年龄匹配分析，以检查 SLE 诊断后发生的不孕时期。

结果

我们的样本包括 75 名 SLE 女性和 154 名无 SLE 女性。SLE 与任何不孕（调整后的风险比 [HR] 2.08 [95%置信区间 (95% CI) 1.38-3.15]）有关，但与试图怀孕时的不孕关系较小（HR 1.30 [95% CI 0.62-2.71]）。匹配分析产生了类似的点估计值。