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中医视角下的女性孕前健康模式对生育结局的预测作用。

Women's preconception health patterns in traditional Chinese medicine as a predictor of fertility outcomes.

机构信息

School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China; Center for East-West Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90024, USA.

Department of Obstetrics & Gynecology, David Geffen School of Medicine, University of California, Los Angeles, CA 90024, USA.

出版信息

J Integr Med. 2020 May;18(3):222-228. doi: 10.1016/j.joim.2020.01.006. Epub 2020 Jan 21.

Abstract

OBJECTIVE

To examine the association between traditional Chinese medicine (TCM), preconception health patterns and fertility outcomes.

METHODS

A community-based prospective cohort study was conducted in China. A total of 3012 newly married women who were willing to conceive within 2 years were enrolled in the study and took National Free Prepregnancy Checkups (NFPC). A reliably structured self-rating scale was used to measure the TCM preconception health patterns of the enrolled women. A 3-year follow-up was conducted to obtain the fertility outcomes, including pregnancy rate, time to pregnancy, spontaneous miscarriage and newborn status. Statistical analyses were conducted using Chi-square or Fisher's exact tests, logistic regression models, general linear models and the Cox proportional hazard model.

RESULTS

The fertility outcomes showed no statistic correlations to the terms of NFPC in this population. Approximately a half of the women (46.66%) had unhealthy patterns. Women with qi & blood-deficiency (odds ratio [OR] = 35.19, 95% confidence interval [CI] = 1.55-801.15) or qi-stagnation (OR = 4.55, 95% CI = 0.90-23.06) pattern took a longer time to get pregnant, and those with qi-stagnation (OR = 2.05, 95% CI = 1.1-3.82) or yang-deficiency (OR = 1.91, 95% CI = 1.12-3.25) pattern had a higher risk of spontaneous miscarriage.

CONCLUSION

Three unhealthy TCM patterns during the preconception period might be risk factors for low fecundity or poor pregnancy outcomes. The TCM preconception pattern identification may provide a convenient and effective way to screen for potential pregnancy risks beyond the NFPC. Further, appropriate interventions based on the TCM preconception health patterns are needed to improve quality in women's fecundability and birth outcomes.

摘要

目的

探讨中医(TCM)、孕前健康模式与生育结局的关系。

方法

在中国进行了一项基于社区的前瞻性队列研究。共纳入 3012 名愿意在 2 年内怀孕的新婚妇女,并进行国家免费孕前检查(NFPC)。采用可靠的结构化自评量表测量纳入妇女的 TCM 孕前健康模式。进行了为期 3 年的随访,以获得生育结局,包括妊娠率、受孕时间、自然流产和新生儿状况。采用卡方检验或 Fisher 精确检验、logistic 回归模型、广义线性模型和 Cox 比例风险模型进行统计分析。

结果

在该人群中,生育结局与 NFPC 无统计学关联。大约一半的妇女(46.66%)存在不健康模式。气血不足(比值比 [OR] = 35.19,95%置信区间 [CI] = 1.55-801.15)或气滞(OR = 4.55,95% CI = 0.90-23.06)模式的女性受孕时间较长,气滞(OR = 2.05,95% CI = 1.1-3.82)或阳虚(OR = 1.91,95% CI = 1.12-3.25)模式的女性自然流产风险较高。

结论

孕前三个不健康的 TCM 模式可能是生育能力低或妊娠结局不良的危险因素。TCM 孕前模式识别可能为 NFPC 之外的潜在妊娠风险提供一种方便有效的筛查方法。此外,需要根据 TCM 孕前健康模式进行适当的干预,以提高女性生育能力和生育结局的质量。

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