Hassam Tayla, Kelso Emma, Chowdary Prathima, Yisma Engida, Mol Ben W, Han Alice
Department of Obstetrics and Gynecology, Lyell McEwin Hospital, Haydown Road Elizabeth Vale, SA 5112, Australia.
Department of Obstetrics and Gynecology, Flinders Medical Centre, Flinders Drive, Bedford Park, SA 5042, Australia.
Eur J Obstet Gynecol Reprod Biol. 2020 Dec;255:222-230. doi: 10.1016/j.ejogrb.2020.10.038. Epub 2020 Oct 18.
Among Australian females, sexual assault affects 1 in 5 Australian women [1], and 1 in 10 girls [2]. While it is well known that females who experience sexual assault have an increased risk of future pelvic pain, there is limited knowledge regarding the occurrence of other gynaecological morbidity. We performed systematic review and meta-analysis for the relationship between sexual assault and gynaecological morbidity. We searched online electronic databases for observational studies on the subject published between 1993 and 2018. Search terms included variants of 'sexual abuse', 'sexual assault' and a range of gynaecological morbidity. Two independent reviewers completed study selection, quality assessment and data extraction. For each gynaecological symptom we calculated common odds ratios and 95 % confidence intervals in relation to sexual abuse history. Our search identified 1846 studies, of which 38 studies were included. A history of sexual assault was significantly associated with overall gynaecological morbidity (RR 1.42; 95%CI, 1.27-1.59), pelvic pain (RR 1.60; 95%CI, 1.36-1.89), 'dyspareunia' (pooled RR 1.74, 95%CI, 1.50-2.02); 'dysmenorrhea' (pooled RR 1.20; 95%CI, 1.11-1.29); 'abnormal menstrual bleeding' (pooled RR 1.29; 95%CI, 1.12-1.49)) and 'urinary incontinence' (pooled RR 1.31; 95%CI, 1.12-1.53)), while association was not statistically significant for 'vaginismus'(pooled RR 1.71; 95%CI, 0.87-3.36) and 'vulvodynia' (pooled RR 1.49; 95%CI, 0.76-2.91). There was no relation with 'prolapse' (pooled RR 1.10; 95%CI, 0.53-2.30). Females with a history of sexual assault have a significantly increased risk of different gynaecological disorders later in life.
在澳大利亚女性中，五分之一的澳大利亚女性（[1]）以及十分之一的女孩（[2]）遭受过性侵犯。众所周知，遭受性侵犯的女性未来患盆腔疼痛的风险会增加，但对于其他妇科疾病的发生率了解有限。我们对性侵犯与妇科疾病之间的关系进行了系统评价和荟萃分析。我们在在线电子数据库中搜索了1993年至2018年期间发表的关于该主题的观察性研究。搜索词包括“性虐待”“性侵犯”的变体以及一系列妇科疾病。两名独立评审员完成了研究筛选、质量评估和数据提取。对于每种妇科症状，我们计算了与性虐待史相关的常见比值比和95%置信区间。我们的搜索共识别出1846项研究，其中38项研究被纳入。性侵犯史与总体妇科疾病（风险比1.42；95%置信区间，1.27 - 1.59）、盆腔疼痛（风险比1.60；95%置信区间，1.36 - 1.89）、“性交困难”（合并风险比1.74，95%置信区间，1.50 - 2.02）、“痛经”（合并风险比1.20；95%置信区间，1.11 - 1.29）、“异常子宫出血”（合并风险比1.29；95%置信区间，1.12 - 1.49）以及“尿失禁”（合并风险比1.31；95%置信区间，1.12 - 1.53）显著相关，而与“阴道痉挛”（合并风险比1.71；95%置信区间，0.87 - 3.36）和“外阴痛”（合并风险比1.49；95%置信区间，0.76 - 2.91）的关联无统计学意义。与“脱垂”无关联（合并风险比1.10；95%置信区间，0.53 - 2.30）。有性侵犯史的女性在晚年患不同妇科疾病的风险显著增加。
