Silman A J, Black C
Department of Clinical Epidemiology, London Hospital.
Ann Rheum Dis. 1988 Jun;47(6):441-4. doi: 10.1136/ard.47.6.441.
A postal questionnaire was used in a nationwide case control study of women with scleroderma to investigate whether there was an increased rate of spontaneous abortion before the onset of the disease. The results from 155 case control pairs studied showed that the women with scleroderma had twice the rate of spontaneous abortion and three times the rate of fertility problems (no successful pregnancy by the age of 35) of the control women. Previous uncontrolled studies have suggested that established scleroderma is associated with an adverse reproductive history. The results from this investigation suggest that the adverse reproductive history may antedate the clinical diagnosis of scleroderma by many years and may possibly have an aetiological role. Such a hypothesis is consistent with the, as yet unexplained, marked female excess in incidence of the disease, with the peak age of onset occurring shortly after the reproductive period.
在一项针对全国范围内硬皮病女性患者的病例对照研究中，采用了邮寄问卷调查的方式，以调查疾病发作前自然流产率是否有所增加。对155对病例对照研究的结果显示，硬皮病女性的自然流产率是对照女性的两倍，生育问题发生率（35岁时未成功受孕）是对照女性的三倍。先前的非对照研究表明，确诊的硬皮病与不良生殖史有关。本次调查结果表明，不良生殖史可能比硬皮病的临床诊断早很多年，并且可能具有病因学作用。这一假设与该病发病率中女性明显居多且发病高峰年龄在生育期后不久出现这一尚未得到解释的现象是一致的。
