Fukushima Regional Center for the Japan Environment and Children's Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
BMC Pregnancy Childbirth. 2022 Feb 15;22(1):125. doi: 10.1186/s12884-021-04347-7.
The association of maternal preconception dysmenorrhea, especially primary dysmenorrhea, with obstetric complications has not been clearly described. Therefore, we evaluated the association of preconception dysmenorrhea with obstetric complications while accounting for the presence of pelvic pathologies.
We analyzed the data of women with singleton live births at and after 22 weeks of gestation enrolled in the Japan Environment and Children's Study, a nationwide birth cohort study, between 2011 and 2014. Participants with psychological disorders were excluded. Preconception dysmenorrhea, identified in the medical record transcripts, was categorized into mild dysmenorrhea (MD) and severe dysmenorrhea (SD). Furthermore, excluding those who had pelvic pathologies via self-reported questionnaires (endometriosis, adenomyosis, and uterine myomas) with MD and SD, preconception dysmenorrhea was categorized into mild primary dysmenorrhea (MPD) and severe primary dysmenorrhea (SPD), respectively. Using multiple logistic regression, adjusted odds ratios (aORs) for obstetric complications, including preterm birth (PTB) before 37 weeks and 34 weeks, small-for-gestational-age infants, preterm premature rupture of membrane, and hypertensive disorders of pregnancy, were calculated (considering confounders) in women with (1) MD or SD and (2) MPD or SPD. Women without preconception dysmenorrhea were used as a reference.
A total of 80,242 participants were analyzed. In women with SD, the aOR for PTB before 37 weeks was 1.38 (95% confidence interval [CI] 1.10, 1.72). In women with SPD, the aOR for PTB before 37 weeks was 1.32 (95% CI 1.02, 1.71). There was no association between women with MD or MPD and obstetric complications.
SD and SPD are significantly associated with an increased incidence of PTB before 37 weeks. Care providers should provide proper counseling regarding the association between preconception dysmenorrhea and obstetric complications. Optimal management of pregnant women with preconception dysmenorrhea to reduce the incidence of PTB should be elucidated in further studies, with detailed clinical data of pelvic pathologies.
母体孕前痛经，尤其是原发性痛经与产科并发症的关系尚未明确描述。因此，我们在考虑到盆腔病变存在的情况下，评估了孕前痛经与产科并发症的关系。
我们分析了 2011 年至 2014 年期间参加日本环境与儿童研究这一全国性出生队列研究的、22 周及以上单胎活产妇女的数据。排除有心理障碍的参与者。孕前痛经通过病历记录进行分类，分为轻度痛经（MD）和重度痛经（SD）。此外，通过自我报告问卷（子宫内膜异位症、子宫腺肌病和子宫肌瘤）排除 MD 和 SD 患者中的盆腔病变，将孕前痛经分为轻度原发性痛经（MPD）和重度原发性痛经（SPD）。使用多因素逻辑回归，计算（考虑混杂因素）有（1）MD 或 SD 和（2）MPD 或 SPD 的妇女发生产科并发症（包括 37 周前和 34 周前早产、小于胎龄儿、早产胎膜早破和妊娠高血压疾病）的调整比值比（aOR）。没有孕前痛经的妇女被用作参考。
共分析了 80242 名参与者。在 SD 妇女中，37 周前早产的 aOR 为 1.38（95%置信区间 [CI]，1.10-1.72）。在 SPD 妇女中，37 周前早产的 aOR 为 1.32（95% CI，1.02-1.71）。MD 或 MPD 妇女与产科并发症之间无关联。
SD 和 SPD 与 37 周前早产的发生率增加显著相关。医务人员应就孕前痛经与产科并发症之间的关系提供适当的咨询。在进一步的研究中，应详细阐明与孕前痛经相关的详细临床数据，以阐明盆腔病变孕妇最佳管理以降低早产发生率。
