Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico.
Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA.
Paediatr Perinat Epidemiol. 2022 May;36(3):347-355. doi: 10.1111/ppe.12866. Epub 2022 Feb 16.
Retrospective studies suggest that menstrual cycle length may be a risk marker of adverse pregnancy outcomes, but this evidence is susceptible to recall bias.
To evaluate the prospective association between menstrual cycle length and the risk of adverse pregnancy outcomes.
Secondary analysis of 2046 women enrolled in Project Viva at ~10 weeks of gestation and followed through delivery. The exposure was menstrual cycle length. The outcomes included gestational glucose tolerance (gestational diabetes/impaired glucose tolerance [GDM/IGT] and isolated hyperglycaemia), hypertensive disorders of pregnancy (gestational hypertension/preeclampsia), gestational weight gain, birthweight-for-gestational age z-scores (BWZ) categorised in tertiles, preterm birth and birth outcome (live birth and pregnancy loss). We used modified Poisson and multinomial logistic regression adjusted for age, race/ethnicity, parity, age at menarche and pre-pregnancy body mass index.
Mean (SD) age at enrolment was 32.1 (4.9) years. Most women (74.3%) had a cycle length of 26-34 days (reference group), 16.2% reported short cycles (≤25 days), and 9.5% reported long/irregular cycles (≥35 days/too irregular to estimate). Compared with the reference group, women with short cycles had lower odds of GDM/IGT (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.28, 0.89), whereas women with long/irregular cycles had higher odds (OR 1.72, 95% CI 1.04, 2.83). Additionally, women with short cycles had higher odds of having a newborn in the lowest tertile of BWZ (OR 1.45, 95% CI 1.06, 1.98). There was a U-shaped relation between cycle length and preterm birth with both short (relative risk [RR] 1.49, 95% CI 0.98, 2.27) and long/irregular (RR 2.04, 95% CI 1.30, 3.20) cycles, associated with a higher risk.
Variation in menstrual cycle length may be a risk marker of GDM/IGT, lower birth size and preterm birth and flag women who may benefit from targeted monitoring and care before and during pregnancy.
回顾性研究表明，月经周期长度可能是不良妊娠结局的风险标志物，但这一证据易受回忆偏倚的影响。
评估月经周期长度与不良妊娠结局风险之间的前瞻性关联。
对在妊娠约 10 周时登记参加 Viva 项目的 2046 名女性进行二次分析，并随访至分娩。暴露因素为月经周期长度。结局包括妊娠葡萄糖耐量（妊娠期糖尿病/糖耐量受损[GDM/IGT]和孤立性高血糖）、妊娠高血压疾病（妊娠期高血压/子痫前期）、妊娠体重增加、出生体重-胎龄 z 评分（BWZ）分为三分位、早产和分娩结局（活产和妊娠丢失）。我们使用修正泊松和多变量逻辑回归，调整了年龄、种族/民族、产次、初潮年龄和孕前体重指数。
登记时的平均（SD）年龄为 32.1（4.9）岁。大多数女性（74.3%）的周期长度为 26-34 天（参考组），16.2%报告短周期（≤25 天），9.5%报告长/不规则周期（≥35 天/不规则无法估计）。与参考组相比，短周期的女性发生 GDM/IGT 的几率较低（比值比[OR]0.50，95%置信区间[CI]0.28，0.89），而长/不规则周期的女性发生 GDM/IGT 的几率较高（OR 1.72，95% CI 1.04，2.83）。此外，短周期的女性新生儿 BWZ 处于最低三分位的几率较高（OR 1.45，95% CI 1.06，1.98）。周期长度与早产之间呈 U 形关系，短周期（相对风险[RR]1.49，95% CI 0.98，2.27）和长/不规则周期（RR 2.04，95% CI 1.30，3.20）均与较高的风险相关。
月经周期长度的变化可能是 GDM/IGT、较低的出生体重和早产的风险标志物，并提示可能需要在妊娠前和妊娠期间进行有针对性的监测和护理的女性。
