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新西兰中年女性队列研究中的儿童期虐待与更年期过渡。

Childhood maltreatment and the menopause transition in a cohort of midlife New Zealand women.

机构信息

From the Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.

Oxford Women's Health, Christchurch, New Zealand.

出版信息

Menopause. 2022 Jul 1;29(7):816-822. doi: 10.1097/GME.0000000000001976.

DOI:10.1097/GME.0000000000001976
PMID:35796554
Abstract

OBJECTIVE

Knowledge surrounding the link between childhood adversity and reproductive outcomes at midlife is limited. The present study examined the relationship between childhood maltreatment (childhood sexual abuse [CSA], childhood physical punishment [CPP]), and menopause status at age 40.

METHODS

Data were gathered from female members of the Christchurch Health and Development Study, a longitudinal birth cohort of 1,265 individuals (630 females) born in Christchurch, New Zealand in 1977. Menopause status was defined by categorizing the female cohort at age 40 as either: 1) premenopausal, or 2) peri/ postmenopausal. Retrospective reports of CSA (<16 y) and CPP (<16 y) were obtained at ages 18 and 21 years.

RESULTS

The analysis sample comprised n = 468 women with data recorded on both their menopause status at age 40 and history of maltreatment (<16 y), of whom 22% (n = 104) were classified as peri/postmenopausal. A statistically significant association was found between and severity of CSA and menopause status, but not between CPP and menopause status. The association with CSA was robust to control for both childhood confounding factors (<16 y) and intervening adult factors (18-40 y) associated with the menopause transition. In the fully adjusted model, women who had experienced severe CSA involving attempted/completed sexual penetration had twice the rate of entering peri/postmenopause compared with those who reported no CSA (39.0% vs 18.8%).

CONCLUSIONS

Severity of CSA exposure was associated with earlier menopausal transition in this female cohort. These findings are consistent with the emerging literature on the long-term health and developmental impacts of CSA.

摘要

目的

关于儿童期逆境与中年生殖结局之间联系的知识有限。本研究探讨了儿童虐待(儿童性虐待[CSA]、儿童身体虐待[CPP])与 40 岁时绝经状态之间的关系。

方法

数据来自新西兰克赖斯特彻奇健康与发展研究的女性成员,这是一个 1977 年在克赖斯特彻奇出生的 1265 名个体(630 名女性)的纵向出生队列。绝经状态通过将女性队列在 40 岁时分为:1)绝经前,或 2)围绝经期/绝经后。在 18 岁和 21 岁时获得了 CSA(<16 岁)和 CPP(<16 岁)的回顾性报告。

结果

分析样本包括 n = 468 名女性,她们的 40 岁时的绝经状态和虐待史(<16 岁)均有记录,其中 22%(n = 104)被归类为围绝经期/绝经后。发现 CSA 的严重程度与绝经状态之间存在统计学显著关联,但 CPP 与绝经状态之间没有关联。与 CSA 的关联在控制儿童期混杂因素(<16 岁)和与绝经过渡相关的成年期干预因素(18-40 岁)后仍然稳健。在完全调整模型中,经历过涉及尝试/完成性渗透的严重 CSA 的女性进入围绝经期/绝经后的比例是未报告 CSA 的女性的两倍(39.0%比 18.8%)。

结论

在这个女性队列中,CSA 暴露的严重程度与更早的绝经过渡有关。这些发现与 CSA 对长期健康和发育影响的新兴文献一致。

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