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反复妊娠丢失与中年新发关节炎:一项对全国妇女健康研究的探索性纵向分析。

Recurrent pregnancy loss and incident arthritis in midlife: an exploratory longitudinal analysis of the Study of Women's Health Across the Nation.

机构信息

Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.

Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada; Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada.

出版信息

Ann Epidemiol. 2022 Dec;76:61-67. doi: 10.1016/j.annepidem.2022.10.002. Epub 2022 Oct 17.

Abstract

PURPOSE

To explore the association between recurrent pregnancy loss (RPL) and incident arthritis in midlife women.

METHODS

We analyzed the U.S. Study of Women's Health Across the Nation, a multi-ethnic cohort following pre- or peri‑menopausal women, using data from baseline up to the tenth annual follow-up visit. Discrete survival analysis was used to estimate adjusted hazard ratios and 95% confidence intervals for risk of incident arthritis at annual intervals in women with versus without RPL.

RESULTS

Of the 2159 participants analyzed, 8.5% reported a history of RPL. Cumulative incidence of arthritis was 43.3% in women with RPL and 40.1% in women without RPL, though differences between groups varied over time. Significant associations were observed only at visits three to seven, with the strongest associations at visits four to six. The adjusted hazard ratios (95% confidence intervals) were 1.80 (1.30-2.50) at visit 4 (median age = 50 years), 1.95 (1.38-2.75) at visit 5 (median age = 51 years), and 1.82 (1.28-2.58) at visit 6 (median age = 52 years).

CONCLUSIONS

Women with previous RPL may have elevated risk of arthritis specifically when entering their 50s, on average. Additional research is needed to determine whether women with a history of RPL may benefit from early detection of arthritis in midlife.

摘要

目的

探讨复发性妊娠丢失(RPL)与中年女性新发关节炎之间的关联。

方法

我们分析了美国妇女健康全国研究,这是一项多民族队列研究,对绝经前或围绝经期女性进行随访,使用基线数据直至第十次年度随访。离散生存分析用于估计 RPL 女性与无 RPL 女性每年新发关节炎的风险调整后的危险比和 95%置信区间。

结果

在分析的 2159 名参与者中,8.5%报告有 RPL 病史。RPL 女性的关节炎累积发病率为 43.3%,无 RPL 女性为 40.1%,但两组之间的差异随时间变化。仅在第 3 至 7 次就诊时观察到显著关联,第 4 至 6 次就诊时关联最强。调整后的危险比(95%置信区间)分别为第 4 次就诊时 1.80(1.30-2.50)(中位年龄 50 岁)、第 5 次就诊时 1.95(1.38-2.75)(中位年龄 51 岁)和第 6 次就诊时 1.82(1.28-2.58)(中位年龄 52 岁)。

结论

平均而言,有 RPL 病史的女性可能会出现关节炎风险升高,特别是进入 50 多岁时。需要进一步研究以确定是否有 RPL 病史的女性可能受益于中年及早发现关节炎。

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