Department of Anthropology, University of Delhi, Delhi, India.
Front Public Health. 2022 Dec 16;10:1065081. doi: 10.3389/fpubh.2022.1065081. eCollection 2022.
Despite indications of a rapid increase in the number of hysterectomies performed in India, very few studies have methodically investigated the rate and determinants of the incidence of hysterectomy. The present study aims to estimate the rate of incidence of hysterectomy and identify predictors/determinants of incident hysterectomy in a cohort of North Indian women.
In the present study, a cohort of 1,009 ever-married North Indian women (aged 30-75 years) was followed up after a median of 8.11 years. Those hysterectomized at the baseline (63) were excluded; and of the rest 946 participants, 702 (74.2%) could be successfully followed-up. During the baseline assessment, data about sociodemographic variables, reproductive history, menopausal status, physiological health, and selected blood biochemicals were collected. During the end-line assessment, data about sociodemographic variables, current menopausal status, and incident hysterectomy were recorded.
The overall rate of incidence of hysterectomy was found to be 11.59 per 1,000 women-years, in the study population. Interestingly, the incidence rates were found to be similar among pre- and post-menopausal women. Further, while late age at menarche was found to be negatively associated with incident hysterectomy, folate repletion and high triglyceride (TG) at the baseline were found to be positively associated.
High rate of incident hysterectomy in the studied population points toward the huge burden of gynecological morbidity and the unavailability of non-invasive protocols. Such a situation warrants immediate policy intervention. Further, maintaining TG and folate within normal physiological ranges may be beneficial in gynecological ailments necessitating hysterectomy.
尽管有迹象表明印度进行的子宫切除术数量迅速增加，但很少有研究系统地调查子宫切除术的发生率及其决定因素。本研究旨在评估印度北部妇女队列中子宫切除术的发生率，并确定子宫切除术的预测因素/决定因素。
本研究对 1009 名已婚的印度北部妇女（年龄 30-75 岁）进行了随访，中位随访时间为 8.11 年。排除基线时已行子宫切除术的 63 名妇女；其余 946 名参与者中，有 702 名（74.2%）成功随访。在基线评估中，收集了社会人口统计学变量、生育史、绝经状态、生理健康和部分血液生化指标的数据。在终线评估中，记录了社会人口统计学变量、当前绝经状态和新发子宫切除术的数据。
研究人群中，子宫切除术的总发生率为每 1000 名妇女年 11.59 例。有趣的是，绝经前和绝经后妇女的发生率相似。此外，虽然初潮年龄较晚与新发子宫切除术呈负相关，但基线时补充叶酸和高甘油三酯（TG）与新发子宫切除术呈正相关。
研究人群中较高的新发子宫切除术率表明妇科发病率负担巨大，且缺乏非侵入性方案。这种情况需要立即采取政策干预。此外，将 TG 和叶酸维持在正常生理范围内可能有益于需要子宫切除术的妇科疾病。
