La Vecchia C, Decarli A, Franceschi S, Gentile A, Negri E, Parazzini F
Istituto di Ricerche Farmacologiche Mario Negri, Università di Milano, Italy.
Am J Obstet Gynecol. 1987 Nov;157(5):1108-12. doi: 10.1016/s0002-9378(87)80271-5.
The relationship between menstrual and reproductive factors and subsequent risk of coronary heart disease was investigated in a hospital-based case-control study of 202 women with acute myocardial infarction and 374 control subjects admitted for a wide spectrum of acute conditions unrelated to any of the established risk factors for ischemic heart disease. No consistent association was observed with age at menarche or menopausal status, but women with a lifelong irregular menstrual cycle pattern were at significantly elevated risk of myocardial infarction (relative risk = 1.8, 95% confidence interval = 1.1 to 2.9). No clear trend in risk was evident with the number of livebirths, miscarriages, or induced abortions. However, women whose first pregnancy or livebirth occurred before age 20 years showed elevated risks of subsequent myocardial infarction compared with nulliparous ones (relative risks = 2.3; 95% confidence interval = 1.1 to 4.9), and there was a significant trend of increasing risk with earlier first birth. These associations were evident in both younger and middle-age women and were not explained by allowance for several identified potential confounding factors.
在一项基于医院的病例对照研究中，研究了月经和生殖因素与随后患冠心病风险之间的关系。该研究纳入了202例急性心肌梗死女性患者以及374名因各种与缺血性心脏病既定风险因素无关的急性疾病而入院的对照受试者。未观察到初潮年龄或绝经状态与冠心病存在一致关联，但月经周期模式终生不规律的女性患心肌梗死的风险显著升高（相对风险=1.8，95%置信区间=1.1至2.9）。活产、流产或人工流产的次数与风险之间无明显趋势。然而，与未生育女性相比，首次怀孕或活产发生在20岁之前的女性随后患心肌梗死的风险升高（相对风险=2.3；95%置信区间=1.1至4.9），且首次生育越早，风险增加的趋势越显著。这些关联在年轻和中年女性中均很明显，且在考虑了几个已确定的潜在混杂因素后仍无法解释。
