Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health, Cheongju, 28159, Republic of Korea.
Department of Food and Nutrition, Seoul National University, Seoul, 08826, Republic of Korea.
BMC Womens Health. 2023 Jun 9;23(1):305. doi: 10.1186/s12905-023-02447-4.
Uterine leiomyomata (UL) are benign smooth muscle tumors that may cause significant morbidity in women of reproductive age. This study aimed to investigate the relationship of menstrual and reproductive factors with the risk of UL in premenopausal women.
This prospective study included 7,360 premenopausal women aged 22-48 years who were part of the Korea Nurses' Health Study. Information on the menstrual cycle and reproductive history was assessed between 2014 and 2016, and self-reported cases of UL were obtained through 2021. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs).
During 32,072 person-years of follow-up, 447 incident cases of UL were reported. After adjusting for other risk factors, women with late age at menarche had a lower incidence of UL (≥ 16 vs. 12-13 years: HR 0.68; 95% CI 0.47-0.99; p for trend = 0.026). The risk of UL was inversely associated with current menstrual cycle length (≥ 40 or too irregular to estimate vs. 26-31 days: HR 0.40; 95% CI 0.24-0.66) and cycle length at ages 18-22 years (HR 0.45; 95% CI 0.31-0.67; p for trend < 0.001, each). Parous women had lower risk of UL than nulliparous women (HR 0.40; 95% CI 0.30-0.53) and women who were aged 29-30 years at first birth had a lower risk of UL than those who were aged ≤ 28 years at first birth (HR 0.58; 95% CI 0.34-0.98). There was no significant association of the number of births or breastfeeding with the risk of UL among parous women. Neither a history of infertility nor oral contraceptive use was associated with the risk of UL.
Our results suggest that age at menarche, menstrual cycle length, parity, and age at first birth are inversely associated with the risk of UL in premenopausal Korean women. Future studies are warranted to confirm the long-term effects of menstrual and reproductive factors on women's health.
子宫肌瘤（UL）是良性平滑肌肿瘤，可导致育龄期妇女出现严重的发病率。本研究旨在探讨月经和生殖因素与绝经前妇女 UL 风险的关系。
本前瞻性研究纳入了年龄在 22-48 岁的 7360 名绝经前妇女，她们是韩国护士健康研究的一部分。在 2014 年至 2016 年期间评估了月经周期和生殖史信息，并通过 2021 年获得了 UL 的自我报告病例。使用 Cox 比例风险模型估计风险比（HR）和 95%置信区间（CI）。
在 32072 人年的随访期间，报告了 447 例 UL 事件。在校正其他危险因素后，初潮年龄较大的女性 UL 发生率较低（≥16 岁比 12-13 岁：HR 0.68；95%CI 0.47-0.99；趋势 p 值=0.026）。UL 风险与当前月经周期长度（≥40 天或不规则难以估计 vs. 26-31 天：HR 0.40；95%CI 0.24-0.66）和 18-22 岁时的周期长度呈负相关（HR 0.45；95%CI 0.31-0.67；趋势 p 值<0.001，每一项）。与初产妇相比，经产妇 UL 风险较低（HR 0.40；95%CI 0.30-0.53），初产年龄为 29-30 岁的女性 UL 风险低于初产年龄≤28 岁的女性（HR 0.58；95%CI 0.34-0.98）。经产妇的生育次数或母乳喂养与 UL 风险之间无显著关联。不孕史或口服避孕药的使用与 UL 风险无关。
我们的研究结果表明，初潮年龄、月经周期长度、产次和初产年龄与绝经前韩国女性 UL 风险呈负相关。需要进一步的研究来证实月经和生殖因素对女性健康的长期影响。
