全球 1990 年至 2019 年盆腔炎性疾病和异位妊娠负担。
Global burden of pelvic inflammatory disease and ectopic pregnancy from 1990 to 2019.
机构信息
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
出版信息
BMC Public Health. 2023 Oct 2;23(1):1894. doi: 10.1186/s12889-023-16663-y.
BACKGROUND
Pelvic inflammatory disease (PID) is a widespread female public problem worldwide. And it could lead to infertility, preterm labor, chronic pelvic pain, and ectopic pregnancy (EP) among reproductive-aged women. This study aimed to assess the global burden and trends as well as the chaning correlation between PID and EP in reproductive-aged women from 1990 to 2019.
METHODS
The data of PID and EP among reproductive-aged women (15 to 49 years old) were extracted from the Global Burden of Disease study 2019. The disease burden was assessed by calculating the case numbers and age-standardized rates (ASR). The changing trends and correlation were evaluated by calculating the estimated annual percentage changes (EAPC) and Pearson's correlation coefficient.
RESULTS
In 2019, the ASR of PID prevalence was 53.19 per 100,000 population with a decreasing trend from 1990 (EAPC: - 0.50), while the ASR of EP incidence was 342.44 per 100,000 population with a decreasing trend from 1990 (EAPC: - 1.15). Globally, PID and EP burdens changed with a strong positive correlation (Cor = 0.89) globally from 1990 to 2019. In 2019, Western Sub-Saharan Africa, Australasia, and Central Sub-Saharan Africa had the highest ASR of PID prevalence, and Oceania, Eastern Europe, and Southern Latin America had the highest ASR of EP incidence. Only Western Europe saw significant increasing PID trends, while Eastern Europe and Western Europe saw increasing EP trends. The highest correlations between PID and EP burden were observed in Burkina Faso, Laos, and Bhutan. General negative correlations between the socio-demographic index and the ASR of PID prevalence and the ASR of EP incidence were observed at the national levels.
CONCLUSION
PID and EP continue to be public health burdens with a strong correlation despite slightly decreasing trends detected in ASRs globally. Effective interventions and strategies should be established according to the local situation by policymakers.
背景
盆腔炎（PID）是全球范围内广泛存在的女性公共卫生问题。它可能导致生殖年龄段女性不孕、早产、慢性盆腔痛和宫外孕（EP）。本研究旨在评估 1990 年至 2019 年期间全球 PID 负担及其变化趋势，以及 PID 与 EP 之间的相关性。
方法
从全球疾病负担研究 2019 年中提取生殖年龄段女性（15 至 49 岁）PID 和 EP 的数据。通过计算病例数和年龄标准化率（ASR）评估疾病负担。通过计算估计年变化百分比（EAPC）和 Pearson 相关系数评估变化趋势和相关性。
结果
2019 年，PID 患病率的 ASR 为 53.19/10 万，呈下降趋势，自 1990 年以来的 EAPC 为-0.50；而 EP 发病率的 ASR 为 342.44/10 万，呈下降趋势，自 1990 年以来的 EAPC 为-1.15。全球范围内，1990 年至 2019 年 PID 和 EP 负担变化呈强正相关（Cor=0.89）。2019 年，撒哈拉以南非洲西部、澳大拉西亚和撒哈拉以南非洲中部的 PID 患病率 ASR 最高，而大洋洲、东欧和南美洲南部的 EP 发病率 ASR 最高。只有西欧 PID 呈显著上升趋势，而东欧和西欧 EP 呈上升趋势。在布基纳法索、老挝和不丹，PID 和 EP 负担之间的相关性最高。在国家层面上，PID 患病率的 ASR 和 EP 发病率的 ASR 与社会人口指数之间存在普遍的负相关关系。
结论
尽管全球 ASR 呈轻微下降趋势，但 PID 和 EP 仍是公共卫生负担，两者之间存在很强的相关性。政策制定者应根据当地情况制定有效的干预和策略。
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