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初潮年龄早与先兆子痫风险增加及不良新生儿结局相关:一项6年回顾性研究

Early age at menarche is associated with an increased risk of preeclampsia and adverse neonatal outcomes: a 6‑year retrospective study.

作者信息

Cheng Xuehua, Jiang Ying, Chen Xiaofeng, Huang Chaolin, Li Shaoxing

机构信息

Department of Obstetrics, The First Affiliated Hospital of Chengdu Medical College, Chengdu, 610500, China.

Department of Gynecology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, 610500, China.

出版信息

Arch Gynecol Obstet. 2024 Aug;310(2):807-815. doi: 10.1007/s00404-023-07256-6. Epub 2023 Oct 14.

Abstract

PURPOSE

Preeclampsia affects between 2 to 8% of pregnancies worldwide and is associated with significant adverse outcomes for both mothers and their offspring. The present study aims to investigate whether there is a correlation between early age at menarche and an increased risk of developing preeclampsia and experiencing adverse neonatal outcomes.

METHODS

The study involved a review of medical records of 4227 pregnant women who gave birth at The First Affiliated Hospital of Chengdu Medical College between January 2017 and December 2022. The collected data included demographic characteristics, clinical manifestations of preeclampsia, laboratory indicators, gestational complications, and neonatal outcomes. Pregnant women were categorized into four groups based on their age at menarche (≤ 12, 13, 14, and ≥ 15 years). Logistic regression analysis was conducted to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for the association between different menarche age groups and the risk of preeclampsia and adverse neonatal outcomes.

RESULTS

Pregnant women who had an age at menarche of ≤ 12 years had a higher risk of preeclampsia than women who had their menarche at 13, 14, and ≥ 15 years of age, with adjusted ORs (95% CIs) for preeclampsia of 1.00 (reference), 0.78 (0.45-0.91), 0.76 (0.59-0.88), and 0.73 (0.56-0.94), respectively. The predictive efficacy of age at menarche for preeclampsia was assessed with a sensitivity and specificity of 85.2% and 76.4%, respectively, and an AUC of 0.82. Moreover, infants born to women with an age at menarche of ≤ 12 years had a higher risk of adverse neonatal outcomes, including small for gestational age, preterm birth, low birth weight, neonatal respiratory distress syndrome, and neonatal intensive care unit admission.

CONCLUSION

Our findings suggest that an early age at menarche is associated with an increased risk of preeclampsia and adverse neonatal outcomes. This information could be useful for obstetricians to identify women at risk for preeclampsia early on and implement timely interventions to reduce the incidence of preeclampsia and associated adverse neonatal outcomes.

摘要

目的

子痫前期在全球2%至8%的妊娠中出现,与母亲及其后代的重大不良后果相关。本研究旨在调查初潮年龄早与子痫前期发病风险增加及新生儿不良结局之间是否存在关联。

方法

该研究回顾了2017年1月至2022年12月在成都医学院第一附属医院分娩的4227名孕妇的病历。收集的数据包括人口统计学特征、子痫前期的临床表现、实验室指标、妊娠并发症和新生儿结局。根据初潮年龄将孕妇分为四组(≤12岁、13岁、14岁和≥15岁)。进行逻辑回归分析,以计算不同初潮年龄组与子痫前期风险及新生儿不良结局之间关联的比值比(OR)和95%置信区间(CI)。

结果

初潮年龄≤12岁的孕妇患子痫前期的风险高于初潮年龄为13岁、14岁和≥15岁的孕妇,子痫前期的调整后OR(95%CI)分别为1.00(参考值)、0.78(0.45 - 0.91)、0.76(0.59 - 0.88)和0.73(0.56 - 0.94)。初潮年龄对子痫前期的预测效能评估显示,敏感性和特异性分别为85.2%和76.4%,曲线下面积为0.82。此外,初潮年龄≤12岁的女性所生婴儿出现新生儿不良结局的风险更高,包括小于胎龄儿、早产、低出生体重、新生儿呼吸窘迫综合征和入住新生儿重症监护病房。

结论

我们的研究结果表明,初潮年龄早与子痫前期风险增加及新生儿不良结局相关。该信息有助于产科医生早期识别子痫前期风险女性,并及时实施干预措施,以降低子痫前期及相关新生儿不良结局的发生率。

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