Chi I C, Galich L F, Tauber P F, Wilkens L R, Waszak C S, Siemens A J, Lippes J
Contraception. 1986 Nov;34(5):483-95. doi: 10.1016/0010-7824(86)90057-0.
This investigation, using a case-control analysis approach on an IUD data set from a less-developed country center, delineated four risk factors in patient characteristics that are associated with severe pain at interval IUD insertion. They are: higher education (greater than or equal to seven years), low-parity (1-2 live births), longer open interval (greater than or equal to 13 months) between the end of the last pregnancy and insertion, and non-breastfeeding at the time of insertion. Adjusted relative risks estimated by odds ratios are 2.1, 2.7, 2.7 and 5.0, respectively. For women with a combination of the above risk factors, they have a further increased (additive in nature) risk of suffering severe insertion pain. Similar analysis was also performed on a developed country center data set for which only the effect of education and parity could be studied; an odds ratio of 5.0 for nulliparity was obtained. The plausibility of these findings as well as their clinical and programmatic implications are discussed.
本研究采用病例对照分析方法，对来自一个欠发达国家中心的宫内节育器（IUD）数据集进行分析，确定了与放置IUD期间出现严重疼痛相关的患者特征中的四个风险因素。它们是：高等教育（七年及以上）、低生育次数（1 - 2次活产）、上次妊娠结束至放置IUD之间的间隔时间较长（13个月及以上）以及放置时未进行母乳喂养。通过比值比估计的调整后相对风险分别为2.1、2.7、2.7和5.0。对于具有上述风险因素组合的女性，她们遭受严重放置疼痛的风险会进一步增加（本质上具有累加性）。还对一个发达国家中心的数据集进行了类似分析，在该数据集中只能研究教育和生育次数的影响；未生育的比值比为5.0。本文讨论了这些发现的合理性及其临床和规划意义。
