Team RISCQ 'Clinical risk and security on women's health and perinatal health', Université Paris-Saclay, UVSQ, Montigny-le-Bretonneux, France; Primary Care and Prevention Team, CESP, INSERM, Villejuif, France; Department of Gynecology and Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France.
Department of Obstetrics and Gynaecology, La Miletrie University Hospital, Poitiers, France; INSERM CIC 1402, Poitiers University, Poitiers, France.
Reprod Biomed Online. 2024 Jul;49(1):103861. doi: 10.1016/j.rbmo.2024.103861. Epub 2024 Feb 6.
How do different warning indicators help to identify disabling dysmenorrhoea among women in young adulthood?
A nationwide cross-sectional study of women aged 18-25 years from the CONSTANCES cohort was constructed. Disability was assessed with the Global Activity Limitation Indicator question 'For the past 6 months, have you been limited in routine activities?Yes, severely limited/Yes, limited/ No, not limited'. Dysmenorrhoea pain intensity and other chronic pelvic pain symptoms (dyspareunia and non-menstrual pain) were evaluated according to questions from a specific questionnaire. Probability of disability was estimated using a logistic prediction model according to dysmenorrhoea intensity, other indicators of pelvic pain symptoms and other obvious covariates. The results of the predictive model of disabling dysmenorrhoea were presented on a nomogram.
Among 6377 women, the rate of disability was estimated at 7.5%. Increased intensity of dysmenorrhoea (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.04-1.13), increased frequency of dyspareunia (from OR 1.69, 95% CI 1.33-2.14 up to OR 3.41, 95% CI 2.16-5.38) non-menstrual chronic pelvic pain (OR 1.75, 95% CI 1.40-2.19), body mass index over 25 kg/m (OR 1.45, 95% CI 1.17-1.80) and non-use of the hormonal contraceptive pill (OR 1.29, 95% CI 1.05-1.59) were significantly associated with disability. According to the nomogram, a predicted probability of 15% or more could be chosen as a threshold. This represents almost 4.6% of young women in this sample being classified at risk of disabling dysmenorrhoea.
Dysmenorrhoea pain intensity and associated pelvic pain symptoms are warning indicators that can be measured to help screen young women who may suffer from disabling dysmenorrhoea.
不同的预警指标如何帮助识别年轻女性中的致残性痛经？
构建了一项来自 CONSTANCES 队列的 18-25 岁女性全国性横断面研究。使用“在过去 6 个月中，您是否在日常活动中受限？是，严重受限/是，受限/否，不受限”这一全球活动限制指标来评估残疾情况。痛经疼痛强度和其他慢性盆腔疼痛症状（性交困难和非经期疼痛）根据特定问卷中的问题进行评估。根据痛经强度、其他盆腔疼痛症状指标和其他明显协变量，使用逻辑预测模型估计残疾的可能性。将致残性痛经的预测模型结果呈现在列线图上。
在 6377 名女性中，残疾率估计为 7.5%。痛经强度增加（比值比[OR] 1.08，95%置信区间[CI] 1.04-1.13）、性交困难频率增加（从 OR 1.69，95% CI 1.33-2.14 增加到 OR 3.41，95% CI 2.16-5.38）、非经期慢性盆腔疼痛（OR 1.75，95% CI 1.40-2.19）、体重指数超过 25 kg/m（OR 1.45，95% CI 1.17-1.80）和不使用激素避孕药（OR 1.29，95% CI 1.05-1.59）与残疾显著相关。根据列线图，可选择预测概率为 15%或更高作为阈值。这代表该样本中几乎有 4.6%的年轻女性被归类为患有致残性痛经的风险。
痛经疼痛强度和相关的盆腔疼痛症状是可以测量的预警指标，可以帮助筛选可能患有致残性痛经的年轻女性。
