College of Nursing, University of Rhode Island, Providence, RI, USA.
Care New England Medical Group/Primary Care and Specialty Services, Center for Primary Care and Prevention, Pawtucket, RI, USA.
Matern Child Health J. 2024 Oct;28(10):1793-1811. doi: 10.1007/s10995-024-03980-w. Epub 2024 Aug 27.
To compare reproductive history and postmenopausal health by birth status (preterm vs. full term) in a U.S. longitudinal study of postmenopausal women. Birth status was examined according to region of residence, household, and neighborhood socioeconomic status (SES).
In the Women's Health Initiative Observational Study, 2271 women were born prematurely (< 37 weeks). ANOVA and Chi-square determined birth status differences of reproductive history, pregnancy, and postmenopausal health. Odds ratios were calculated using either binary logistic or multinomial logistic regression. SES and U.S. region of residence were examined as potential effect modifiers.
Preterm-born women compared to term-born women had higher risk of delivering a premature infant (aOR 1.68, 95% CI [1.46, 1.93]), higher odds of later-age first pregnancy (aOR 1.27 95% CI [1.02, 1.58]), longer duration to become pregnant (> 1 year to pregnancy) (aOR 1.10 95% CI [1.01, 1.21]), more miscarriages (aOR 1.23 95% CI [1.11, 1.37]), and more pregnancy complications including hypertension (aOR 1.58 95% CI (1.13, 2.21)], preeclampsia (aOR 1.64 95% CI [1.24, 2.16]), and gestational diabetes (aOR 1.68 95% CI [1.11, 2.53]). Preterm-born women had higher odds of menopause before age 50 (aOR 1.09 95% CI [1.05, 1.14]). Post-menopause, they had higher rates of diabetes (p = .01), hypertension (p = .01), hysterectomy (p = .045), and higher Charlson Comorbidity Index scores (p = .01).
Preterm-born women had higher reproductive and pregnancy risks which when coupled with early menopause, may indicate a shorter childbearing period than term-born women. Guidelines for integration of preterm history in women's health care across the life course are needed to identify and manage their higher risk.
通过居住地区、家庭和社区社会经济地位（SES），比较美国一项绝经后妇女纵向研究中早产（<37 周）与足月产（≥37 周）的生育史和绝经后健康状况。
在妇女健康倡议观察研究中，2271 名妇女早产（<37 周）。采用方差分析和卡方检验比较出生状况对生育史、妊娠和绝经后健康的影响。采用二项逻辑或多项逻辑回归计算优势比。SES 和美国居住地区被视为潜在的效应修饰剂。
与足月产妇女相比，早产妇女早产的风险更高（aOR 1.68，95%CI [1.46，1.93]），首次妊娠年龄较大的几率更高（aOR 1.27，95%CI [1.02，1.58]），受孕时间更长（>1 年）（aOR 1.10，95%CI [1.01，1.21]），流产次数更多（aOR 1.23，95%CI [1.11，1.37]），妊娠并发症更多，包括高血压（aOR 1.58，95%CI [1.13，2.21]）、子痫前期（aOR 1.64，95%CI [1.24，2.16]）和妊娠期糖尿病（aOR 1.68，95%CI [1.11，2.53]）。早产妇女绝经前年龄<50 岁的几率更高（aOR 1.09，95%CI [1.05，1.14]）。绝经后，她们患糖尿病的比例更高（p=.01），高血压（p=.01），子宫切除术（p=.045）和更高的 Charlson 合并症指数评分（p=.01）。
早产妇女的生殖和妊娠风险更高，加上更早的绝经，可能表明她们的生育期比足月产妇女更短。需要制定贯穿女性生命周期的将早产史纳入女性健康护理的指南，以识别和管理她们的更高风险。
