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不孕症女性慢性子宫内膜炎危险因素分析

Analysis of the risk factors of chronic endometritis in infertile women.

作者信息

Zhang Chaoyu, Meng Shan, Tu Xiaojuan, Wang Yang, Meng Dan, Zhang Weixuan, Li Yuyan, He Wei

机构信息

Reproductive Medical Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.

出版信息

BMC Womens Health. 2025 Jul 28;25(1):378. doi: 10.1186/s12905-025-03868-z.

DOI:10.1186/s12905-025-03868-z
PMID:40722162
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12302440/
Abstract

OBJECTIVE

To identify if there is a high-risk group for chronic endometritis (CE) in infertile women.

METHODS

A retrospective single-center cohort study was conducted on 209 infertile women with CE and 843 women without. Both univariate and multivariate logistic regression were utilized to examine the risk factors for CE.

RESULTS

The risk of developing CE was found to be 1.8 times higher in multipara than in nullipara (OR = 1.794; 95% CI, 1.216-2.645; P = 0.003), and 1.7 times higher in patients with more than 6 years of infertility than in patients with less than 2 years of infertility (OR = 1.733; 95% CI, 1.040-2.887; P = 0.035). Patients with sequelae of pelvic inflammatory disease and endometrial hyperplasia have a 1.7-fold (OR = 1.702; 95% CI, 1.214-2.387; P = 0.002) and 2.2-fold (OR = 2.165; 95% CI, 1.376-3.406; P = 0.001) increased likelihood of developing chronic endometritis, respectively. The possibility of acquiring CE increases by 1.6 times for each increase in the number of deliveries (OR = 1.621; 95% CI, 1.200-2.189; P = 0.002) and 1.1 times for every additional year of infertility (OR = 1.077; 95% CI, 1.032-1.125; P = 0.001).

CONCLUSION

Based on univariable and multivariable regression analyses, significant risk factors for CE in infertile women include a history of pregnancy, prolonged infertility of more than 6 years, sequelae of pelvic inflammatory diseases, and endometrial hyperplasia. These findings may assist in identifying a high-risk group for CE within the infertile population.

摘要

目的

确定不孕女性中是否存在慢性子宫内膜炎(CE)的高危人群。

方法

对209例患有CE的不孕女性和843例未患CE的女性进行了一项回顾性单中心队列研究。采用单因素和多因素逻辑回归分析来研究CE的危险因素。

结果

经产妇发生CE的风险比初产妇高1.8倍(OR = 1.794;95%CI,1.216 - 2.645;P = 0.003),不孕6年以上的患者发生CE的风险比不孕2年以下的患者高1.7倍(OR = 1.733;95%CI,1.040 - 2.887;P = 0.035)。患有盆腔炎后遗症和子宫内膜增生的患者发生慢性子宫内膜炎的可能性分别增加1.7倍(OR = 1.702;95%CI,1.214 - 2.387;P = 0.002)和2.2倍(OR = 2.165;95%CI,1.376 - 3.406;P = 0.001)。每次分娩次数增加,发生CE的可能性增加1.6倍(OR = 1.621;95%CI,1.200 - 2.189;P = 0.002),不孕每增加一年,发生CE的可能性增加1.1倍(OR = 1.077;95%CI,1.032 - 1.125;P = 0.001)。

结论

基于单因素和多因素回归分析,不孕女性中CE的显著危险因素包括妊娠史、6年以上的长期不孕、盆腔炎后遗症和子宫内膜增生。这些发现可能有助于在不孕人群中识别出CE的高危人群。

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本文引用的文献

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Chronic endometritis and fertility: A binomial linked by microorganisms.慢性子宫内膜炎与生育能力:由微生物联系起来的二项式
Eur J Obstet Gynecol Reprod Biol. 2025 Feb;305:86-91. doi: 10.1016/j.ejogrb.2024.11.032. Epub 2024 Nov 23.
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Impact of oral antibiotic treatment for chronic endometritis on pregnancy outcomes in the following frozen-thawed embryo transfer cycles of infertile women: a cohort study of 640 embryo transfer cycles.口服抗生素治疗慢性子宫内膜炎对不孕妇女后续冻融胚胎移植周期妊娠结局的影响:一项 640 个胚胎移植周期的队列研究。
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Multiple endometrial polyps is associated with higher risk of chronic endometritis in reproductive-aged women.多发性子宫内膜息肉与生育期妇女慢性子宫内膜炎的风险增加相关。
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Impact of chronic endometritis on endometrial receptivity analysis results and pregnancy outcomes.慢性子宫内膜炎对子宫内膜容受性分析结果及妊娠结局的影响。
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Variation of diagnostic criteria in women with chronic endometritis and its effect on reproductive outcomes: A systematic review and meta-analysis.慢性子宫内膜炎女性诊断标准的差异及其对生殖结局的影响:一项系统评价和荟萃分析
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Chronic Endometritis: Old Problem, Novel Insights and Future Challenges.慢性子宫内膜炎:老问题、新见解与未来挑战
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