Tzonou A, Hsieh C C, Trichopoulos D, Aravandinos D, Kalandidi A, Margaris D, Goldman M, Toupadaki N
Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115.
J Epidemiol Community Health. 1993 Feb;47(1):36-9. doi: 10.1136/jech.47.1.36.
The aim was to determine whether induced abortions could increase the risk of secondary infertility.
This was a case-control study; cases were women with secondary infertility, individually matched to two controls who were currently pregnant. Each participant was interviewed by one of two medical doctors using a questionnaire that sought information on their demographic, socioeconomic, medical, and reproductive status. The data were analysed by conditional logistic regression.
The study took place in the Alexandra Maternity Hospital in Athens, Greece, in 1987-88.
84 women consecutively admitted with secondary infertility and 168 pregnant controls took part.
Eight cases and no controls reported a previous ectopic pregnancy, confirming that the occurrence of a pregnancy of this type dramatically increases the risk of secondary infertility. Furthermore, the occurrence of either induced abortions or spontaneous abortions independently and significantly increased the risk of subsequent development of secondary infertility. The logistic regression adjusted relative risks (and 95% confidence intervals) for secondary infertility were 2.1 (1.1-4.0) when there was one previous induced abortion and 2.3 (1.0-5.3) when there were two previous induced abortions. Tobacco smoking significantly increased the risk of secondary infertility, the adjusted relative risk being 3.0 (1.3-6.8).
Legalised induced abortions, as currently practised in Greece, appear to increase slightly the relative risk of secondary infertility.
旨在确定人工流产是否会增加继发性不孕的风险。
这是一项病例对照研究；病例为继发性不孕的女性，个体匹配两名当前怀孕的对照。两名医生之一使用一份问卷对每位参与者进行访谈，问卷收集有关其人口统计学、社会经济、医疗和生殖状况的信息。数据通过条件逻辑回归进行分析。
该研究于1987 - 1988年在希腊雅典的亚历山德拉妇产医院进行。
84名因继发性不孕连续入院的女性和168名怀孕对照参与了研究。
8例病例报告有既往异位妊娠，而对照中无一人报告，证实此类妊娠的发生会显著增加继发性不孕的风险。此外，人工流产或自然流产的发生独立且显著增加了随后发生继发性不孕的风险。既往有一次人工流产时，继发性不孕的逻辑回归调整相对风险（及95%置信区间）为2.1（1.1 - 4.0），既往有两次人工流产时为2.3（1.0 - 5.3）。吸烟显著增加继发性不孕的风险，调整后的相对风险为3.0（1.3 - 6.8）。
希腊目前实行的合法化人工流产似乎会略微增加继发性不孕的相对风险。
