Mant J, Painter R, Vessey M
Department of Public Health and Primary Care. Radcliffe Infirmary, Oxford, UK.
Br J Obstet Gynaecol. 1997 May;104(5):579-85. doi: 10.1111/j.1471-0528.1997.tb11536.x.
To explore the epidemiology of uterovaginal and post-hysterectomy prolapse.
Cohort study.
Seventeen large family planning clinics in England and Scotland.
17,032 women who attended family planning clinics between 1968 and 1974, aged between 25 and 39 years at study entry.
Annual follow up by interview, postal or telephone questionnaire until July 1994. Further details on all hospital admissions were obtained from the hospital discharge summaries. All women were flagged at time of recruitment in the NHS central registers.
In-patient admission with diagnosis of prolapse (ICD codes 8th Revision 623.0-623-9).
The incidence of hospital admission with prolapse is 2.04 per 1000 person-years of risk. Age, parity, calendar period and weight were significantly associated with risk of an inpatient admission with prolapse after adjustment for principal confounding factors. Significant trends were observed with regard to smoking status and obesity (Quetelet Index) at entry to the study and risk of prolapse. Social class, oral contraceptive use and height were not significantly associated with risk of prolapse. The incidence of prolapse which required surgical correction following hysterectomy was 3.6 per 1000 person-years of risk. The cumulative risk rises from 1% three years after a hysterectomy to 5% 15 years after hysterectomy. The risk of prolapse following hysterectomy is 5.5 times higher (95% CI 3.1-9.7) in women whose initial hysterectomy was for genital prolapse as opposed to other reasons.
Among the potential risk factors that were investigated, parity shows much the strongest relation to prolapse.
探讨子宫阴道脱垂及子宫切除术后脱垂的流行病学情况。
队列研究。
英格兰和苏格兰的17家大型计划生育诊所。
1968年至1974年间在计划生育诊所就诊的17032名女性，研究开始时年龄在25至39岁之间。
通过面谈、邮寄或电话问卷进行年度随访，直至1994年7月。从医院出院小结中获取所有住院情况的进一步详细信息。所有女性在加入国民健康服务中央登记册时都被标记。
诊断为脱垂的住院情况（国际疾病分类第8版编码623.0 - 623.9）。
脱垂住院的发生率为每1000人年风险2.04例。在对主要混杂因素进行调整后，年龄、产次、日历时间段和体重与脱垂住院风险显著相关。在研究开始时的吸烟状况和肥胖程度（奎特利指数）与脱垂风险方面观察到显著趋势。社会阶层、口服避孕药使用情况和身高与脱垂风险无显著关联。子宫切除术后需要手术矫正的脱垂发生率为每1000人年风险3.6例。累积风险从子宫切除术后3年的1%上升至子宫切除术后15年的5%。初始子宫切除术因生殖器脱垂而非其他原因的女性，子宫切除术后脱垂风险高5.5倍（95%可信区间3.1 - 9.7）。
在所研究的潜在风险因素中，产次与脱垂的关系最为密切。
