Brett K M, Marsh J V, Madans J H
National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.
J Womens Health. 1997 Jun;6(3):309-16. doi: 10.1089/jwh.1997.6.309.
We describe the epidemiology of hysterectomy, overall as well as for specific indications. Data were obtained from the Epidemiologic Follow-up to the First National Health and Nutrition Examination Survey, a nationally representative cohort followed prospectively from the mid-1970s through 1992. Black and white women 25-49 years of age, interviewed during follow-up, were included in the analyses. The probability of undergoing a hysterectomy was estimated by demographic and reproductive factors. Hysterectomy as confirmed by hospital records was our main outcome measure. We found that women who had completed 9-11 years of education were more likely to have undergone a hysterectomy than were women with either more or less education. Women who had completed 9-11 years of education were also more likely to have had a hysterectomy because of menstrual problems. Three or more miscarriages, especially if caused by uterine prolapse, increased the probability of hysterectomy. Having had no live births decreased the probability of hysterectomy for menstrual disorders and uterine prolapse, but women who had their first child before age 20 were at increased risk of hysterectomy because of endometriosis. Hysterectomy appears to be associated with low education, high parity, and a history of multiple miscarriages. The influence of these factors varies depending on the primary indication for the hysterectomy.
我们描述了子宫切除术的流行病学情况，包括总体情况以及特定指征的情况。数据来自首次全国健康与营养检查调查的流行病学随访，这是一个具有全国代表性的队列，从20世纪70年代中期开始进行前瞻性跟踪，直至1992年。纳入分析的是在随访期间接受访谈的25至49岁的黑人和白人女性。根据人口统计学和生殖因素估计接受子宫切除术的概率。以医院记录证实的子宫切除术是我们的主要结局指标。我们发现，完成9至11年教育的女性比受教育程度更高或更低的女性更有可能接受子宫切除术。完成9至11年教育的女性也更有可能因月经问题而接受子宫切除术。三次或更多次流产，尤其是由子宫脱垂引起的流产，会增加子宫切除术的概率。未生育活产会降低因月经紊乱和子宫脱垂而进行子宫切除术的概率，但20岁之前生育第一胎的女性因子宫内膜异位症而接受子宫切除术的风险会增加。子宫切除术似乎与低教育程度、高生育次数和多次流产史有关。这些因素的影响因子宫切除术的主要指征而异。
