初潮时的年龄与不孕症之间的关联:观察性研究的系统综述和元分析
Mahmood Moosazadeh1, Amir-Hassan Bordbari2, Seyyed Mohammad Hashemi3
1Gastrointestinal Cancer Research Center, Non-Communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, Iran.
Contraception and reproductive medicine
|February 25, 2025
概括
晚期初潮,即15岁后的月经开始,与不孕症风险增加有关,特别是初级不孕症. 早期初潮没有与不孕症有显著的关联. 建议进行进一步的研究.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 初潮时的年龄是生殖发育的关键指标.
- 早期和晚期初潮都与不良健康结果有关.
- 初潮时间和不孕症风险之间的关系需要进一步澄清.
研究的目的:
- 调查初潮时的年龄 (早期,正常,晚期) 与不孕症风险之间的关联.
- 进行现有研究的元分析,以量化这种关系.
- 探索潜在的剂量反应关系,并确定受影响的特定不孕症类型.
主要方法:
- 一个系统的审查和元分析,遵循PRISMA指南.
- 在主要数据库 (PubMed,Scopus,Web of Science,Embase,Cochrane) 进行全面的文献搜索.
- 用于估计几率比率 (OR) 和95%置信区间 (CI) 的随机效应模型;评估异质性和偏差.
主要成果:
- 对18项研究 (21项证据) 的元分析发现,初潮早期或晚期与一般不孕症之间没有总体显著的关联.
- 亚组分析显示,初潮晚期和初级不孕症之间存在显著的关联 (OR: 1.98,95% CI: 1.02-3.85).
- 与晚期初潮相比,初潮早期显示出对初级不孕不育的保护作用 (OR:0.59,95% CI:0.36-0.97).
结论:
- 虽然整体不孕不育风险没有显著影响,但晚期初潮是初级不孕不育的潜在风险因素.
- 可能存在剂量反应关系,晚期初潮与更高的不育率相关.
- 这些发现强调了监测初经时间对于生殖健康评估的重要性.
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