| Summary: | 碩士 === 國立陽明大學 === 公共衛生研究所 === 97 === Objective: To evaluate the risk of preterm delivery in patients who had adenomyosis.
Design A 1: 2 nested case-control study
Setting:Tertiary-care institution.
Population: A base cohort population of 2138 pregnant women who attended routine prenatal checkup between July 1999 and June 2005 were enrolled.
Methods: From this base cohort population, we identified and sampled all women who delivered prior to the completion of 37 weeks gestation (preterm delivery cases). Concurrently, singleton gravid women with normal uterus, matched with age and body mass index were served as controls. Preterm delivery cases were further classified into two categories: spontaneous preterm delivery cases and preterm premature rupture of membranes (PPROM) cases.
Main outcome measures: Comparison of risk of preterm delivery between gravid women with adenomyosis and without adenomyosis.
Results: One-hundred and four preterm delivery case subjects and 208 control subjects were assessed. Overall, gravid women with adenomyosis were associated with significantly increased risk of preterm delivery (adjusted OR 1.91, 95% CI 1.26 – 4.46, P = 0.028). For subgroup analysis, gravid women with adenomyosis were associated with an adjusted 1.83-fold risk of spontaneous preterm delivery (95% CI 1.32 – 4.28, P = 0.012), and with an adjusted 1.94-fold risk of preterm premature rupture of membranes (95% CI 1.39 – 2.96, P = 0.031).
Conclusion:Gravid women with adenomyosis were associated with increased risk of both spontaneous preterm delivery and preterm premature rupture of membranes. A common pathophysiologic pathway may exist between these disorders. Further in-depth biochemical and molecular studies are necessary to explore this phenomenon.
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