PDF(Pubmed)
Abstract：
OBJECTIVE: There is a secular trend towards earlier age of menarche in the US and globally. Earlier age at menarche (AAM) has been associated with metabolic disorders that increase risk for preterm delivery (PTD), yet no studies in the US have investigated whether AAM influences risk of PTD. This study tested the hypothesis that AAM is associated with PTD.
METHODS: A case-control study.
METHODS: The Boston Medical Center (BMC) in Boston, Massachusetts.
METHODS: 8264 mother-newborn dyads enrolled at birth at BMC between 1998 and 2019, of which 2242 mothers had PTD (cases) and 6022 did not have PTD (controls).
METHODS: Multivariable-adjusted logistic regression models and restricted cubic splines were used to examine the association between AAM and risk of PTD. The combined impact of AAM and age at delivery on the risk of PTD was also examined.
METHODS: Preterm delivery and gestational age (GA) was defined by maternal last menstrual period and early ultrasound documented in medical records.
RESULTS: Maternal age at delivery was 28.1 ± 6.5 years and AAM was 12.85 ± 1.86 years. Multivariable-adjusted cubic spline suggested an inverse dose-response association of AAM with odds of PTD and, consistently, a positive association with GA. A 1-year earlier AAM was associated with 5% (95% CI 2%-8%) higher odds of PTD, after adjustment for maternal year of birth, parity, maternal place of birth, education, smoking status and Mediterranean-style diet score. The association between AAM and PTD was stronger among older mothers whose age at delivery was ≥35 years.
CONCLUSIONS: Earlier AAM is associated with higher odds for PTD, and this association is stronger among women at advanced reproductive age.
METHODS: A case-control study.
METHODS: The Boston Medical Center (BMC) in Boston, Massachusetts.
METHODS: 8264 mother-newborn dyads enrolled at birth at BMC between 1998 and 2019, of which 2242 mothers had PTD (cases) and 6022 did not have PTD (controls).
METHODS: Multivariable-adjusted logistic regression models and restricted cubic splines were used to examine the association between AAM and risk of PTD. The combined impact of AAM and age at delivery on the risk of PTD was also examined.
METHODS: Preterm delivery and gestational age (GA) was defined by maternal last menstrual period and early ultrasound documented in medical records.
RESULTS: Maternal age at delivery was 28.1 ± 6.5 years and AAM was 12.85 ± 1.86 years. Multivariable-adjusted cubic spline suggested an inverse dose-response association of AAM with odds of PTD and, consistently, a positive association with GA. A 1-year earlier AAM was associated with 5% (95% CI 2%-8%) higher odds of PTD, after adjustment for maternal year of birth, parity, maternal place of birth, education, smoking status and Mediterranean-style diet score. The association between AAM and PTD was stronger among older mothers whose age at delivery was ≥35 years.
CONCLUSIONS: Earlier AAM is associated with higher odds for PTD, and this association is stronger among women at advanced reproductive age.
摘要：
目的：在美国和全球范围内，月经初潮的年龄都有长期趋势。初潮年龄较早（AAM）与代谢紊乱有关，代谢紊乱会增加早产（PTD）的风险。然而,美国尚无研究调查AAM是否影响PTD风险.这项研究检验了AAM与PTD相关的假设。
方法：病例对照研究。
方法：波士顿的波士顿医疗中心（BMC），马萨诸塞州。
方法：在1998年至2019年期间，8264名母亲出生时在BMC登记，其中2242名母亲患有PTD（病例），6022名母亲没有PTD（对照）。
方法：使用多变量调整逻辑回归模型和有限三次样条来检查AAM与PTD风险之间的关联。还检查了AAM和分娩年龄对PTD风险的综合影响。
方法：早产和孕龄（GA）由产妇末次月经期和早期超声记录在医疗记录中定义。
结果：产妇分娩年龄为28.1±6.5岁，AAM为12.85±1.86岁。多变量调整的三次样条表明AAM与PTD几率的剂量反应逆关联，始终如一，与GA呈正相关。一年前的AAM与5%(95%CI2%-8%)的PTD几率相关，在调整了产妇出生年份后，奇偶校验，母亲的出生地，教育,吸烟状况和地中海式饮食评分。在分娩年龄≥35岁的大龄母亲中，AAM和PTD之间的关联更强。
结论：早期AAM与PTD的较高几率相关，这种联系在育龄妇女中更为强烈。
方法：病例对照研究。
方法：波士顿的波士顿医疗中心（BMC），马萨诸塞州。
方法：在1998年至2019年期间，8264名母亲出生时在BMC登记，其中2242名母亲患有PTD（病例），6022名母亲没有PTD（对照）。
方法：使用多变量调整逻辑回归模型和有限三次样条来检查AAM与PTD风险之间的关联。还检查了AAM和分娩年龄对PTD风险的综合影响。
方法：早产和孕龄（GA）由产妇末次月经期和早期超声记录在医疗记录中定义。
结果：产妇分娩年龄为28.1±6.5岁，AAM为12.85±1.86岁。多变量调整的三次样条表明AAM与PTD几率的剂量反应逆关联，始终如一，与GA呈正相关。一年前的AAM与5%(95%CI2%-8%)的PTD几率相关，在调整了产妇出生年份后，奇偶校验，母亲的出生地，教育,吸烟状况和地中海式饮食评分。在分娩年龄≥35岁的大龄母亲中，AAM和PTD之间的关联更强。
结论：早期AAM与PTD的较高几率相关，这种联系在育龄妇女中更为强烈。
