女性荷尔蒙和生殖因素与蛛网膜下腔出血的风险。

IF 6.3 2区 医学 Q1 CLINICAL NEUROLOGY International Journal of Stroke Pub Date : 2024-10-07 DOI:10.1177/17474930241283377
Fang Cao, Junyu Liu, Yuge Wang, Qingyue He, Yuxin Guo, Junxia Yan
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引用次数: 0

摘要

背景蛛网膜下腔出血(SAH)主要由颅内动脉瘤破裂引起,女性发病率较高。我们旨在评估女性荷尔蒙和生殖因素与蛛网膜下腔出血之间的关系。方法 对英国生物库中的 226,469 名前瞻性队列参与者进行了中位 14.75 年的随访。采用Cox比例危险模型和限制性三次样条来探讨13个主要因素与SAH之间的关系,包括初潮年龄、绝经状态、绝经年龄、生育年限、妊娠史、首次和最后一次活产的年龄、活产次数、不良生育结局、口服避孕药或激素替代疗法(HRT)使用史以及子宫切除术或双侧输卵管切除术的手术史。初潮年龄较小(42 岁)的女性具有保护作用(HR,0.65;95%CI,0.55-0.77)。首次活产年龄较小(42 岁)的女性具有保护作用(HR 值为 0.65;95%CI 为 0.55-0.77
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Female hormonal and reproductive factors and the risk of subarachnoid hemorrhage.

Background: Subarachnoid hemorrhage (SAH), primarily caused by rupture of intracranial aneurysm, has a high incidence rate in women. We aimed to evaluate the association between female hormonal and reproductive factors and SAH.

Methods: A prospective cohort of 226,469 participants from the UK Biobank was followed for a median period of 14.75 years. Cox proportional hazards models and restricted cubic splines were used to explore the associations between 13 major factors and SAH, including menarche age, menopausal status, age at menopause, reproductive lifespan, pregnancy history, age at first and last live births, number of live births, adverse fertility outcomes, history of oral contraception or hormone-replacement therapy (HRT) use, and surgical history of hysterectomy or bilateral oophorectomy.

Results: SAH occurred in 769 of participants during the follow-up period. Both women with a younger age at menarche (< 12 years) and post-menopausal women had a higher SAH risk (hazard ratio (HR), 1.28; 95% confidence interval (CI), 1.06-1.54) and (HR, 1.48; 95% CI, 1.10-1.99), respectively. A higher risk of SAH was identified in those with an earlier age at menopause (< 40 years: HR, 2.09; 95% CI, 1.43-3.06; 40-44 years: HR, 1.68; 95% CI, 1.23-2.29). A shorter reproductive lifespan (< 30 years) was associated with increased SAH risk (HR, 1.64; 95% CI, 1.28-2.11), while a longer reproductive lifespan (> 42 years) showed a protective effect (HR, 0.65; 95% CI, 0.55-0.77). Younger age at first live birth (< 24 years) was associated with SAH (HR, 1.39; 95% CI, 1.13-1.72). Hysterectomy (HR, 2.55; 95% CI, 2.12-3.05) or bilateral oophorectomy (HR, 1.51; 95% CI, 1.14-2.01) also predisposed women to SAH. Age at last live birth, number of live births, pregnancy history, adverse fertility outcomes, and HRT or oral contraceptive use were not associated with SAH.

Conclusions: Female hormonal and reproductive factors are important for evaluating SAH risk in women. In particular, earlier menopause is associated with an increased risk of SAH.

Data access statement: The data utilized in this study were sourced from a third party and are not publicly accessible. The UK Biobank data that support the findings of this research are available from the UK Biobank (www.ukbiobank.ac.uk), subject to review and approval by the UK Biobank.

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来源期刊
International Journal of Stroke
International Journal of Stroke 医学-外周血管病
CiteScore
13.90
自引率
6.00%
发文量
132
审稿时长
6-12 weeks
期刊介绍: The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.
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