女性不孕症影响因素的病例对照研究

A case-control study on the risk factors of female infertility

目的探讨已婚育龄妇女不孕症的影响因素及其变化情况。方法采用以省级医院为基础的配对病例对照研究，按年龄（±2岁）配对，共收集383对病例和对照，进行统一的问卷调查。用EpiData3．0软件建立数据库，应用SPSS11．5软件进行单因素和多因素条件logistic回归分析。结果多因素条件logistic回归分析表明，盆腔感染性疾病史（OR=7．078，95％CI：3．462～14．467）、末次妊娠产后或流产后并发症史（OR=3．674，95％CI：1．690～7．986）、药物治疗史（OR=23．576，95％CI：12．324～45．102）、痛经（OR=1．622，95％CI：1．161～2．266）、性交痛（OR=2．447，95％CI：1．201～4．986）、每月性生活次数（OR=1．416，95％CI：1．048～1．913）及精神压力（OR=2．146，95％CI：1．662～2．771）可能是女性不孕症的危险因素，而文化程度（OR=0．522，95％CI：0．391～0．696）可能为其保护因素。结论预防和治疗盆腔感染，严格掌握治疗药物的适应证，重视生殖健康的宣传教育，提倡晚婚晚育，避免婚前性生活等可能减少女性不孕症的发生。

Objective Understanding the risk factors of female infertility among child-bearing aged women, in Nanchang area. Methods A hospital-based matched case-control study was carried out in Nanchang. Matched by age （ ± 2 years old） , 383 pairs of cases and controls were recruited and studied. Database was established with EpiData 3.0 software. Both cases and controls were interviewed face to face, with a uniformed questionnaire. Conditional logistic regression model was used for univariate and multivariate analysis on SPSS 11.5 to estimate odds ratios （OR） and 95% confidence intervals （CI）. Results Data from multiple conditional logistic regression analysis showed that the risk factors of infertility would include pelvic inflammatory diseases （OR=7.078, 95% CI： 3.462-14.467） , post-abortion complications＇ history （OR = 3.674, 95 % CI： 1.690-7.986）, drug treatment history （ OR = 23.576, 95% CI： 12.324-45.102）, dysmenorrhea （OR= 1.622, 95% CI： 1.161-2.266） , pain from sexual intercourse （OR=2.447, 95% CI： 1.201-4.986） , monthly frequency of sexual intercourse （OR= 1.416, 95% CI： 1.048-1.913） and mental stress （OR=2.146, 95% CI： 1.662-2.771 ）. The protective factor of infertility, however, was level ofeducation（OR=0.522,95%CI：0.391-0.696）. Conclusion Prevention and treatment of pelvic infection, application of strictly controlled drugs, popularization of awareness on sexual and reproductive health and relief of mental stress would be important measures in decreasing the incidence of infertility.