基于倾向性评分匹配方法的孕前使用避孕药和妊娠天数的相关性分析  

Correlation between contraceptive use before pregnancy and the days of pregnancy:a cohort study based on propensity score matching

作　　者：庾静云 甘展鹏 姜碧 曾思良[1] YU Jing-yun;GAN Zhan-peng;JIANG Bi;ZENG Si-liang(Dongguan Municipal Maternal and Child Health Hospital,Dongguan,Guangdong 523112,China)

机构地区：[1]广东省东莞市妇幼保健院,广东东莞523112

出　　处：《实用预防医学》2021年第6期658-661,共4页Practical Preventive Medicine

基　　金：国家科技基础性工作专项(2013FY110500);东莞市社会科技发展项目(201950715007842)。

摘　　要：目的探讨孕前使用避孕药对妊娠天数的影响。方法采用倾向性匹配评分方法,以基础资料为匹配条件,将使用避孕药者设为观察组,按照1∶4匹配未使用者为对照组。随访获取妊娠天数资料,进而探讨孕前使用避孕药和妊娠天数的关系。结果共匹配避孕药组241例,对照组964例,匹配以后各项资料均未见显著性差异(P>0.05)。Cox回归分析发现,在调整基础资料后,使用避孕药可使妊娠天数缩短,危害比(hazard ratio,HR)为0.85(95%CI:0.74~0.98)。亚组分析发现,年龄≥31岁、体质指数≥24、无妊娠史三个亚组,孕前服用避孕药使妊娠天数缩短,HR(95%CI)分别为0.76(0.59,0.97)、0.67(0.46,0.98)、0.78(0.63,0.96)。结论孕前服用避孕药可能缩短妊娠天数,特别是高龄、肥胖、初次妊娠女性,更应注意避孕药的使用。Objective To explore the effect of contraceptive use before pregnancy on the days of pregnancy.Methods Propensity score matching method was used in this study,with the basic data as matching conditions.Contraceptive users were treated as the observation group and non-contraceptive users serving as the control group were matched according to 1∶4.Data regarding the days of pregnancy were obtained by follow-up visits,and then the relationship between contraceptive use before pregnancy and the days of pregnancy was explored.Results A total of 241 cases were matched in the contraceptive group and 964 cases in the control group.There was no significant difference in the data after matching(P>0.05).Cox regression analysis showed that the use of contraceptives could shorten the days of pregnancy after adjusting the basic data,with the hazard ratio(HR)of 0.85(95%CI:0.74-0.98).Subgroup analysis displayed that taking contraceptives before pregnancy could shorten the days of pregnancy in the three subgroups at the age≥31 years,with body mass index≥24 and without history of pregnancy,with the HRs(95%CI)of 0.76(0.59,0.97),0.67(0.46,0.98)and 0.78(0.63,0.96),respectively.Conclusion Taking contraceptives before pregnancy may shorten the days of pregnancy,especially in women with advanced age,obesity and at first pregnancy;and hence,more attention should be paid to contraceptive use among them.

关 键 词：避孕药 妊娠天数 倾向性评分 队列研究 

分 类 号：R173[医药卫生—妇幼卫生保健]