上海市医科女大学生异常子宫出血模式及相关因素

陆璇; 肖彤彤; 尤小芳; 谭晖; 钱序

doi:10.16835/j.cnki.1000-9817.2023.01.024

上海市医科女大学生异常子宫出血模式及相关因素

doi: 10.16835/j.cnki.1000-9817.2023.01.024

复旦大学公共卫生学院/公共卫生安全教育部重点实验室, 上海 200032

基金项目:

上海市第五轮公共卫生体系建设三年行动计划重点学科项目 GWV-10.1-XK08

详细信息

作者简介:
陆璇(1996-), 女, 江苏苏州人, 在读硕士, 主要研究方向为生殖保健与妇幼健康

通讯作者:
谭晖, E-mail: htan@fudan.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R173
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- 被引次数: 0
出版历程
- 收稿日期: 2022-08-30
- 修回日期: 2022-11-02
- 网络出版日期: 2023-02-06
- 刊出日期: 2023-01-25

Abnormal uterine bleeding and associated factors among female medical college students in Shanghai

School of Public Health, Fudan University/Key Laboratory of Public Health Safety of Ministry of Education, Shanghai(200032), China

摘要

摘要: 目的了解上海市医科女大学生异常子宫出血(AUB)现状及其出血模式构成, 为女大学生月经健康提供依据。方法整群抽取上海市某高校医学专业912名女大学生为调查对象, 于2021年3月进行月经史及相关因素匿名问卷调查。结果医科女大学生AUB检出率为39.9%, 周期紊乱型和非周期紊乱型检出率分别为24.7%和15.2%。在AUB女大学生中, 21.7%同时存在2种或3种月经异常症状。多因素Logistic回归分析显示, 睡眠质量较差/差的女大学生检出周期紊乱型AUB (OR=2.05)和非周期紊乱型AUB (OR=2.00)的风险均增加; 低体质量指数(BMI)(OR=1.66)、体重时增时减(OR=1.76)与周期紊乱型AUB风险增加有关; 经常失眠(OR=2.45)与非周期紊乱型AUB风险增加均有关(P值均 < 0.05)。结论女大学生AUB常见, 且存在多种出血模式共存的现象, 周期紊乱型和非周期紊乱型AUB的影响因素存在差异, 睡眠质量可能是共同的影响因素。
- 子宫不规则出血 /
- 回归分析 /
- 学生 /
- 女(雌)性
Abstract: Objective To understand the prevalence and pattern of abnormal uterine bleeding (AUB) among female medical college students in Shanghai, to provide a basis for menstrual health intervention for female college students. Methods A total of 912 female medical students from a university in Shanghai were selected through cluster sampling.An anonymous questionnaire survey on menstrual history and related factors was conducted in March 2021. Results The prevalence of AUB among female medical college students was 39.9%, with cycle-disordered and non-cycle-disordered AUB of 24.7% and 15.2%, respectively.Among female college students with AUB, 21.7% had two or three abnormal menstrual symptoms.Multivariate Logistic analysis showed that sleep quality was associated with both types of AUB, and female undergraduates with poorer and poor sleep quality were at increased risk of both cyclic-disordered AUB (OR=2.05) and non-cyclic-disordered AUB (OR=2.00).Low BMI (OR=1.66) and weight gain and loss (OR=1.76) were associated with cycle-disordered AUB.Frequent insomnia (OR=2.45) was associated with non-cyclic-disordered AUB (P < 0.05). Conclusion Abnormal uterine bleeding (AUB) is common in female college students, female medical college students with AUB have multiple concurrent abnormal bleeding patterns.Factors associated with AUB varied according to the type of AUB, with sleep quality correlates with both types of AUB.
- Metrorrhagia /
- Regression analysis /
- Students /
- Female
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 不同组别女大学生AUB检出率比较

Table 1. Comparison of prevalence rate of AUB among female college students in different demographic groups

组别	选项	人数	周期紊乱型	非周期紊乱型	AUB	χ²值	P值
年级	大一	187	45(24.1)	30(16.0)	75(40.1)	0.60	0.90
	大二	160	43(26.9)	25(15.6)	68(42.5)
	大三	227	57(25.1)	32(14.1)	89(39.2)
	大四	338	80(23.7)	52(15.4)	132(39.1)
专业	临床	371	92(24.8)	61(16.4)	153(41.2)	0.69	0.88
	护理	183	41(22.4)	28(15.3)	69(37.7)
	药学	113	27(23.9)	17(15.0)	44(38.9)
	公卫	245	65(26.5)	33(13.5)	98(40.0)
民族	汉族	812	195(24.0)	131(16.1)	326(40.1)	0.17	0.68
	少数民族	100	30(30.0)	8(8.0)	38(38.0)
生源地	城市	632	148(23.4)	95(15.0)	243(38.4)	1.84	0.18
	农村	280	77(27.5)	44(15.7)	121(43.2)
合计		912	225(24.7)	139(15.2)	364(39.9)
注： ()内数字为检出率/%。

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表 2 女大学生周期紊乱型和非周期紊乱型AUB相关因素的单因素分析

Table 2. Univariate analysis on relevant factors of cycle-disorder-type AUB and non-cycle-disorder-type AUB among female college students

因素	选项	人数	周期紊乱型			非周期紊乱型
因素	选项	人数	检出人数	χ²值	P值	检出人数	χ²值	P值
月经初潮年龄/岁	< 12	148	36(24.3)	0.99	0.61	21(14.2)	0.38	0.83
	12~ < 14	537	128(23.8)			82(15.3)
	≥14	227	61(26.9)			36(15.9)
自评健康状况	良好	624	150(24.0)	3.76	0.15	81(13.0)	9.37	< 0.01
	一般/较差	288	75(26.0)			58(20.1)
近3个月患病	无	820	189(23.0)	13.89	< 0.01	127(15.5)	0.05	0.82
	有	92	36(39.1)			12(13.0)
BMI	过低	146	45(30.8)	4.87	0.09	23(15.8)	3.38	0.82
	正常	673	156(23.2)			97(14.4)
	超重肥胖	93	24(25.8)			19(20.4)
近1年体重波动	无	588	134(22.8)	4.79	0.19	89(15.1)	1.83	0.61
	明显增加	90	25(27.8)			11(12.2)
	明显降低	41	10(24.4)			6(14.6)
	时增时减	193	56(29.0)			33(17.1)
饮食规律性	总是规律	356	89(25.0)	0.44	0.80	47(13.2)	2.29	0.32
	有时不规律	474	114(24.1)			77(16.2)
	经常不规律	82	22(26.8)			15(18.3)
节食行为	没有	498	134(26.9)	1.73	0.42	68(13.7)	2.24	0.33
	偶尔	309	71(23.0)			49(15.9)
	有时/经常	105	20(19.0)			22(21.0)
体力活动	几乎没有	315	84(26.7)	1.47	0.48	49(15.6)	0.45	0.80
	未达到推荐量	470	114(24.3)			72(15.3)
	达到推荐量	127	27(21.3)			18(14.2)
入睡时间	23:30前	124	28(22.6)	0.90	0.64	17(13.7)	0.57	0.75
	23:30—1:00	599	146(24.4)			95(15.9)
	1:00后	189	51(27.0)			27(14.3)
每日睡眠时长/h	≤6	187	43(23.0)	0.17	0.92	34(18.2)	2.84	0.24
	>6~ < 8	590	148(25.1)			90(15.3)
	≥8	135	34(25.2)			15(11.1)
睡眠质量	好/较好	813	193(23.7)	7.58	0.01	114(14.0)	13.42	< 0.01
	较差/差	99	32(32.3)			25(25.3)
失眠	没有	314	70(22.3)	4.27	0.12	46(14.6)	14.76	< 0.01
	偶尔/有时	557	143(25.7)			79(14.2)
	经常	41	12(29.3)			14(34.1)
通宵熬夜	没有	503	132(26.2)	4.47	0.11	66(13.1)	6.39	0.04
	偶尔	344	73(21.2)			58(16.9)
	有时/经常	65	20(30.8)			15(23.1)
自评学习压力	没有	43	9(20.9)	0.35	0.84	7(16.3)	0.56	0.76
	有但能应付	795	197(24.8)			123(15.5)
	有且应付困难	74	19(25.7)			9(12.2)
家庭重大事件	无	753	181(24.0)	3.30	0.19	108(14.3)	3.96	0.14
	有, 好事	30	6(20.0)			7(23.3)
	有, 坏事	129	38(29.5)			24(18.6)
交友重大事件	无	425	98(23.1)	3.57	0.17	58(13.6)	6.73	0.03
	有, 好事	166	39(23.5)			21(12.7)
	有, 坏事	321	88(27.4)			60(18.7)
注： ()内数字为检出率/%。

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表 3 女大学生周期紊乱型AUB相关因素的多因素Logistic回归分析(n=773)

Table 3. Multivariate Logistic analysis on relevant factors of cycle-disorder-type AUB among female college students(n=773)

自变量与常量	β值	标准误	Wald χ²值	P值	OR值(OR值95%CI)
BMI
过低	0.51	0.21	5.64	0.02	1.66(1.09~2.52)
超重肥胖	0.30	0.27	1.23	0.27	1.35(0.80~2.28)
近1年体重波动
明显增加	0.31	0.28	1.21	0.27	1.37(0.78~2.38)
明显降低	0.11	0.42	0.07	0.80	1.11(0.49~2.53)
时增时减	0.56	0.22	6.61	0.01	1.76(1.14~2.70)
近3个月患病
有	0.85	0.24	12.16	< 0.01	2.34(1.45~3.78)
睡眠质量
较差/差	0.72	0.25	8.03	0.01	2.05(1.25~3.36)
常量	-1.18	0.11	123.37	< 0.01	0.31
注： BMI以体重正常为参照，近1年体重波动、近3个月患病以无为参照，睡眠质量以好/较好为参照。

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表 4 女大学生非周期紊乱型AUB相关因素的多因素Logistic回归分析(n=687)

Table 4. Multivariate Logistic analysis on relevant factors of non-cycle-disorder type AUB among female college students(n=687)

自变量与常量	β值	标准误	Wald χ²值	P值	aOR值(OR值95%CI)
自评健康状况
一般/较差	0.50	0.21	5.81	0.02	1.64(1.10~2.46)
睡眠质量
较差/差	0.70	0.31	5.18	0.02	2.00(1.10~3.65)
近3个月失眠
偶尔或有时	-0.07	0.21	0.10	0.75	0.94(0.62~1.42)
经常	0.90	0.45	4.04	0.05	2.45(1.02~5.86)
少数民族	-0.82	0.40	4.30	0.04	0.44(0.20~0.96)
常量	-1.57	0.18	80.16	< 0.01	0.21
注：自评健康状况以良好为参照，睡眠质量以好/较好为参照，近3个月失眠以无为参照，民族以汉族为参照。

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