Author:
Zhang Yue,Luo Zhou,Jia Yingxian,Zhao Yunxiu,Huang Yizhou,Ruan Fei,Ying Qian,Ma Linjuan,Luo Jie,Zhou Jianhong
Abstract
Abstract
Background
Abnormal uterine bleeding associated with ovulatory dysfunction (AUB-O) is a typical gynecological disease that can affect women of various ages. Being able to identify women at risk of AUB-O could allow physicians to take timely action. This study aimed to identify the influencing factors of AUB-O in Chinese women, and then develop and validate a predictive model.
Methods
In this multicenter case–control study, 391 women with AUB-O and 838 controls who came from nine hospitals in Zhejiang province were recruited between April 2019 and January 2022. All the participants completed a structured questionnaire including general characteristics, lifestyle and habits, menstrual and reproductive history, and previous diseases. The predictive model was developed on a group of 822 women and validated on a group of 407 women. Logistic regression was adopted to investigate the influencing factors and develop the model, and validation was then performed.
Results
The independent predictive factors of AUB-O were age (OR 1.073, 95% CI 1.046—1.102, P < 0.001), body mass index (OR 1.081, 95% CI 1.016—1.151, P = 0.015), systolic blood pressure (OR 1.016, 95% CI 1.002—1.029, P = 0.023), residence (OR 2.451, 95% CI 1.727—3.478, P < 0.001), plant-based diet (OR 2.306, 95% CI 1.415—3.759, P < 0.001), fruits eating (OR 1.887, 95% CI 1.282—2.776, P = 0.001), daily sleep duration (OR 0.819; 95% CI 0.708—0.946, P = 0.007), multiparous (parity = 1, OR 0.424, 95% CI 0.239—0.752, P = 0.003; parity > 1, OR 0.450, 95% CI 0.247—0.822, P = 0.009), and history of ovarian cyst (OR 1.880, 95% CI 1.305—2.710, P < 0.001). The predictive ability (area under the curve) in the development group was 0.77 (95% CI 0.74—0.81), while in the validation group it was 0.73 (95% CI 0.67—0.79). The calibration curve was in high coincidence with the standard curve in the development group, and similar to the validation group. A tool for AUB-O risk calculation was created.
Conclusions
Nine influencing factors and a predictive model were proposed in this study, which could identify women who are at high risk of developing AUB-O. This finding highlights the importance of early screening and the lifelong management of ovulatory disorders for women.
Funder
Zhejiang Provincial Natural Science Foundation of China
the Key Research and Development Projects in Zhejiang Province
Publisher
Springer Science and Business Media LLC
Subject
Obstetrics and Gynecology,Reproductive Medicine,General Medicine