ABSTRACT
Little is known about the mechanism and biochemical pathway of preterm delivery. Some drugs used to treat preterm labor are also useful for the treatment of primary dysmenorrhea. This study attempted to evaluate the association between primary dysmenorrhea and preterm delivery from an epidemiological perspective. A nested case-control study was conducted; 329 singleton preterm delivery cases were investigated, in aggregate and in subgroups (spontaneous preterm labor and preterm premature rupture of membranes). Concurrently, 329 singleton gravid women with term delivery served as controls. Medical charts and records provided information about the maternal history of dysmenorrhea, index pregnancy outcome, and demographic characteristics. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using the multiple logistic regression method. Gravid women with a history of primary dysmenorrhea had no more risk of preterm delivery than those without a history of primary dysmenorrhea (adjusted OR, 1.16; 95% CI, 0.95 to 2.19; p = 0.37). However, for subgroup analysis, gravid women with severe primary dysmenorrhea were associated with an adjusted 2.73-fold risk of spontaneous preterm delivery (95% CI, 1.49 to 4.95; p = 0.02), and with an adjusted 1.51-fold risk of preterm premature rupture of membranes (95% CI, 0.68 to 3.22; p = 0.31). Severe primary dysmenorrhea is associated with an increased risk of spontaneous preterm delivery. A common pathophysiologic pathway may exist between these two disorders. Further in-depth biochemical and molecular studies are necessary to explore this phenomenon.
KEYWORDS
Multidimensional scoring - oxytocin - primary dysmenorrheal - preterm delivery
REFERENCES
-
1
Chan W Y, Hill J C.
Determination of menstrual prostaglandin levels in non-dysmenorrheic and dysmenorrheic subjects.
Prostaglandins.
1978;
15
365-375
-
2
Creatsas G, Deligeoroglou E, Zachari A et al..
Prostaglandins: PGF2 alpha, PGE2, 6-keto-PGF1 alpha and TXB2 serum levels in dysmenorrheic adolescents before, during and after treatment with oral contraceptives.
Eur J Obstet Gynecol Reprod Biol.
1990;
36
292-298
-
3
Abu J I, Konje J C.
Leukotrienes in gynaecology: the hypothetical value of anti-leukotriene therapy in dysmenorrhoea and endometriosis.
Hum Reprod Update.
2000;
6
200-205
-
4
Bieglmayer C, Hofer G, Kainz C, Reinthaller A, Kopp B, Janisch H.
Concentrations of various arachidonic acid metabolites in menstrual fluid are associated with menstrual pain and are influenced by hormonal contraceptives.
Gynecol Endocrinol.
1995;
9
307-312
-
5
McCormick M C.
The contribution of low birth weight to infant mortality and childhood morbidity.
N Engl J Med.
1985;
312
82-90
-
6
Goldenberg R L, Rouse D J.
The prevention of premature birth.
N Engl J Med.
1998;
339
313-320
-
7
Hack M, Fanaroff A A.
Outcome of children of extremely low birth weight and gestational age in the 1990's.
Early Hum Dev.
1999;
53
193-218
-
8
Challis J RG.
Mechanism of parturition and preterm labor.
Obstet Gynecol Surv.
2000;
55
650-660
-
9
Challis J R.
Understanding preterm birth.
Clin Invest Med.
2001;
24
60-67
-
10
Byrne B, Morrison J.
Preterm birth.
Clin Evid.
2002;
7
1310-1324
-
11
Kjell H, Jan H S, Anne L W.
Preterm delivery: an overview.
Acta Obstet Gynecol Scand.
2003;
82
687-704
-
12
Åkerlund M.
Can primary dysmenorrhea be elevated by a vasopressin antagonist?.
Acta Obstet Gynecol Scand.
1987;
66
459-461
-
13
Åkerlund M, Bossmar T, Brouard R et al..
Receptor binding of oxytocin and vasopressin antagonists and inhibitory effects on isolated myometrium from preterm and term pregnant women.
BJOG.
1999;
106
1047-1053
-
14
Bosmar T, Åkerlund M, Fantoni G, Maggi M, Szamatowics J, Laudanski T.
Receptor-mediated uterine effects of oxytocin and vasopressin in non-pregnant women.
BJOG.
1995;
102
907-912
-
15
Åkerlund M, Strömberg P, Forsling M L.
Primary dysmenorrhea and vasopressin.
BJOG.
1979;
86
484-487
-
16
Brouard R, Bossmar T, Fournie-Lloret D, Chassard D, Akerlund M.
Effect of SR49059, an orally active V1a vasopressin receptor antagonist, in the prevention of dysmenorrhoea.
BJOG.
2000;
107
614-619
-
17
Andersch B, Milsom I.
An epidemiologic study of young women with dysmenorrhea.
Am J Obstet Gynecol.
1982;
144
655-660
-
18 Rothman K J, Greenland S. Modern Epidemiology. 2nd ed. Philadelphia; Lippincott-Raven 1998
-
19
Ylikorkala O, Kujansuu E.
Increased rate of primary dysmenorrhea in women with spontaneous premature labor.
Prostaglandins Med.
1981;
6
213-216
-
20
Lumsden M A, Baird D T.
Intrauterine pressure in dysmenorrhea.
Acta Obstet Gynecol Scand.
1985;
64
183-186
-
21
Goldenberg R L.
Prevention of premature birth.
N Engl J Med.
1998;
339
313-320
-
22
Parry S, Strauss J F.
Mechanisms of disease-premature rupture of the fetal membranes.
N Engl J Med.
1998;
338
663-670
-
23
Smith R P, Powell J R.
Simultaneous objective and subjective evaluation of meclofenamate sodium in the treatment of primary dysmenorrhea.
Am J Obstet Gynecol.
1987;
157
611-618
-
24
Macones G A, Robinson C A.
Is there justification for using indomethacin in preterm labor? An analysis of neonatal risks and benefits.
Am J Obstet Gynecol.
1998;
178
873-874
Chi-Mou JuangM.D.
No. 201, Section 2, Shih-Pai Road, Department of Obstetrics and Gynecology
Veterans General Hospital, Taipei, Taiwan