A Study On Risk Factors Related To Adolescent Endometriosis

ObjectiveAnalyze the risk factors of adolescent endometriosis and establish a clinical risk assessment model for adolescent endometriosis based on the risk factors.Methods1.This study collected 255 cases of adolescent endometriosis from January 1998 to May 2018 in Women's Hospital School Of Medicine Zhejiang University.The control group consisted of 255 counterparts without endometriosis from January 2016 to May 2018 in Women's Hospital School Of Medicine Zhejiang University.Compare the body mass index(BMI),the years of menstruation,the history of dysmenorrhea,sexual life,irregular menstruation,genital neoplasm and genital tract malformation between the two groups.A risk assessment model for adolescent endometriosis was established based on the significant risk factors.2.Ninety-nine cases with adolescent endometriosis in Women's Hospital School Of Medicine Zhejiang University from January to December 2019 were collected to verify the accuracy of the risk assessment model.Results1.This study included 255 cases of adolescent endometriosis and 255 cases in control group.Univariate analysis showed that BMI,history of dysmenorrhea,sexual life,genital neoplasm and genital tract malformation and irregular menstruation were significantly different between the two groups(P <0.05).2.Take BMI,history of dysmenorrhea,sexual life,genital neoplasm and genital tract malformation and irregular menstruation as independent variables,and whether or not they have adolescent endometriosis as the dependent variable.The binary multivariate Logistic regression analysis showed that the history of sexual life [P = 0.000,OR = 3.932,95% confidence interval: 2.266-6.824],genital neoplasm[P = 0.000,OR = 12.857,95% confidence interval: 6.248-26.460],genital tract malformation [P = 0.000,OR = 160.683,95% confidence interval: 36.815-701.309] and irregular menstruation [P = 0.000,OR = 0.344,95% confidence interval: 0.192-0.615] can be used as predictors of adolescent endometriosis.3.Establish a risk assessment model for adolescent endometriosis: ratios of the incidence of adolescent endometriosis in the population with related risk factors and the incidence of adolescent endometriosis in the population without related risk factors were assigned to independent risk factors,respectively.The history of sexual life,genital neoplasm,genital tract malformation and irregular menstruation are assigned as follows: 1.62/0,1.97/0,2.41/0,-0.74/0.The area under the ROC curve of this risk assessment model is 0.845 [P=0.000,95% confidence interval: 0.811-0.879].The optimal cut-off value is 1.055,the sensitivity is 0.725,the specificity is 0.867,and the Youden index is 0.592.The area under the ROC curve of this risk assessment model predicting severe adolescent endometriosis is 0.817[P=0.000,95% confidence interval 0.766-0.867].The optimal cut-off value is 1.425,the sensitivity is 0.660,the specificity is 0.875 and the Youden index is 0.535.4.The validation group included 99 cases of adolescent endometriosis,38 cases of stage I/II(38.38%),and 61 cases of stage III/IV(61.62%).The sensitivity of this model to predict adolescent endometriosis was 85.86%(85/99),and the sensitivity of this model to predict severe adolescent endometriosis was 75.41%(46/61).Conclusions1.The history of sexual life,genital neoplasm and genital tract malformation are independent risk factors for adolescent endometriosis.Irregular menstruation is a protective factor for adolescent endometriosis.2.The risk assessment model for adolescent endometriosis: history of sexual life,genital neoplasm,genital tract malformation,irregular menstruation are assigned as follows: 1.62/0,1.97/0,2.41/0,-0.74/0.The risk value of adolescent endometriosis= 1.62*[sexual life] + 1.97*[genital neoplasm] + 2.41*[genital tract malformation]-0.74*[irregular menstruation].3.According to the risk assessment model,when the risk value is greater than 1.055,the possibility of suffering from adolescent endometriosis is high,and when the risk value is greater than 1.425,the possibility of suffering from severe adolescent endometriosis is high.