The Risk Factors Of Premature Ovarian Failure:A Meta Analysis

Objective:Meta-analysis method is used to comprehensively evaluate the risk factors of premature ovarian failure in Chinese women nearly ten years.The relative intensity of each factor is obtained,which provides a theoretical basis for the prevention of POF disease and provides relevant clues for further etiological research.Methods:We collected relevant informations published from January 2011 to December 2020 by searching in Pubmed,Web of science,Embase,Cochrane Library,China National Knowledge Base(CNKI),China Biomedical Literature Database(CBM)and other databases which risk factors for premature ovarian failure,the type of study is case-control study,and all the literatures in Chinese or English.According to the specified inclusion and exclusion criteria,literatures were strictly screened.Meta-analysis was used for comprehensive evaluation including OR value and 95%CI.Finally,Stata 15.1 software was used for heterogeneity test,sensitivity analysis and publication bias evaluation.Results:Finally,29 case-control studies were included,with 3615 cases in the POF group and 3245 cases in the control group.The results of Meta-analysis: 1.POF risk factors and related intensity(OR and 95% CI): Family history 3.69(2.60,5.25);Pelvic surgery history 4.27(2.56,7.15);Ovarian surgery history 6.69(3.83,11.70);History of repeated abortions and curettages 3.99(2.54,6.26);Long-term oral contraceptives2.88(1.64,5.04);Autoimmune disease 5.89(3.87,8.97);History of mumps virus infection 9.23(4.41,19.33);History of chronic pelvic inflammation 2.44(1.64,3.61);History of tuberculosis 4.11(2.08,8.09);History of toxic substance exposure 4.53(3.42,6.01);Often dye hair 2.84(2.17,3.73);History of smoking 3.79(3.11,4.61);History of drinking 1.86(1.45,2.38);Poor sleeping 3.74(2.39,5.85);A personality5.14(4.25,6.22);High pressure 3.28(2.42,4.46);Depression 7.48(3.01,18.59);Anxiety 2.91(1.96,4.31).2.Radiotherapy and chemotherapy were not statistically significant(P>0.05).The relationships with POF is still uncertain,and further research is needed in the future.3.Sensitivity analysis results show that after removing individual studies one by one and combining effect sizes,there is no significant difference between the above factors,and the results are considered credible.4.The publication bias of each factor was evaluated by Harbord(counting data)and Egger’s(measurement data)methods.It was found that none of the above factors had publication bias,and the results were considered credible.Conclusion:1.Genetic family history is a risk factor for POF.2.Medical factors are the risk factors of POF,including pelvic surgery history、ovarian surgery history、history of repeated abortions and curettages、long-term oral contraceptives.3.Autoimmune factors are the risk factors for POF.4.Infectious factors are the risk factors for POF,including history of mumps virus infection、 history of chronic pelvic inflammation、history of tuberculosis.5.Environmental and life behavior factors are risk factors for POF,including History of toxic substance exposure、often dye hair、history of smoking、history of drinking、poor sleeping、A personality、high pressure、depression、anxiety.Figure 22;Table 8;Reference 87.