接种 COVID-19 疫苗与月经之间的关系:科学现状综述。

IF 3.4 3区 医学 Q1 FAMILY STUDIES
Laura A Payne, Lauren A Wise, Amelia K Wesselink, Siwen Wang, Stacey A Missmer, Alison Edelman
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引用次数: 0

摘要

导言:月经健康是一项重要的患者报告结果,它是健康和生育能力的一般指标。然而,COVID-19 疫苗的临床试验并未对月经功能进行测量。本综述旨在对有关 COVID-19 疫苗接种与月经健康结果之间关系的现有文献进行综述:截至 2023 年 10 月 31 日,在 PubMed 上共搜索到 53 篇文献:方法:在PubM上搜索至2023年10月31日,共发现53篇文献:11篇前瞻性队列研究、11篇回顾性队列研究或基于登记处的队列研究,以及31篇横断面或回顾性病例对照研究:由于存在回顾性设计、访谈者偏倚以及未纳入未接种疫苗的对照组,已识别的研究普遍存在中度至高度的偏倚风险。尽管如此,大部分文献表明,COVID-19 疫苗与月经特征(周期长度和流量)和痛经的暂时性改变有关。卵泡期(接种疫苗时)与周期长度的增加有关。有证据表明,接种疫苗后,青少年的月经会发生暂时性变化,绝经后的人可能会出现异常阴道出血,使用激素避孕可能会起到保护作用:在本综述中,我们发现有证据支持 COVID-19 疫苗与月经健康结果之间存在关联。鉴于月经功能对整体健康的重要性,我们建议所有未来的疫苗试验都将月经作为一项研究结果。未来的疫苗研究应将月经周期作为结果变量进行严格评估,以限制偏倚来源、确定生物机制并阐明压力的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association between COVID-19 vaccination and menstruation: a state of the science review.

Introduction: Menstrual health is a key patient-reported outcome beyond its importance as a general indicator of health and fertility. However, menstrual function was not measured in the clinical trials of COVID-19 vaccines. The purpose of this review was to synthesise the existing literature on the relationship between COVID-19 vaccination and menstrual health outcomes.

Methods: A PubMed search to 31 October 2023 identified a total of 53 publications: 11 prospective cohort studies, 11 retrospective cohort studies or registry-based cohort studies, and 31 cross-sectional or retrospective case-control studies.

Results: Identified studies were generally at moderate-to-high risk of bias due to retrospective design, interviewer bias, and failure to include a non-vaccinated control group. Nonetheless, the bulk of the literature demonstrates that COVID-19 vaccine is associated with temporary changes in menstrual characteristics (cycle length and flow) and menstrual pain. Follicular phase (at the time of vaccination) is associated with greater increases in cycle length. Evidence suggests temporary post-vaccine menstrual changes in adolescents, abnormal vaginal bleeding in postmenopausal individuals, and a potential protective effect of using hormonal contraception.

Conclusions: In this review we found evidence supporting an association between the COVID-19 vaccine and menstrual health outcomes. Given the importance of menstrual function to overall health, we recommend that all future vaccine trials include menstruation as a study outcome. Future vaccine studies should include rigorous assessment of the menstrual cycle as an outcome variable to limit sources of bias, identify biological mechanisms, and elucidate the impact of stress.

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来源期刊
BMJ Sexual & Reproductive Health
BMJ Sexual & Reproductive Health Medicine-Reproductive Medicine
CiteScore
5.10
自引率
6.10%
发文量
38
期刊介绍: BMJ Sexual & Reproductive Health is a multiprofessional journal that promotes sexual and reproductive health and wellbeing, and best contraceptive practice, worldwide. It publishes research, debate and comment to inform policy and practice, and recognises the importance of professional-patient partnership.
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