بررسی اختلالات قاعدگی و عوامل مرتبط با آن در زنان مبتلا به مولتیپل اسکلروزیس

نوع مقاله: اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران.

2 استادیار گروه بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران.

3 دانشیار گروه مغز و اعصاب، دپارتمان مغز و اعصاب و علوم شناختی پژوهشکده علوم سلولی پژوهشگاه رویان، تهران، ایران.

4 مربی گروه آمار زیستی، دانشکده مدیریت، دانشگاه علوم پزشکی ایران، تهران، ایران.

چکیده

مقدمه: مولتیپل اسکلروزیس، شایع‌ترین بیماری خود­ایمنی است که اغلب زنان سنین باروری را تحت تأثیر قرار می‌دهد. یکی از شکایات بالینی در زنان مبتلا، ابتلاء به انواعی از اختلالات قاعدگی است. مطالعه حاضر با هدف بررسی اختلالات قاعدگی و عوامل مرتبط با آن در زنان مبتلا به مولتیپل اسکلروزیس انجام شد.
روش‌کار: این مطالعه توصیفی- مقطعی در سال 96-1395 بر روی 172 زن مبتلا به MS مراجعه‌کننده به کلینیک خصوصی متخصص مغز و اعصاب واقع در شهر تهران انجام شد. ابزار مورد استفاده، شامل پرسشنامه مشخصات قاعدگی (شامل سؤالات مربوط به سن اولین قاعدگی، طول مدت هر دوره قاعدگی، فواصل بین دو قاعدگی، میزان خونریزی، وجود و یا عدم وجود درد قاعدگی و نمره درد قاعدگی) و همچنین پرسشنامه مشخصات فردی و بیماری (سن، تحصیلات، شغل، وضعیت اقتصادی و مشخصات بیماری شامل: مدت زمان ابتلاء به بیماری، مدت زمان مصرف ویتامین D و نمره ناتوانی (EDSS)) بود. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 22) و مدل رگرسیون لوجستیک چندگانه و آزمون‌های کای دو و ضریب همبستگی اسپیرمن انجام شد. میزان p کمتر از 05/0 معنی­دار در نظر گرفته شد.
یافته‌ها: 88 نفر (2/51%) از بیماران الگوی نامنظم قاعدگی را تجربه کردند. 116 نفر (5/67%) از بیماران، انواعی از اختلالات قاعدگی داشتند. شایع‌ترین اختلال در بین شرکت‌کنندگان، لکه‌بینی بین قاعدگی‌ها (5/17%) بود. نتایج مدل رگرسیون لوجستیک چندگانه نشان‌دهنده ارتباط معنادار نمره ناتوانی (001/0=p، 702/0=b)، میزان خونریزی قاعدگی متوسط (001/0p<، 561/2=b) و زیاد (001/0p<،730/2=b)، مدت زمان مصرف ویتامین D (048/0=p، 187/0- =b)، دیسمنوره (006/0=p، 246/1=b)، سن منارک (05/0=p، 298/0- =b) و الگوی قاعدگی (001/0p<، 912/1=b) با اختلال قاعدگی بود. نتیجه آزمون‌های همبستگی اسپیرمن و کای دو، نشان‌دهنده ارتباط معنی‌دار بین الگوی قاعدگی، دیسمنوره و میزان خونریزی با اختلال قاعدگی بود که این رابطه مؤید نتایج مدل رگرسیون نیز بود.
نتیجه‌گیری: اختلال قاعدگی در بین زنان مبتلا به MS از شیوع بالایی برخوردار است. همچنین عواملی نظیر مدت زمان مصرف ویتامین D، میزان خونریزی قاعدگی، سن منارک، الگوی قاعدگی، دیسمنوره و نمره ناتوانی بر اختلالات قاعدگی مبتلایان اثرگذار است.

کلیدواژه‌ها


عنوان مقاله [English]

Menstrual disorders and related factors in women with multiple sclerosis

نویسندگان [English]

  • Simin Zarabadipour 1
  • Leila Amini 2
  • Seyed Massood Nabavi 3
  • Hamid Haghani 4
1 M.Sc. in Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
2 Assistant Professor, Department of Reproductive Health, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
3 Associate Professor, Department of Neurology, Department of Neurology and Cognitive Sciences Research Institute of Cellular Sciences, Royan Research Center, Tehran, Iran.
4 Instructor, Department of Biostatistics, School of Management, Iran University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Multiple sclerosis (MS) is the most common autoimmune disease that often affects women within the reproductive age. Among the common clinical complaints in these women is variety of menstrual disorders. Thus, we aimed to examine menstrual disordersand related factors in women with MS.
Methods: A descriptive cross-sectional study was performed among 172 women with MS who visited the Neurology Specialized Clinic in Tehran, Iran, during 2016-2017. The participants filled out a questionnaire consisting of demographic (e.g., age, educational level, economic status, disease duration, vitamin D consumption duration, and Expanded Disability Status Scale [EDSS]) and disease characteristics (age at menstruation, duration of each period, interval between two periods, the amount of bleeding, presence or lack of presence of pain, and menstruation pain score). Data were analyzed by using SPSS version 22 and multiple logistic regression model, Chi-square test, and Spearman correlation coefficient. P-value less than 0.05 was considered significant.
Results: Overall, 88 patients (51.2%) experienced irregular menstruation patterns, and 116 patients (67.5%) had some forms of menstruation disorders. Multiple logistic regression reflected statistically significant correlations between disability score (β=0.702, P=0.001), moderate (β=2.561, P<0.001) and high (β=2.730, P<0.001) menstrual bleeding, duration of vitamin D intake (β= -0.187, P=0.048), dysmenorrhea (β=1.246, P=0.006), age of the menarche (β= -0.298, P=0.05) and menstrual pattern (β=1.912, P<0.001) with menstrual disorders. Spearman correlation and Chi-square revealed the significant relationship of menstruation pattern, dysmenorrhea, and amount of bleeding with menstrual disorders, which corroborated the results of regression. 
Conclusion: The results of the present study showed that menstrual disorders have high prevalence in women with MS. Our results also indicated that factors such as duration of vitamin D intake, menstrual bleeding, menarche, menstrual pattern, dysmenorrhea, and EDSS affect menstrual disorders.

کلیدواژه‌ها [English]

  • Menstrual disorders
  • Menstrual Pattern
  • Multiple Sclerosis
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