Résumé :
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[BDSP. Notice produite par INIST-CNRS F3R1R0x2. Diffusion soumise à autorisation]. Study objective : To investigate of the extent to which violence over the life course accelerates the onset of perimenopause, as measured by menstrual changes. Design : Prospective cohort study. Setting : Boston, Massachusetts. Participants : 603 premenopausal women aged 36-45 years at baseline who completed a cross sectional survey on childhood and adult violence history. Main outcome measure : Time to perimenopause, defined as time in months from baseline interview to a woman's report of (1) an absolute change of at least seven days in menstrual cycle length from baseline or subjective report of menstrual irregularity ; (2) a change in menstrual flow amount or duration ; or (3) cessation of periods for at least three months, whichever came first. Main results : Experience of abuse was associated with delayed onset of menstrual changes indicative of onset of perimenopause. Women reporting childhood or adolescent abuse entered perimenopause about 35% slower than women who reported no abuse (IRRadj=0.65,95% Cl 0.45 to 0.95) after adjusting for age, age at menarche, ever live birth, ability to maintain living standard, smoking, BMI, and depression. There was a similar association among women who reported first abuse during adulthood (IRRadj=0.72,95% Cl 0.28 to 1.80). These findings persisted when the cohort was restricted to non-depressed women (childhood/adolescent IRRadj=0.57,95% Cl 0.36 to 0.90 ; adulthood IRRadj=0.63,95% Cl 0.23 to 1.77). Conclusions : This study is the first longitudinal analysis of the timing of perimenopause to show an association with a history of physical or sexual abuse. Further study of the relation between violence and reproductive aging is needed.
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