The global prevalence of premature ovarian insufficiency: a systematic review and meta-analysis

The objective of this review was to answer the global prevalence of premature ovarian insufficiency (POI), and explore the associated factors including etiopathology and regions with POI. The search was conducted on reports from a total of eight databases that comprised Chinese National Knowledge Infrastructure (CNKI), Wanfang, China BioMedical Literature Database (CBM), PubMed, the Cochrane Library, Embase, Web of Science and Ovid MEDLINE^® between 1946 and 2021. To analyze the source of heterogeneity, we performed subgroup analysis based on different etiologies and regions. Meta-analysis was carried out by Stata14.0 software. The results showed that the global overall prevalence of POI among women was 3.5%. By subgroup analysis, the prevalence of POI among women with iatrogenic etiology was 11.2%, followed by autoimmunity (10.5%); the prevalence of POI by region was 11.3% at the highest in North America followed by South America (5.4%); and the prevalence of POI was 5.3% in a developing country, higher than 3.1% in a developed country. The trend of prevalence of POI over the past 20 years was on the rise (although <i>p</i> &gt; 0.05). We recommend that health and medical institutions strengthen public health awareness, achieve health-education goals related to POI and increase women’s awareness of and attention to POI.

本综述旨在明确早发性卵巢功能不全（premature ovarian insufficiency, POI）的全球患病率，并探究其相关影响因素，包括病因学与地域分布特征。本研究检索了1946年至2021年间收录于中国知网（CNKI）、万方数据、中国生物医学文献数据库（China BioMedical Literature Database, CBM）、PubMed、Cochrane图书馆、Embase、Web of Science以及Ovid MEDLINE^®共8个数据库的相关文献。为分析异质性来源，本研究基于不同病因与地域开展亚组分析，并采用Stata14.0软件完成Meta分析。结果显示，全球女性早发性卵巢功能不全的总体患病率为3.5%。亚组分析表明，医源性病因所致POI的患病率为11.2%，其次为自身免疫性病因（10.5%）；按地域划分，北美地区POI患病率最高，达11.3%，其次为南美洲（5.4%）；发展中国家女性POI患病率为5.3%，高于发达国家的3.1%。近20年来，POI患病率呈上升趋势（尽管P>0.05）。本研究建议医疗卫生机构加强公众健康宣教，落实与POI相关的健康教育目标，提升女性对早发性卵巢功能不全的认知与重视程度。