初产前人工流产对再次妊娠女性健康的影响

Study on impact of induced abortion before primiparity on subsequent pregnancy

目的：探讨人工流产特别是初产前人工流产对再次妊娠女性健康的影响。方法：采用回顾性队列研究法，将2003年5～11月住院分娩的单胎初产妇按照有无人工流产史分为人流组和非人流组，于产后第2天对其进行问卷调查并摘录住院病例。结果：前置胎盘、分娩期胎盘并发症（包括胎盘粘连、残留、植入）、第三产程延长以及产后出血的比例，人工流产组均高于非人工流产组，两组间差异有统计学意义。因子分析和多因素非条件Logistic回归分析显示，人工流产高危行为（包括人工流产史、人工流产数、末次人流与本次妊娠的时间间隔）会使第三产程延长的风险增加。结论：初产前人工流产对再次妊娠时女性健康的影响较大，应采取科学有效的措施降低人工流产率，促进女性健康。

Objective： To explore the impact of induced abortion before primiparity on subsequent pregnancy, provide scientific evidences for the government to take effective measures to decrease the number of induced abortion, reduce the abortion rate and improve maternal health. Methods： Retrospective cohort study was carried out to analyze the impact of induced abortion on subsequent pregnancy. The study was restricted to primiparous women which were divided into two groups ： abortion group and reference group. All eases were interviewed on the second postnatal day and recorded at the same time. Results： The proportions of placenta praevia, placenta complication at labor stage （including retained placenta, placenta adhesion and placenta implantation）, postpartum haemorrhage, the prolonged third stage labor of the induced abortion group were significantly higher than that of reference group. Conclusion： Induced abortion before primiparity has more serious impact on maternal reproductive health. Scientific and effective measures should be taken to reduce induced abortion rate and relieve the impact of induce abortion on maternal reproductive health.