上海市未婚女性重复人工流产状况及其影响因素研究

Status and influencing factors of repeated induced abortion among unmarried women in Shanghai

目的:了解上海市未婚女性重复人工流产现状及其影响因素,探讨降低重复人工流产率的策略。方法:对在上海市提供常规人工流产服务的3家不同等级医院内自愿要求人工流产、<25岁的429例未婚女性进行描述性问卷调查。结果:未婚女性重复人工流产发生比例为33.10%;其中曾有过1次人工流产者占79.29%;在20岁前进行首次人工流产的比例为27.66%;11.68%的对象距上次人工流产时间不到半年。与非重复人工流产组相比,重复人工流产组中首次性行为<19岁的比例较高(23.51%,31.91%,P<0.05),暴露于性生活≥1.2年的比例较高(37.63%,76.06%,P<0.01),多性伴的比例较高(27.14%,60.87%,P<0.01),同居的比例较高(40.91%,55.32%,P<0.01),过去半年内从未使用过避孕措施的比例较低(23.51%,11.97%,P<0.05);本次避孕失败比例较高(27.18%,37.32%,P<0.05)。多因素分析结果也显示,暴露于性生活时间长、同居、多性伴、本次避孕失败均为重复人工流产的危险因素。结论:未婚女性重复人工流产与不安全性生活方式密切相关,应加强对这一人群避孕知识的宣传教育,提高避孕药具的正确使用率,在医院内推广和实施规范化的流产后咨询与教育服务。

Objective ： To investigate the status and influencing factors of repeated induced abortion among unmarried women in Shanghai and to explore appropriate strategies to decrease the rate of repeated induced abortion. Methods ： A cross - sectional survey was conducted among 429 unmarried women aged below 25, seeking abortion in 3 different hospitals which provided routine abortion service in Shanghai. Results： About one third respondents were repeated abortion seekers, among them 79. 29% had undergone one induced abortion before, 27.66% had sought the first abortion before the age of 20, and 11.68% had undergone two induced abortions within six months. In comparison with those without repeated induced abortion, higher proportion of repeated seekers had the first sexual intercourse before the age of 19 （ 31.91% 23.51%, P 〈 0.05 ）, longer his- tory of sexual behavior （76.06% 37.63%, P 〈 0.01 ）, multi - partners （60.87% 27.14%, P 〈 0. 01 ）, and had been in cohabitation （55.32% 40.91% , P 〈0.01 ） , a contraceptive failure for this unwanted pregnancy （37.32% 27.18% , P 〈0. 05） and. While lower proportion of repeated abortion seekers reported no contraceptive use during the last six months （ 11. 97% 23.51% , P 〈 0.05 ）. Multivariate analysis also showed that having sexual behavior, multi - partners and cohabitation for a long time as well as failure in contraceptive use resulting in current pregnancy were risk factors of repeated induced abortion. Conclusion： High proportion of unmarried women undergone repeated induced abortion could be closely related to their unsafe sexual behaviors. It is urgent to provide information and education and communication （IEC） intervention on contraceptives for unmarried women, to increase their correct use of modem and efficient contraceptive methods, and to promote post abortion counseling and education services in hospital.