流动已婚育龄妇女避孕生殖健康相关因素与人工流产风险关联的研究

Association between contraceptive choice and the risk of induced abortion among floating married women of childbearing age

目的了解流动已婚育龄妇女避孕生殖健康相关因素与人工流产发生风险的关联，为改善流动育龄妇女人工流产保健服务及利用提供依据。方法利用2005年全国五城市流动人口生殖健康调查数据，对543例有过1次及以上人工流产的流动已婚育龄妇女和1796例未经历人工流产的流动已婚育龄妇女的人口学特征、避孕方法选择、保健服务利用及人工流产状况进行描述分析，采用多因素logistic回归模型分析避孕相关因素与其人工流产发生风险的关联。结果〈30岁流动已婚育龄妇女发生人工流产风险是≥40岁者的2．08倍（95％a：1．26。3．42）；选择短效避孕方法者的人工流产风险是选择长效方法者的2．56倍（95％CI：1．84～3．56），需要付费才能获得避孕药具的人工流产风险是免费获得者的1．72倍（95％CI：1．32～2．24），从妇幼保健院、综合医院、街道居委会获得避孕工具者的人工流产风险分别是从乡镇或市计划生育服务站获得避孕工具者的2．69倍（95％CI：1．71～4．22）、2．49倍（95％CI：1．68，3．68）和1．81倍（95％CI：1．20～2．72），不了解紧急避孕措施的流动已婚育龄妇女发生人工流产风险是知晓者的1．41倍（95％CI：1．12～1．78），避孕知识来源于同事／亲友中的流动育龄妇女人工流产风险是来源于计生服务人员的1．85倍（95％CI：1．28～2．67）。结论年龄、短效避孕方法、付费获得避孕药具、不知晓紧急避孕措施可能是流动已婚育龄妇女发生人工流产的危险因素，据此针对流动已婚育龄妇女开展生殖健康教育，提高保健服务利用水平，可有助于预防和减少其人工流产发生风险。

Objective To find the association between factors related to contraception, reproductive health and the risk of induced abortion among floating married women of childbearing age, so as to provide basis for improving the access to health services for floating women of childbearing age. Methods Using data from the reproductive health survey on floating population from five cities in 2005, factors as demographic characteristics, contraceptive choice, settings and access to health services, induced abortion among the floating married women of childbearing age were described. Multivariate logistic regression was used to investigate the association the factors relative to contraception, reproductive health and the risk of induced abortion between 543 cases and 1796 controls. Results The risks of induced abortion among those under 30-years-old floating married women of childbearing age were 2.08-fold （95%CI： 1.26-3.42） of the group at the age of 40years old. The risk of abortion among floating married women at childbearing age who were taking short-acting contraceptive methods, was 2.56-fold （95%CI： 1.84-3.56） of those using the long-acting methods of contraception. The induced abortion risk of floating women at childbearing age who paid the contraceptive implement out of their own pockets, was 1.72-fold （95% CI： 1.32-2.24） of those who got it free of charge. The risks of abortion among women who recieved the contraceptive devices through maternal and child health centers, general hospitals or street residential committees were 2.69-fold （95%CI： 1.71-4.22） ,2.49-fold （95%CI： 1.68-3.68） and 1.81-fold （95%CI： 1.20-2.72） of those who received them from urban or rural family planning stations, respectively. The induced abortion risk for women who were ignorant of emergency contraception, was 1.41-fold （95% CI： 1.12-1.78） of those who had the knowledge. The abortion risks of floating women at childbearing age who get the contraceptive knowledge from the colleagues,relatives or friends were 1.85 times （95% CI： 1.28-2.67） of those from family planning workers. Conclusion Factors, including age, short-acting contraceptive methods, paid access to contraceptive implement, ignorance of emergency contraception might largely contribute to the increased risk of induced abortion among floating married women of childbearing age, which called for future attention.