武汉市和黄石市妇女妊娠意愿影响因素研究

Study on the influential factors of pregnancy intention in Wuhan and Huangshi City

目的探讨武汉市和黄石市妇女妊娠意愿的影响因素。方法采用现况研究,对2016年8—11月期间因产前保健、人工流产和分娩在湖北省两家市级妇幼保健院就诊的孕产妇进行自填式问卷调查。以生态学模型为理论框架探讨影响妇女妊娠意愿的个人、人际、机构、社区、政策等多个方面因素。结果单因素分析结果表明:年龄(P=0.027)、婚姻状况(P<0.001)、小孩性别(P<0.001)、伴侣工作状态(P=0.004)、伴侣关系满意度评分(P<0.001)、首次性行为是否避孕(P=0.039)、流产次数(P=0.001)、医疗保险类型(P=0.001)、伴侣意愿(P<0.001)、亲密女性朋友影响程度(P=0.001)、是否考虑双方父母意见(P=0.007)与妊娠意愿相关联;多元线性回归结果表明:年龄35~45岁(β=1.930,P=0.016)、已婚(β=-4.877,P<0.001)、伴侣意愿一般(β=3.040,P<0.001)以及伴侣意愿强烈(β=4.200,P<0.001)、伴侣关系满意度评分9~10分(β=2.038,P=0.037)、伴侣有工作(β=2.964,P=0.022)、新农合/城镇居民医疗保险与妊娠意愿较高相关联(β=1.466,P=0.007);而已有小孩且为男孩与妊娠意愿较低相关联(β=-2.583,P<0.001);研究未显示流产次数、年龄24~35岁、已有小孩但为女孩、儿女双全、伴侣关系满意度评分6~8分、亲密女性朋友的影响、是否考虑双方父母的意见、有城镇职工医疗保险、有商业医保与妊娠意愿存在关联(P>0.05)。结论妇女妊娠意愿与个体、人际、政策等因素相关联,利用生态学模型能够较好地解释此关联,有助于产科临床及保健工作中识别不同妊娠意愿水平的妇女,以为其提供针对性的服务。

ObjectiveTo explore the influential factors of female pregnancy intention in Wuhan and Huangshi City.MethodsAdopting a method of prevalence study, self-administrated questionnaire survey was conducted among women who went to both of city-level maternal and child healthcare hospital in Hubei Province for antenatal care, induced abortion or childbirth from August to November in 2016. We established an ecological theoretical framework to describe the influential factors of the pregnancy intention in terms of individual, interpersonal, institutional, community and policy.ResultsResults of the univariate analysis showed that age (P=0.027), marital status (P<0.001), gender of children (P<0.001), partner’s working status (P=0.004), ratings of relationship satisfaction (P<0.001), contraception at the first sexual intercourse (P=0.039), times of induced abortion (P=0.001), type of medical insurance (P=0.001), partner’s will (P<0.001), the influence of female friends on pregnancy intention (P=0.001) and whether to consider the views of both parents (P=0.007) were associated with pregnancy intention. Result of multiple linear regression showed that association of age group of 35-45 years (β=1.930, P=0.016), married (β=-4.877, P<0.001), partner’s intention of moderate-level (β=3.040, P<0.001) and strong-level (β=4.200, P<0.001), rating of relationship satisfaction 9-10 (β=2.038, P=0.037), partner’s employed (β=2.964, P=0.022), the new rural cooperative/urban residents medical insurance (β=1.466, P=0.007) with pregnancy intention were positive;while the association of already having a son with pregnancy intention was negative (P<0.05);the association between frequency of abortion, age group of 24-35 years, having a daughter, having both son and daughter, the influence of the close female friends, whether to consider the views of both parents, having the medical insurance for urban workers and commercial medical insurance with pregnancy intention were not found in this research (P>0.05).ConclusionFemale pregnancy intention has association with factors of individual, interpersonal and policy, and the association can be explained preferably with ecological theoretical framework. It is helpful to recognize women with pregnancy intention of different levels and the women can enjoy specific service from obstetrical and health department.