山东女性继发性不孕影响因素调查

Factors associated with secondary female infertility in Shandong Province

目的探讨影响女性继发性不孕的因素。方法采用问卷调查方式，对山东省部分地区1408例20-44岁育龄妇女进行继发不孕影响因素调查。结果（1）单因素分析显示，两组年龄、民族、职业、文化程度、人均年收入、月经规律情况、月经周期、月经量、痛经情况、继发性闭经情况、流引产次数，生殖道情况、生殖系统感染、宫外孕情况、接触毒物和噪音、工作强度、重大不良生活史、精神压力比较，差异有统计学意义。（2）多因素分析显示，年龄大（OR=1．094，95％CI为1．065-1．125）、月经不规律（OR=2．977，95％CI为1．467—6．041）、月经量少（OR=0．494，95％CI为0．317—0．769）、痛经（OR=1．623，95％CI为1．030—2．557）、子宫炎症（OR=1．261，95％CI为1．042-1．525）、宫颈炎症（OR=2．129，95％CI为1．751—2．591）、精神压力大（OR=1．642，95％CI为1．214-2．221）等因素为影响山东女性继发不孕的因素。结论年龄、职业、月经规律情况、月经量、是否痛经、子宫炎症、宫颈炎症、精神压力因素为影响继发性不孕的因素。加强生殖健康及不孕不育知识宣传，可降低不孕症发病风险。

Objective To investigate factors associated with secondary female infertility. Methods A total of 1408 women aged between 20 and 44 years, including 462 in case group and 946 in control group, in selected area of Shandong province were recruited and interviewed with a structural questionnaire. Results Univariate analysis showed that distribution of age, occupation as farmers, the Hui nationality, low educational level, low income, irregular menstruation, longer menstrual cycle, fewer menses amounts, dysmenorrhea, secondary amenorrhea, number of induced abortion, reproductive tract abnormalities, reproductive system infection, ectopic pregnancy, hazards exposure, noise, high work strength, adverse life event, and mental stress were significantly different between the case group and the control group. Multivariate analysis indicated that advanced age （ OR = 1.09）, irregular menstruation （ OR = 2.30）, menstrual quantity （ OR = 1.62）, dysmenorrhea （ OR = 0.49）, uterine inflammation （ OR = 1.26）, cervicitis （ OR = 2.13 ）, and mental stress （OR = 1.64） were associated with infertility. Conclusion Reproductive health care providers should take these messages in their services.