河南省城乡地区育龄妇女产后2 a内非意愿妊娠发生现况分析

Analysis of unwanted pregnancy in 2 years postpartum among women of childbearing age in urban and rural areas of Henan Province

目的:了解河南省育龄妇女产后2 a内非意愿妊娠发生现况。方法:选取河南省7个省辖市的13家医院为项目点,随机抽取2015年7月至2016年12月在项目点住院分娩的5900名产妇为调查对象,于2017年9月1日至2018年3月31日电话调查其分娩后非意愿妊娠发生情况。结果:收回有效问卷5860份,有效应答率为99.32%,城市妇女3344人(57.06%),农村妇女2516人(42.94%)。产后2 a内非意愿妊娠473人(8.07%),城市237人,农村236人。城市地区育龄妇女产后2 a内非意愿妊娠发生水平低于农村(P=0.003)。非意愿妊娠妇女473人中,避孕失败184人(38.90%),未采取避孕措施289人(61.10%)。安全期避孕、不规范使用避孕套、体外排精是避孕失败主要原因;认为哺乳期不会怀孕、偶尔一次不会怀孕是产后未采取避孕措施的主要原因。非意愿妊娠妇女中,人工流产254人(53.70%),自然流产15人(3.17%),计划流产9人(1.90%),继续妊娠190人(40.17%),宫外孕5人(1.06%)。结论:河南省农村妇女产后2 a内非意愿妊娠发生率高于城市;应重点加强农村地区产前避孕宣教和产后避孕指导。

Aim:To understand the occurrence of unwanted pregnancy in 2 years postpartum among women of childbearing age in Henan Province.Methods:At 13 hospitals selected as the subjects of the survey from 7 cities of Henan Province,5900 delivery women in these hospitals from July 2015 to December 2016 were selected,and were surveyed by telephone from 1 September 2017 to 31 March 2018 about the cause of unwanted pregnancy and the outcome.Results:A total of 5860 valid questionnaires were collected with an effective response rate of 99.32%,including 3344(57.06%)Urban women and 2516(42.94%)rural women.Unwanted pregnancy within 2 years after birth occurred in 473(8.07%)women,237 from urban areas and 236 from rural areas.The unwanted pregnancy level in urban women was lower than that in rural women(P=0.003).Among the 473 women,38.90%(184/473)were ascribed to contraception failure,and 61.10%(289/473)did not take any measures of contraception.Rhythm method,unregulated use of condoms,and extracorporeal sperm extraction were the main reasons for the contraception failure.Among the women who did not use contraceptives after childbirth,"believed that they would not get pregnant during lactation"and"felt that they would not get pregnant once in a while"were the main reasons.Among the 473 women,254(53.70%)had induced abortion,15(3.17%)had spontaneous abortion,9(1.90%)had planned abortion,190(40.17%)continued pregnancy,and 5(1.06%)had ectopic pregnancy.Conclusion:The incidence of unwanted pregnancy in 2 years postpartum in rural areas is higher than that of urban areas in Henan Province;the propaganda and education of prenatal contraception and guidance of postpartum contraception should be strengthened,especially in urban areas.