产后重复人工流产现状及其影响因素分析:全国15省市现况调查

Prevalence and influence factors of postpartum repeat abortion:a cross-sectional study in 15 provinces in China

目的:分析我国妇女产后发生重复人工流产现状及其影响因素,为有效降低产后重复人工流产提供科学依据。方法:在全国15个省市60家医院,随机抽取2015年7月—2016年6月分娩妇女1.8万例,每家医院300例,了解其分娩前后人工流产、产后避孕、性生活恢复等情况,采用描述性分析和两水平二分类Logistic回归等方法进行数据分析。结果:共调查18045例产后妇女,产后3,6,12个月的累积重复人工流产率分别为0.21%(95%CI 0.14%~0.27%),0.89%(95%CI 0.75%~1.04%)和3.46%(95%CI 3.19%~3.73%),Logistic回归分析显示,产妇年龄、职业、文化水平、产后首次避孕方法、产后避孕启动时间与性生活恢复时间差、母乳喂养时间等是产后重复人工流产的重要影响因素。结论:我国妇女产后1年内的重复人工流产率较高,应加强对低龄、脑力劳动、文化程度低、母乳喂养时间短妇女的产后避孕干预,建议在产后性生活恢复之前就采取避孕措施。

Objective:To investigate the prevalence and influence factors of the postpartum repeat abortion(PRA)of women in China,and to provide scientific evidences for reducing PRA effectively.Methods:The study was conducted in China.18000 postpartum women were randomly selected from 60 hospitals in 15 provinces.300 postpartum women who gave a birth in the each participating hospital between July 2015 and June 2016 were interviewed for collecting the information on women's induced abortion before and after delivery,postpartum contraceptive used,resumption of sexual activity after delivery,etc.Descriptive analysis and 2 level binominal Logistic regression were used in data analysis.Results:Among the 18045 postpartum women who were investigated in this study,the rates of postpartum repeat abortion by the end of 3,6,and 12 months after delivery were 0.21%(95%CI:0.14%-0.27%),0.89%(95%CI:0.75%-1.04%),and 3.46%(95%CI:3.19%-3.73%),respectively.The results of logistic regression analysis showed that women’s age,occupation,education level,first choices of postpartum contraceptive methods,time difference between sexual resumption and postpartum contraceptive initiation,and length of breastfeeding were the significant influence factors of PRA.Conclusion:The one-year rate of PRA of the women is relatively high.Postpartum contraceptive intervention should be strengthened for the young women,and the women with mental work,low educational level,and short duration of breastfeeding.Contraceptive methods should be used before sexual resumption for postpartum women.