河南省育龄妇女产后2 a内避孕方法使用情况及影响因素分析

Research on contraceptive measures and the influencing factors within 2 years after delivery among women of childbearing age in Henan Province

目的:了解河南省育龄妇女产后2 a内避孕方法使用情况及其影响因素。方法:在河南省7个省辖市13家医院,按照分娩时间顺序依次通过电话调查2015年7月至2016年12月分娩的孕妇共5860名,了解其产后避孕药具使用、性生活恢复、月经恢复等情况,分析产后避孕方法使用情况的影响因素。结果:河南省育龄妇女产后6、12、18和24个月累积避孕率分别为70.63%、80.59%、83.72%和84.90%,城市育龄妇女产后2 a内避孕水平高于农村(P<0.001)。产后首次和调查时使用的避孕方法中均以避孕套占比最高(64.76%、58.23%),高效避孕方法(包括绝育、放置宫内节育器、放置皮下埋植剂和服用复方口服避孕药)占比最少(4.78%、12.97%)。相对于选择低效(包括安全期和体外排精)/未常规避孕法,年龄在30~岁(OR=1.636,95%CI为1.144~2.338)、35~岁(OR=1.907,95%CI为1.248~2.912)相较<25岁者,文化程度为高中/中专(OR=1.425,95%CI为1.106~1.835),分娩方式为剖宫产(OR=1.371,95%CI为1.138~1.651),产次多(2次,OR=6.290,95%CI为4.052~9.764;≥3次,OR=10.416,95%CI为5.898~18.393),产后月经恢复时间早(>12个月,OR=0.624,95%CI为0.473~0.822),性生活恢复时间早(4~6个月,OR=0.749,95%CI为0.602~0.933;>6个月,OR=0.221,95%CI为0.150~0.326)者更倾向于选择高效避孕法进行避孕。结论:河南省育龄妇女产后2 a内避孕率有待提高,避孕措施以避孕套和低效避孕法为主。

Aim:To investigate the contraceptive measures and the influencing factors within 2 years after delivery among childbearing age women in Henan Province.Methods:A total of 5860 women,who gave birth during the period from July 2015 to December 2016 from 13 hospitals in 7 cities under the jurisdiction of Henan Province were randomly selected for investigation by telephone.They were investigated for postpartum contraceptive measures,sexual life recovery,menstrual recovery etc.Analysis was performed on the factors influencing the use of postpartum contraceptive measures.Results:The cumulative contraceptive rates of childbearing age women at 6,12,18 and 24 months postpartum were 70.63%,80.59%,83.72%and 84.90%in Henan Province,respectively.The contraception rate in urban women was higher than that in rural women(P<0.001).Condom accounted for the highest proportion(64.76%,58.23%)and high efficiency contraceptive methods(including sterilization,intrauterine devices,subcutaneous implants and combined oral contraceptives)accounted for the lowest(4.78%,12.97%)in the initial and current contraceptive methods after delivery.Compared with the choice of inefficient(including safe periods and extracorporeal ejaculation)/unconventional contraception,compared with those aged<25 years,those aged 30-years(OR=1.636,95%CI was 1.144-2.338),35-years(OR=1.907,95%CI was 1.248-2.912)having high school/technical secondary school education(OR=1.425,95%CI was 1.106-1.835),giving birth by cesarean section(OR=1.371,95%CI was 1.138-1.651),giving birth more often(2 deliveries,OR=6.290,95%CI was 4.052-9.764;≥3 deliveries,OR=10.416,95%CI was 5.898-18.393),tending to have early recovery time of postpartum menstruation(>12 months,OR=0.624,95%CI was 0.473-0.822),and having early recovery time of sexual life(4-6 months,OR=0.749,95%CI was 0.602-0.933;>6 months,OR=0.221,95%CI was 0.150-0.326)were more likely to choose highly effective contraception.Conclusion:The contraceptive rate of childbearing age women within 2 years after delivery in Henan Province should be improved.The main methods of postpartum contraception are condoms and inefficient methods of contraception.