北京地区育龄夫妇不育症的流行病学研究

目的 了解北京地区育龄夫妇不育症患病率及其危险因素.方法 2007年10月至2008年5月,在北京地区6个市辖区和1个远郊县中整群抽取女方年龄为20～49岁的已婚育龄夫妇,设计统一的生育状况调查表,进行不育症患病率现况调查,不育症诊断标准是夫妇双方均有肯定的生育愿望,正常同居2年、有规律性生活、未避孕未孕.描述该人群不育症状况的年龄、城乡分布,比较不育症危险因素暴露的组间差异,进行多因素Logistic回归分析.结果 共调查已婚育龄夫妇5862对,实际调查5632对,调查总体应答率96.07%.共发现不育症夫妇97对,样本的不育症患病率为1.72%,标化率为2.1%,其中原发不育占58.76%;继发不育占41.24%.按女方年龄分组后不育症患病率显示,20～30岁组为3.13%,30～40岁组为1. 69%,40岁以后组为1.38%,不育症患病率随妇女年龄增加而降低(x2=590.08,P＜0.01).按结婚年龄分组,不育妇女有83.5%在20～30岁结婚,其余16.5%在30以后或20岁之前结婚.单因素分析结果提示:影响不育的因素有结核病、子宫内膜异位症和生殖道感染性疾病.多因素Logistic回归分析结果表明,对不育的影响程度从大到小顺序为子宫内膜异位症、结核病、生殖道感染、子宫肌瘤和放射性物质接触史,相对危险度分别为3.13、1.57、4.81、2.62和1.48.其中,子宫内膜异位和生殖道感染史对不育的影响差异有统计学意义(P＜0.05).结论 研究结果反映了北京地区目前生育状况下不育症的总体患病率;不育症患病率随着妇女年龄增高呈下降趋势,结婚年龄偏大在30岁以上妇女不育症的患病率明显增高;子宫内膜异位和生殖道感染对不育的影响显著.

Abstract：

Objective To investigate the prevalence of infertility and its risk factors in the fertileage couples of Beijing, China. Methods A cross-sectional survey on the prevalence and risk factors was conducted from July 2007 to May 2008 in 7 Beijing districts. The districts were subdivided into the administrative units of "communities". A total of 33 communities were sampled and households selected randomly within each community. Of 5862 couples (women aged 20 -49 years) who were eligible for an interview, 5632 (96. 07% ) provided information in relation to all the questionnaire questions. The other couples did not participate because they were not at home for the interview, or became incapacitated, refused or others. The trained interviewers administered a detailed questionnaire to each study couple at their home,collecting the relevant information about contraception, sexual practices, marriage and a complete pregnancy history. The definition of infertility in the study was "a noncontracepting couple who want another child or a child if childless tried to conceive for at least 2 years" following the WHO recommendation[c2]. The study protocol was approved by the ethics committee of National Research Institute for Family Planning (NRIFP).Results A total of 97 couples were classified as infertile. And the total prevalence of infertility in 7 Beijing districts was 1.72%. The standardized prevalence of infertility was 2. 1%. 57 (58. 76% ) couples were classified as of primary infertility and 40 (41.24%) of secondary infertility. So the prevalence of primary and secondary infertilities were 1.01% and 0. 71% respectively. In women, the prevalence of infertility was the highest in the age group of 20 -29 (3.13%) and the lowest in the age group of 40 -49 (1.38%). The prevalence rate of infertility in the women whose marriage age were younger than 20 years or elder than 29 years of age was apparently higher than those of the 20 - 29 years old. The risk factors of infertility were tuberculosis ( TB), endometriosis (EM) and pelvic infection disease (PID). Conclusion The prevalence rate of infertility declines with age in women. Both EM and PID are the risk factors for infertility.

A prevalence survey of infertility in Beijing, China

Objective To investigate the prevalence of infertility and its risk factors in the fertileage couples of Beijing, China. Methods A cross-sectional survey on the prevalence and risk factors was conducted from July 2007 to May 2008 in 7 Beijing districts. The districts were subdivided into the administrative units of "communities". A total of 33 communities were sampled and households selected randomly within each community. Of 5862 couples (women aged 20 -49 years) who were eligible for an interview, 5632 (96. 07% ) provided information in relation to all the questionnaire questions. The other couples did not participate because they were not at home for the interview, or became incapacitated, refused or others. The trained interviewers administered a detailed questionnaire to each study couple at their home,collecting the relevant information about contraception, sexual practices, marriage and a complete pregnancy history. The definition of infertility in the study was "a noncontracepting couple who want another child or a child if childless tried to conceive for at least 2 years" following the WHO recommendation[c2]. The study protocol was approved by the ethics committee of National Research Institute for Family Planning (NRIFP).Results A total of 97 couples were classified as infertile. And the total prevalence of infertility in 7 Beijing districts was 1.72%. The standardized prevalence of infertility was 2. 1%. 57 (58. 76% ) couples were classified as of primary infertility and 40 (41.24%) of secondary infertility. So the prevalence of primary and secondary infertilities were 1.01% and 0. 71% respectively. In women, the prevalence of infertility was the highest in the age group of 20 -29 (3.13%) and the lowest in the age group of 40 -49 (1.38%). The prevalence rate of infertility in the women whose marriage age were younger than 20 years or elder than 29 years of age was apparently higher than those of the 20 - 29 years old. The risk factors of infertility were tuberculosis ( TB), endometriosis (EM) and pelvic infection disease (PID). Conclusion The prevalence rate of infertility declines with age in women. Both EM and PID are the risk factors for infertility.