山东省已婚育龄妇女避孕套使用情况调查

目的调查农村已婚育龄妇女避孕套使用状况及分析避孕失败原因，以提高避孕套使用效率，减少非意愿妊娠。方法采用横断面调查方法，分层整群随机抽样问卷调查山东省8个市县农村20543名已婚育龄妇女在2002年1月-2005年6月期间的生育避孕情况；采用病例对照研究方法，分析使用避孕套避孕的失败率和危险因素。结果近3年的避孕模式中，单纯使用避孕套的比例为45．1％，与节育器合用的比例为38．1％。避孕套避孕失败率为11．2％。避孕套避孕失败主要原因是未能坚持使用、套破裂和套滑脱。低年龄组使用避孕套失败的危险性增加，月经规律及没有月经期症状可降低避孕套使用的失败率，怀孕次数少和无流产史与使用避孕套避孕失败呈负关联。结论山东省农村避孕套使用率不断增加。但在使用过程中存在较多问题。应加强宣传教育。提高避孕套的正确使用率。     

口服避孕药的六大认识误区

我国避孕失败的已婚妇女中有56％使用避孕套，24％使用宫内节育器；而避孕失败的未婚妇女主要是使用避孕套（71％）。专家分析得出，口服避孕药的可靠性要比避孕套高10～15倍，比宫内节育器高1．5～4倍。     

人工流产术与并发症

人工流产是终止早孕和有效控制人口数量的一种补救措施，但部分受术者可能发生并发症。因此，必须规范技术操作。 一、人工流产的原因 1．非意愿妊娠与人工流产 据1991年上海市调查，已婚人工流产妇女主要妊娠原因为避孕失败占71.5％，未避孕的占28.5％。2000年调查已婚和未婚妇女非意愿妊娠原因中避孕失败分别占44.6％和73.1％。 2．避孕措施与人工流产 上海对7 826例新婚妇女避孕方法调查，有63.7％的对象不愿使用口服避孕药，怕影响健康及发胖；6.2％的对象不愿使用……     

人工流产妇女避孕现状及失败原因分析

目的：调查人工流产妇女的避孕情况,分析其失败原因,以便提高妇女生殖健康水平,降低人工流产率。方法：随机选取2010年10月-2011年12月笔者所在医院妇科门诊要求人工流产妇女357例,采用问卷方法进行调查。结果：无人工流产史181例,人工流产1次111例,2次45例,3次及以上20例。未婚与已婚妇女人工流产史比较差异无统计学意义（P〉0.05）。未避孕者及避孕方法使用不当者占20.2%（72/357）,避孕套是首选避孕方法,占31.4%,其次为安全期、节育器、避孕药,未婚女性多选择安全期避孕,而已婚女性多选择节育器。本组避孕失败285例,其中首位原因是避孕套,占30.8%,其次为安全期计算（14.6%）、节育器（14.6%）、避孕药（9.2%）、体外排精（6.4%）。结论：加强宣传教育,正确使用避孕方法,降低人工流产率,促进生殖健康。     

育龄妇女避孕套知识掌握情况的调查

目的了解避孕套知识在育龄妇女中的掌握情况,为十一五农村卫生适宜技术推广宣传避孕套提供依据。方法采用横断面调查法,对庄河市18乡50村2436名18—45岁育龄妇女进行问卷调查。结果不知道避孕套避孕方法的占4．8％,其中未婚占83．6％,已婚占16．4％;不知道避孕套可防性病的占48．7％,其中未婚占62．3％,已婚占37．7％;不能正确说出避孕套使用方法的占16．20％,其中未婚占69．5％,已婚占30．5％。结论在育龄妇女中,应加强宣传用避孕套有避孕和防病双重功效,并且把未婚女青年作为计划生育宣传教育工作的重点对象。     

深圳市福田区短效避孕方法的使用情况分析

目的全面了解深圳福田区育龄妇女短效避孕措施使用情况,为最大限度调动育龄群众节育主动性、减少因避孕方法失败导致的意外妊娠提供参考。方法以深圳福田区的9个街道计生服务站和福田区计生服务中心对20～49岁使用短效避孕措施的育龄妇女进行短效避孕措施使用及意外妊娠情况的问卷调查。结果 2 048名对象中现正使用的避孕措施为避孕套1 819例占88. 8%、安全期/体外排精115例占5. 6%、口服避孕药73例占3. 6%、外用避孕药41例占2. 0%。多数人认为避孕套、IUD或结扎最安全,比例分别为63. 1%、29. 6%。高年龄组认为避孕套最安全的比例较低,而认为上环结扎最安全的比例较高(P0. 01);随着文化程度的升高认为避孕套最安全的比例升高,而认为上环结扎最安全的比例下降(P0. 01)。因避孕失败导致流产的负面因素有年龄和生育子女数,而文化程度是保护因素。宣传材料、电视录像广播和网络是最受欢迎的宣传教育方式。结论有必要对不同年龄、文化程度、子女情况等特征的育龄妇女开展有针对性的避孕节育知情选择宣传教育,提高避孕药具质量,提高育龄人群获取免费避孕药具的主动性和易得性,以降低避孕失败率。     

新疆生产建设兵团已婚育龄妇女人工流产状况分析

目的：了解新疆生产建设兵团已婚育龄妇女人工流产情况。方法：采用分层、四阶段、整群、概率比抽样方法,共调查已婚育龄妇女7026人,用单因素和多因素的方法对妇女人工流产水平及其影响因素进行分析。结果：兵团已婚育龄妇女的人工流产发生率为47．34％,居住地,民族、生育年龄、文化程度及曾生男孩或女孩数是妇女妊娠后是否做人工流产的影响因素。由于未避孕、避孕失败导致人工流产的比例分别占57．44％和40．68％,避孕失败的主要原因是节育器移位和避孕套破裂。结论：兵团已婚妇女的人工流产发生率较高,发生非意愿妊娠的主要原因是未避孕和避孕失败,提示应进一步加大避孕相关知识的宣传力度,同时保证有效避孕药具的供给,并加强随访,以降低人工流产发生。     

科学服用紧急避孕药才能确保有效

育龄妇女如果因为安全套破损或滑脱、体外排精时计算安全期错误、避孕药漏服、节育环脱落等避孕失败；遭受性侵害等无防护性生活，往往造成意外妊娠。如果能科学服用紧急避孕药，避孕效果可达98％，能有效地保护当事妇女的身心健康。     

妇科门诊人工流产患者避孕知识、态度与行为调查

目的 了解妇科门诊人工流产后患者避孕知识态度与行为,为更好地开展妇科门诊人流后关爱服务（PAC）.方法 使用自制调查问卷表对235例门诊人工流产患者进行避孕相关知识、态度、行为等调查.结果 没有避孕（48.9％）和避孕失败（51.1％）是导致此次意外妊娠的主要原因,避孕失败采用的避孕方法依次为安全期、避孕套、体外排精、口服紧急避孕药、宫内节育器、口服避孕药;以往使用的避孕方法中,使用避孕套207人（88.1％）,避孕套使用完全正确仅4.8％ （10/207）;口服避孕药35人（14.9％）,服药方法不正确占使用人数的57.1％ （20/35）;使用宫内节育器避孕32人（13.6％）;从没避孕5人（2.1％）.对不可靠避孕方法、紧急避孕方法、避孕套正确使用、流产后排卵时间、人流危害完全知晓率分别为24.3％、19.1％、29.8％、9.8％、9.8％,研究对象中有49.8％认为偶尔性生活不会怀孕,6.4％认为紧急口服避孕药可用于日常避孕.不同婚姻状态、年龄、文化程度患者的避孕知识、态度水平比较,差异有统计学意义,均有P＜0.05.结论 妇科门诊人工流产患者避孕相关知识知晓率低,存在错误的避孕认知态度,避孕方法使用不当和低效的避孕方法使用率较高,必须通过PAC服务,立即落实避孕措施.     

深圳市南山区人工流产女青年性相关知识和性行为调查

目的:研究人工流产女青年的性知识掌握情况和性行为特征。方法:以自填式问卷,对年龄≤24岁,自愿要求行人工流产的女青年618名进行横断面调查。结果:女青年的避孕知识和生殖健康知识缺乏,其中部分知识点知晓情况已婚者好于未婚者,具有显著性差异(P<0．05)。41．0％的人知道性生活后立即冲洗阴道不能有效避孕,知道避孕失败可用紧急避孕作为补救方法的占52．2％, 口服避孕药和紧急避孕药服用时间回答正确的分别占9．2％和30．0％,认为使用避孕套比安全期和体外射精避孕有效的分别占56．2％和61．1％。调查对象首次性行为和首次人工流产的平均年龄分别为20．42岁和21．42岁,其中首次人工流产年龄≤19岁的占16．5％。最近3个月内性生活时有效避孕措施使用率低,均使用避孕套的仅为9．2％,29．3％使用过紧急避孕药。34．0％的女青年为多次人工流产。结论:人工流产女青年性相关知识掌握较差,有效避孕措施使用率低,首次性行为年龄小, 多次人工流产率高。应对青少年加强性教育,促进安全、有效避孕措施的使用,减少非意愿妊娠的发生。     

Contraceptive failure, method-related discontinuation and resumption of use: results from the 1995 National Survey of Family Growth

This study computed life table probabilities of contraceptive failure, discontinuation of use, and return to contraceptive use in the US. Data were obtained from the 1995 National Survey of Family Growth (NSFG) among a nationally representative sample of 6867 contraceptive use intervals contributed by women 15-45 years old who began use or resumed use after discontinuation during 1991-95. Analysis was based on Kaplan-Meier product-limit single decrement life table probability methods. Findings indicate that the risk of failure during typical use of reversible methods was 9% within 1 year of starting. Women with continuous lifetime use will experience 1.8 contraceptive failures. Failure rates were 7% for the pill, 9% for the male condom, 8% for the diaphragm, 20% for periodic abstinence, and 15% for spermicides. Failure rates reflect imperfect use. 31% of women discontinued use within 6 months of starting use. 44% discontinued within 12 months. Women using reversible methods continuously will discontinue use nearly 10 times during the reproductive period. Most women resumed use shortly after discontinuation. Low income women had higher risk of unintended pregnancy for all methods and the pill and lower risk of resumption after discontinuation. Hispanics had a higher risk of contraceptive failure for all methods and the condom. Black women had a higher risk of discontinuation of oral pills and condoms.     

未婚青年对避孕方法的选择

目的　了解未婚青年避孕状况 ,为婚前性教育提供依据。方法　利用上海市“未婚青年生殖健康保健需求调查”资料 ,对婚检青年关于避孕方法的选择进行分析。结果　未婚青年首次性行为时的避孕措施使用率为 2 4 0 % ;首次性生活后至首次怀孕间每次性生活时都使用避孕措施的使用率为 38 4 %。最常用的避孕方法为避孕套 ,其次依次为体外排精、口服药和安全期等。停用避孕套和体外排精法的主要原因是由于这两种方法影响性生活 ,停用口服药及安全期避孕的主要原因分别为不易获得、避孕失败。结论　未婚青年对常用避孕方法选择有性别差异和城乡差别 ,其它影响因素有文化程度性知识和避孕知识以及职业。     

Characteristics of reproductive life and risk of breast cancer in a case-control study of young nulliparous women

Between 1982 and 1985, a case-control study of nulliparous women, aged 25–45, was conducted to analyse the relationships between the risk of breast cancer and causes of nulliparity, including contraceptive methods. Fifty-one cases of breast cancer diagnosed less than 3 months before interview were matched with 95 controls on age at diagnosis, year of interview, and medical center. The causes of nulliparity related to fernale sterility or subfertility (mechanical or hormonal disorders) were not found to be associated with a significantly higher risk of breast cancer. The causes related to fertilization failure, i.e. no sexual partner, rare sexual intercourse (less than once per month), or partner with abnormal semen, were found to lead to an increased risk. Detailed analysis of contraceptive methods showed that the risk of breast cancer increased (p = 0.02) with a longer duration of use of barrier methods (withdrawal or condom). Conversely, the risk significantly decreased (p = 0.004) with a longer duration of use of non-barrier methods (oral contraceptives, IUD, cap, local spermicides, vaginal douche, safe period, or no method), i.e. methods allowing a direct exposure to human semen.     

Estimates of contraceptive failure from the 2002 National Survey of Family Growth

BACKGROUND: In 2001, the US government's "Healthy People 2010" initiative set a goal of reducing contraceptive failure during the first year of use from 13% in 1995 to 7% by 2010. We provide updated estimates of contraceptive failure for the most commonly used reversible methods in the United States, as well as an assessment of changes in failure rates from 1995 to 2002. STUDY DESIGN: Estimates are obtained using the 2002 National Survey of Family Growth (NSFG), a nationally representative sample of US women containing information on their characteristics, pregnancies and contraceptive use. We also use the 2001 Abortion Patient Survey to correct for underreporting of abortion in the NSFG. We measure trends in contraceptive failure between 1995 and 2002, provide new estimates for several population subgroups, examine changes in subgroup differences since 1995 and identify socioeconomic characteristics associated with elevated risks of failure for three commonly used reversible contraceptive methods in the United States: the pill, male condom and withdrawal. RESULTS: In 2002, 12.4% of all episodes of contraceptive use ended with a failure within 12 months after initiation of use. Injectable and oral contraceptives remain the most effective reversible methods used by women in the United States, with probabilities of failure during the first 12 months of use of 7% and 9%, respectively. The probabilities of failure for withdrawal (18%) and the condom (17%) are similar. Reliance on fertility-awareness-based methods results in the highest probability of failure (25%). Population subgroups experience different probabilities of failure, but the characteristics of users that may predict elevated risks are not the same for all methods. CONCLUSION: There was no clear improvement in contraceptive effectiveness between 1995 and 2002. Failure rates remain high for users of the condom, withdrawal and fertility-awareness methods, but for all methods, the risk of failure is greatly affected by socioeconomic characteristics of the users.     

Contraceptive failure in the United States: revised estimates from the 1982 National Survey of Family Growth

It is estimated that only about half of all abortions occurring during the period covered by the 1982 National Survey of Family Growth were actually reported in the survey; thus, contraceptive failure rates calculated from these data are almost certainly inaccurate. An attempt to correct for the underreporting of abortion indicates that actual 12-month use-failure rates are more than one-third higher than those calculated without taking abortion underreporting into account, with rates ranging from six percent for the pill to 14-16 percent for the condom, diaphragm and rhythm and to 26 percent for spermicides. Patterns of contraceptive failure are similar to those found in earlier studies.     

Contraception and STDs

Since behavioral research indicates that assumption of less risky sexual practices is unlikely, prevention of sexually transmitted diseases (STDs) by alteration in contraceptive practice is more realistic. Condoms, known from laboratory tests to be impermeable to semen, body fluids, and all STD organisms except hepatitis B fragments, only reduce transmission of most STD infections by 50% in actual use. Those who use condoms more consistently achieve better protection, while condom failure due to breakage is concentrated among some users. Spermicides, including nonoxynol-0, benzalkonium chloride, menfegol, and octoxynol, act as lipid solvent, killing sperm and all STD agents. Most studies suggest about a 50% reduction in transmission, with perhaps a 33 less transmission of chlamydia. There is one report of possible enhancement of transmission of HIV by use of spermicides, among prostitutes in Africa. Neither condoms nor spermicides protect against extragenital transmission, especially for organisms transmitted by skin contact, i.e., syphilis, herpes, or chancroid. Oral contraceptives provide clear protection, about 50%, against pelvic inflammatory disease (PID), while they may facilitate cervical ectopy, and associated cervical chlamydia and gonorrhea. IUDs, once believed to heighten the risk of PID, now are considered increase this risk only a few days or months after insertion. Such insertion-related infection can be controlled with a single dose of a broad-spectrum antibiotic. Unfortunately those methods which are most effective in preventing pregnancy, pill and IUDs, are not particularly useful in preventing STDs, as are the less effective barriers and spermicides.     

人工流产女青年避孕知识、态度和行为的调查研究

目的:研究人工流产女青年的避孕知识、态度、行为及影响避孕行为的相关因素。方法:采用个人问卷调查方式,对618名年龄≤24周岁,自愿要求行人工流产的早孕女青年进行横断面调查。结果:在本次妊娠前3个月,仅有12.3%的女青年坚持每次性行为时使用避孕方法,偶尔使用和从未使用者的比例分别为58.9%和28.8%。在440名使用过避孕方法的女青年中,最常用的方法分别是避孕套(58.7%)、体外射精(28.5%)和安全期(27.5%),只有29.3%的人使用过紧急避孕药。本次妊娠原因58.7%是未采用任何避孕措施,其余是避孕失败。Logistic逐步回归分析显示,女青年的文化程度、对避孕知识的了解、对避孕方法的态度、男友对避孕的关心程度是影响避孕行为的主要因素。结论:亟需对女青年开展有关避孕知识的教育,促进安全、有效避孕措施的使用,促进男性积极参与避孕,以减少非意愿妊娠的发生,避免重复流产。     

Factors associated with contraceptive choice and inconsistent method use, United States, 2004

CONTEXT: Pregnancies among contraceptive users account for nearly half of all unintended pregnancies and are almost entirely due to inconsistent or incorrect contraceptive use. Understanding what factors contribute to inconsistent contraceptive behavior can help efforts to reduce unintended pregnancy. METHODS: In 2004, a nationally representative sample of women aged 18-44 using reversible contraceptive methods were surveyed to examine factors associated with contraceptive choice and with inconsistent use of the pill and condoms. Bivariate and multivariate analyses were used to examine the data. RESULTS: Contraceptive choice was associated with a range of socioeconomic and partnership characteristics, and with pregnancy-, method- and provider-related experiences and attitudes; inconsistent pill or condom use was associated mainly with partnership, experiential and attitudinal factors. For example, not having a college education was negatively associated with pill use (odds ratio, 0.6) and positively associated with use of long-acting methods (1.8-1.9). Women for whom avoiding pregnancy was only a little or not important had reduced odds of using the pill (0.4) and elevated odds of using other methods, such as withdrawal or periodic abstinence (4.4), and of using condoms inconsistently (2.6). Use of a method chosen mostly out of dislike of other methods was positively associated with condom use (4.0) and negatively associated with use of the pill or long-acting methods (0.4 for each). Women who were not completely satisfied with their method were more likely than others to use their method inconsistently (1.6 for pill users and 1.9 for condom users). CONCLUSIONS: Greater efforts are needed to provide women and their partners with a range of method options, to facilitate selection of methods that best suit their needs and circumstances, and to identify and assist users who are dissatisfied or are having difficulties using contraceptives effectively.     

Contraception: gypsy versus non-gypsy women

186 non-Gypsy and 126 Gypsy women attending a primary care center in Barcelona for any reason during March-August 1997 were surveyed regarding personal characteristics and contraceptive knowledge and usage to assess differences between the two groups. The women were of fertile age, sexually active, and did not desire pregnancy. 92% had a regular sexual partner. 83% of the Gypsies and 65% of the others lived with the partner. The average relationship duration was 9.6 years for both groups. The most used contraceptive method was the condom for non-Gypsy women (36%) and withdrawal for Gypsy women (23%). Oral contraceptives and IUDs were the second and third most widely used for both groups, respectively. 18% of Gypsies and 4% of non-Gypsies currently used no method. The Gypsy women had significantly less knowledge of barrier methods, IUDs, spermicides, periodic continence, vasectomy, or tubal occlusion. Gypsy women were significantly less likely to seek contraceptive advice or monitoring of their contraceptive usage. The median number of induced abortions reported was 0.2 for Gypsy and 0.1 for non-Gypsy women. It was concluded that family planning programs should be tailored to promote use of effective contraceptive methods among Gypsy women, who have distinct cultural and family traits.     

Contraceptive failure rates based on the 1988 NSFG.

Analysis of data from the 1988 National Survey of Family Growth--corrected for the underreporting of abortion--reveals that contraceptive failure during the first year of use remains a serious problem in the United States, contributing substantially to unintended pregnancy. The pill continues to be the most effective reversible method for which data were available (8% of users accidentally became pregnant during the first year of use), followed by the condom (15%). Periodic abstinence is the method most likely to fail (26%), but accidental pregnancy is also relatively common among women using spermicides (25%). Failure rates vary more by user characteristics such as age, marital status and poverty status than by method, suggesting the extent to which failure results from improper and irregular use rather than from the inherent limitations of the method.