藏族农村育龄妇女自然流产的流行病学特征及其影响因素分析

目的 了解藏族农村育龄妇女自然流产状况及其相关影响因素。方法 对2006-2012年藏族农村孕妇采取入户访问获得其生育史,并进行随访直至获得本次妊娠结局。采用广义Poisson回归模型探索影响自然流产的因素,估计各研究因素的OR值及其95%Cl。结果 共随访l557名孕妇,总妊娠2687次,总产次2382次,发生自然流产171人204次;人工流产93人101次。自然流产妊娠比为7.6%,自然流产率为7.9%,发生自然流产的育龄妇女比例为11.O%。孕次是发生自然流产的重要原因,随着孕次增加,育龄妇女发生自然流产的风险增加,孕次超过3次时其风险最大,Poisson回归分析OR=3.921(95%Cl:2.553～6.021),OR=4.722(95%17/:2.834～7,866);随着产次的增加,育龄妇女发生自然流产的风险减少。自然流产的发生风险与怀孕年份有关,2009年后妇女发生自然流产的风险较低,OR=O.419(95%Cl:0.285。0.616),OR=0.580(95%Cl:0.380～0.885)。并未发现社会人口学特征与其自然流产的发生有显著关联。结论 藏族育龄妇女自然流产率并不高于陕西等平原地区,加强孕产期保健、延长生育间隔和减少育龄妇女的妊娠次数有助于降低西藏地区育龄妇女发生自然流产的风险。     

陕西省咸阳地区贫困农村育龄妇女自然流产状况调查

目的了解陕西省贫困农村育龄妇女自然流产状况及其相关因素。方法于2002—2005年间对陕西省长武县、彬县的农村怀孕妇女进行入户访问获得孕产妇的既往生育史,并对孕妇进行随访,直至获得本次妊娠结局。结果共随访5844例孕产妇,总妊娠次数为9638次,其中1153次为自然流产。孕产妇自然流产妊娠比为12.0%,自然流产率为13.6%,发生自然流产的比例为16.4%。随着妇女年龄的增加、妊娠次数的增加等,育龄妇女发生自然流产的危险性也在增加。结论加强计划生育,减少妊娠次数,延长生育间隔,防止高龄怀孕将有助于降低陕西省贫困农村育龄妇女自然流产的发生水平。     

沿奎河地区妇女自然流产流行状况及其影响因素

目的 了解沿奎河地区妇女自然流产状况及其影响因素。方法 于2012年至2013年对沿奎河地区40~70岁妇女进行问卷调查,获得生育史和相关影响因素。结果 共调查4 438名妇女,总妊娠次数为14 418次,自然流产次数587次。自然流产妊娠比、自然流产率和自然流产妇女所占比例分别为4.07%、4.40%、10.23%。多因素分析显示,孕前被动吸烟（OR=1.28,95%CI：1.03~1.61）、孕前饮酒（OR=1.33,95%CI：1.01~1.77）、做饭时厨房油烟量（OR=1.44,95%CI：1.08~1.92）、平时容易生气（OR=1.46,95%CI：1.16~1.84）、睡眠状况不好（OR=1.37,95%CI：1.07~1.74）会增加妇女自然流产的发生风险。怀孕次数是发生自然流产的重要原因,随着怀孕次数的增加,妇女发生自然流产的风险增加,孕次〉3次者发生自然流产的风险最大（OR=31.54,95%CI：17.88~55.64）。结论 奎河地区妇女自然流产率较高,孕前被动吸烟、孕前饮酒、做饭时厨房油烟量大、平时容易生气、睡眠状况不好、怀孕次数多是妇女发生自然流产的危险因素。     

自然流产患者的甲状腺功能检测及分析

目的:了解自然流产妇女的甲状腺功能状态。方法:以2007年1月～2009年2月在本中心就诊的自然流产妇女作为病例组,并在本地选择已有正常生育经历,无任何不良产史同年龄女性作为对照组。采用电化学免疫分析法检测其甲状腺功能,包括血清促甲状腺素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、抗甲状腺过氧化物酶抗体(TPOAb),并对异常者给予干预治疗。结果:病例组与对照组妇女血清TSH、FT3、TPOAb平均值差异经秩和检验比较有统计学意义。多元回归分析结果表明自然流产发生与有无人工流产史以及妊娠次数具有相关性。结论:诊治育龄妇女临床或者亚临床甲减,减少其妊娠及人工流产次数对预防自然流产发生有重要意义。     

武汉市青山区已婚育龄妇女意外妊娠状况调查

目的 探索武汉市青山区不同年龄队列已婚育龄妇女意外妊娠发生状况及影响因素.方法 采用横断面调查,于2010年3月以整群抽样抽取青山区18～49岁已婚育龄妇女3256人,应用自编调查表调查意外妊娠史及有关影响因素.结果 3256人中,53.8％报告有意外妊娠史,9.1％报告过去一年有意外妊娠,3个年龄队列(18～30岁、31～40岁和41～49岁)报告过去一年意外妊娠史的比例依次为31.8％、10.5％和1.8％.3个年龄队列均报告最近一次妊娠的主要原因是“没有采取避孕措施”(报告比例分别为69.7％、51.1％和42.4％);其次是“传统避孕法失败”(18～30岁为13.0％)和“环脱落或带环怀孕”(31～ 40岁为23.4％,41 ～49岁为37.0％).各年龄组队列报告“没有采取避孕措施”的主要原因是“存在侥幸心理”(59.6％).年龄大、初婚年龄小、初次性交年龄小是已婚育龄妇女意外妊娠发生相关危险因素.结论 青山区已婚育龄妇女报告意外妊娠者的比例较高.生育健康服务和干预应区别对待不同年龄队列的已婚育龄妇女,尤其重点关注年轻的妇女.     

武汉市青山区已婚育龄妇女意外妊娠状况调查

目的 探索武汉市青山区不同年龄队列已婚育龄妇女意外妊娠发生状况及影响因素.方法 采用横断面调查,于2010年3月以整群抽样抽取青山区18～49岁已婚育龄妇女3256人,应用自编调查表调查意外妊娠史及有关影响因素.结果 3256人中,53.8％报告有意外妊娠史,9.1％报告过去一年有意外妊娠,3个年龄队列(18～30岁、31～40岁和41～49岁)报告过去一年意外妊娠史的比例依次为31.8％、10.5％和1.8％.3个年龄队列均报告最近一次妊娠的主要原因是“没有采取避孕措施”(报告比例分别为69.7％、51.1％和42.4％);其次是“传统避孕法失败”(18～30岁为13.0％)和“环脱落或带环怀孕”(31～ 40岁为23.4％,41 ～49岁为37.0％).各年龄组队列报告“没有采取避孕措施”的主要原因是“存在侥幸心理”(59.6％).年龄大、初婚年龄小、初次性交年龄小是已婚育龄妇女意外妊娠发生相关危险因素.结论 青山区已婚育龄妇女报告意外妊娠者的比例较高.生育健康服务和干预应区别对待不同年龄队列的已婚育龄妇女,尤其重点关注年轻的妇女.     

609例城乡育龄妇女人工流产现状及其影响因素的研究

对６０９例城乡育龄妇女的人工流产现状进行了调查。结果发现,６０．５９％的城乡育龄妇女有人工流产史１８．３９％的妇女有婚前人工流产史。人流次数最多的７次,婚前人流次数最多达７次。多因素线性回归分析发现,妇女妊娠次数、生育次数、丈夫的年龄、妇女结婚时的年龄、性伴数等是影响妇女人工工流产的主要危险因素。研究提示,加强育龄妇女的生殖健康知识教育,减少婚前性行为和意外妊娠的发生率,降低人工流产率对保护妇女生     

南昌市己婚育龄妇女自然流产情况调查

目的 了解江西省南昌市已婚育龄妇女自然流产人次率及其分布特点.方法 采用横断面调查设计和多阶段按人口容量比抽样方法获得样本.对南昌市(2县、2区)己婚育龄妇女生育状况进行问卷调查.结果 共调查5 468名20～44岁南昌市己婚育龄妇女,共计10 098次妊娠,自然流产次数396次,自然流产人次率5.27%(396/7 516);自然流产人数为325人,自然流产人数发生比例为6.04%(325/5379).孕次越多,自然流产发生比例越高,差异有统计学意义.初孕年龄越大,自然流产发生比例越高,差异有统计学意义,P<0.01.结论 自然流产的发生随孕次的增加而增加;自然流产发生较多是结婚后5～10年;自然流产的发生随初孕年龄增加而增加;职业是自然流产的危险因素;南昌市自然流产人次率与历史资料比较呈增加趋势.     

中国已婚育龄妇女自然流产的危险因素分析

目的　探索育龄妇女自然流产的危险因素。方法　应用 1997年全国人口与生殖健康调查资料 ,通过单因素及多因素Logistic回归模型分析 1988～ 1997年 72 93例已婚育龄妇女、12 4 4 1次妊娠结局中自然流产的危险因素。结果　 1988～ 1997年全国自然流产率为 4 2 6 %。自然流产率存在地区差异 ,华北地区育龄妇女发生自然流产的危险最高。结论　随着育龄妇女初婚年龄和孕次的增加育龄妇女发生自然流产的风险显著上升     

西藏6个高海拔县藏族人群骨质疏松患病现状及其影响因素研究

目的 了解西藏地区6个高海拔县藏族成年人骨质疏松的患病现状及其影响因素。方法 采用多阶段分层随机抽样,从西藏地区6个高海拔县随机抽取1 309名藏族居民作为研究对象,采用χ2检验和logistic回归方法分析该地区骨质疏松检出率情况及影响因素。结果 西藏地区6个高海拔县成年女性骨质疏松的检出率为3.8％,男性为3.0％;60岁及以上女性骨质疏松的检出率为16.7％,男性为12.8％。Logistic回归分析结果显示:在女性群体中,年龄、从事农牧活动、BMI、绝经与骨质疏松的发生有关。在男性群体中,年龄与骨质疏松的发生有关。结论 西藏地区6个高海拔县60岁及以上男性和女性的骨质疏松的检出率偏低。增龄是该地区藏族成年女性、男性骨质疏松发生的独立危险因素。绝经、BMI偏低是该地区成年女性骨质疏松发生的独立危险因素。从事农牧活动是该地区成年女性骨质疏松发生的保护因素。     

Pregnancies,Abortions, and Births among Women with and without Borderline Personality Disorder

BackgroundThe purpose of this study was to examine history of pregnancies among women with and without borderline personality disorder (BPD), to determine whether BPD symptoms are associated with teenage pregnancies, unplanned pregnancies, elective and spontaneous abortions, and live births.MethodsThree hundred seventy-nine women completed the Structured Clinical Interview for DSM-IV Axis I diagnoses, Structured Interview for DSM-IV Personality for Axis II diagnoses, and a reproductive health interview. African-American (AA) women were oversampled, because little is known about BPD in AA women and they are at greater risk of teenage pregnancy, unplanned pregnancies, and spontaneous abortions.ResultsBPD symptom severity was associated with a teenage pregnancy, even after controlling for race and socioeconomic status. Symptom severity was also associated with unplanned pregnancies and live births, but only for women without a history of a substance use disorder. BPD symptom severity was not associated with abortion.ConclusionWomen with BPD become pregnant and have children, often during the period when BPD symptoms emerge and intensify. They are at increased risk of teenage pregnancies and unintended pregnancies compared with women with Axis I disorders. Treatment planning for this population should include attention to their reproductive health and better integration of physical and mental health services.     

Multiple Abortions and Sexually Transmitted Infections Among Young Migrant Women Working in Entertainment Venues in China

We conducted a survey of 358 young migrant women working in entertainment venues in China to explore the prevalence of and factors associated with two indicators of sexual and reproductive health: (1) multiple abortions and (2) the dual risk of sexually transmitted infections (STI) and abortion history. One quarter (25.4 percent) of the women in this sample had multiple abortions during their lifetime and, of those with any abortion history, 18.3 percent had had an abortion outside of a regulated health clinic. One-third (33.0 percent) of the sample had had an STI during the past year, and approximately one-fourth (23.7 percent) of those women did not receive STI treatment in a public hospital. Approximately one-fourth (23.5 percent) of the sample reported both a history of abortion and an STI during the past year. Women with a history of multiple abortions had significantly lower income levels, were more likely to have sex with clients and with husbands, and tended more to use alcohol before sex. Women who experienced both abortion and STI risks were more likely to report having had unprotected sex, genitourinary tract infections symptoms, anxiety, illicit drug use, and suicidal ideation. Enhanced efforts are needed to improve reproductive and sexual health for female migrants in urban China, particularly those working in entertainment venues.     

安徽省新婚女性感染状况与影响因素研究

目的:了解安徽省新婚女性感染及合并感染的发生情况,进一步探讨感染的影响因素。方法:以2008年9月～2011年9月在安徽省8个地区妇幼保健机构的20 000名新婚女性为调查对象,对其进行问卷调查及一系列常规体检与生化检查。采用二分类binary Logistic回归模型分析安徽省新婚女性感染的影响因素。结果:安徽省新婚女性生殖道感染率为9.11%。HBsAg(+)、RPR(+)及HIV(+)率分别为3.23%、0.23%及0.18%。现居住地为集镇及县郊区和市区、高家庭人均月收入、饮酒、被动吸烟、有自然流产、药物流产或手术流产史的女性患生殖道感染的风险增加;城镇户口是HBsAg(+)的保护因素,被动吸烟和1次手术流产是HBsAg(+)的危险因素;现居住地在集镇及县郊区、自然流产和≥2次药物流产是RPR(+)的危险因素;现居住地在集镇及县郊区是HIV(+)的危险因素。结论:多种因素与安徽省新婚女性感染有关。加强围婚期感染或合并感染的预防对促进生殖健康十分必要。     

Contraceptive failure--results from a study conducted among women with accepted and unaccepted pregnancies in Denmark

Most studies focusing on contraceptive failure in relation to pregnancy have focused on contraceptive failure among women having induced abortions, thereby neglecting those women who, despite contraceptive failure, accept the pregnancy and intend to carry the fetus to term. To get a more complete picture of the problem of contraceptive failure, this study focuses on contraceptive failure among women with diverse pregnancy outcomes.In all, 3520 pregnant women attending Odense University Hospital were included: 373 had induced abortions, 435 had spontaneous abortions, 97 had ectopic pregnancies, and 2614 received antenatal care. The variables studied comprise age, partner relationship, number of births, occupational and economical situation, and contraceptive use.Contraceptive failure, defined as contraceptive use (condom, diaphragm, IUD, oral contraception, or another modern method) at the intercourse where conception most likely occurred, were reported by 315 women, 52% of these women had induced abortions, 10% had spontaneous abortions, 3% had ectopic pregnancies, and 36% received antenatal care. Women aged 15-24 years were more likely to have experienced contraceptive failure in relation to use of condom and oral contraception than women aged 25-34 years. In addition, contraceptive failure was found to be associated with being single, a student, and having given birth twice or more previously. Regarding pregnancy acceptance, being 25-34 years of age was positively associated, whereas being single and a student was negatively associated with pregnancy acceptance.     

Examining the association of abortion history and current mental health: A reanalysis of the National Comorbidity Survey using a common-risk-factors model

Using the US National Comorbidity Survey (NCS), Coleman, Coyle, Shuping, and Rue (2009) published an analysis indicating that compared to women who had never had an abortion, women who had reported an abortion were at an increased risk of several anxiety, mood, and substance use disorders. Here, we show that those results are not replicable. That is, using the same data, sample, and codes as indicated by those authors, it is not possible to replicate the simple bivariate statistics testing the relationship of ever having had an abortion to each mental health disorder when no factors were controlled for in analyses (Table 2 in Coleman et al., 2009). Furthermore, among women with prior pregnancies in the NCS, we investigated whether having zero, one, or multiple abortions (abortion history) was associated with having a mood, anxiety, or substance use disorder at the time of the interview. In doing this, we tested two competing frameworks: the abortion-as-trauma versus the common-risk-factors approach. Our results support the latter framework. In the bivariate context when no other factors were included in models, abortion history was not related to having a mood disorder, but it was related to having an anxiety or substance use disorder. When prior mental health and violence experience were controlled in our models, no significant relation was found between abortion history and anxiety disorders. When these same risk factors and other background factors were controlled, women who had multiple abortions remained at an increased risk of having a substance use disorder compared to women who had no abortions, likely because we were unable to control for other risk factors associated with having an abortion and substance use. Policy, practice, and research should focus on assisting women at greatest risk of having unintended pregnancies and having poor mental health—those with violence in their lives and prior mental health problems.     

Abortion incidence and services in the United States in 2000

CONTEXT: Nearly half of unintended pregnancies and more than one-fifth of all pregnancies in the United States end in abortion. No nationally representative statistics on abortion incidence or on the universe of abortion providers have been available since 1996.
METHODS: In 2001-2002, The Alan Guttmacher Institute (AGI) conducted its 13th survey of all known U.S. abortion providers, collecting information for 1999, 2000 and the first half of 2001. Trends were calculated by comparing the survey results with data from previous AGI surveys.
RESULTS: From 1996 to 2000, the number of abortions fell by 3% to 1.31 million, and the abortion rate declined 5% to 21.3 per 1,000 women 15–44. (In comparison, the rate declined 12% between 1992 and 1996.) The abortion ratio in 2000 was 24.5 per 100 pregnancies ending in abortion or live birth, 5% lower than in 1996. The number of abortion providers decreased by 11% to 1,819 (46% were clinics, 33% hospitals and 21% physicians' offices); clinics provided 93% of all abortions in 2000. In that year, 34% of women aged 15-44 lived in the 87% of counties with no provider, and 86 of the nation's 276 metropolitan areas had no provider. About 600 providers performed an estimated 37,000 early medical abortions during the first six months of 2001; these procedures represented approximately 6% of all abortions during that period. Abortions performed by dilation and extraction were estimated to account for 0.17% of all abortions in 2000.
CONCLUSIONS: Abortion incidence and the number of abortion providers continued to decline during the late 1990s but at a slower rate than earlier in the decade. Medical abortion began to play a small but significant role in abortion provision.     

Adverse outcomes of planned and unplanned pregnancies among users of natural family planning: a prospective study.

OBJECTIVES: The purpose of this study was to determine prospectively whether unplanned pregnancies are associated with adverse pregnancy outcomes among users of natural family planning. METHODS: Women who became pregnant while using natural family planning were identified in five centers worldwide: there were 373 unplanned and 367 planned pregnancies in this cohort. The subjects were followed up at 16 and 32 weeks' gestation and after delivery. The risks of spontaneous abortion, low birth-weight, and preterm birth were estimated after adjustment by logistic regression. RESULTS: The women with unplanned pregnancies were more likely to be at the extremes of age, to report more medical problems before and during the index pregnancy, and to seek antenatal care later in gestation than the women with planned pregnancies. However, women with planned pregnancies reported a higher rate of spontaneous abortion in previous pregnancies (28.8%) than did women with unplanned pregnancies (12.9%). There were no significant differences in the rates of spontaneous abortion, low birthweight, or preterm birth between the two groups. CONCLUSIONS: No increased risk of adverse pregnancy outcomes was observed among women who experienced an unplanned pregnancy while using natural family planning.