河北省农村地区不育症患病现况调查

目的:了解河北省农村育龄夫妇不育患病率及其原因,为不育防治和病因学研究提供信息。方法:根据世界卫生组织不育症定义,通过分层整群横断面抽样方法,选取河北省5个县计划妊娠的育龄夫妇进行调查研究。结果:共调查19588对计划妊娠的育龄夫妇,其中不育症夫妇2256对,患病率为11.5%;其中单纯女方因素占26.4%,原发不育中首位因素是排卵障碍,继发不育是输卵管因素;单纯男方因素占34.5%,无论是原发还是继发不育,首位因素均为精液异常。结论:河北省农村地区不育症患病率较高,改变农村育龄夫妇传统的生育观念,规范不育症的诊疗是解决农村不育夫妇生育问题的主要任务。     

山东省不育症流行病学研究

1995年10月～1996年12月在山东省进行了不育症流行病学调查。采用分层、整群抽样的方法,调查地区人口数208 829人,其中已婚育龄夫妇38 356对,实际调查37589对,调查率98.0％。1年标准原发不育症现患率2.18％,继发不育症现患率1.11％;2年标准原发不育症现患率1.70％,继发不育症现患率1.06％。本文还分析了不同地域、不同年龄组、不同文化程度及不同结婚年龄的不育症现患率。调查显示不育症现患率农村高于城市,内陆高于沿海,平原高于山区,且农村产棉区最高,食用棉子油是导致不育的明显因素。     

上海市闸北区不育夫妇现状研究

目的:进行不育患病率及其有关影响因素和不育夫妇对生殖健康的服务需求的研究。方法:对上海市闸北区育龄夫妇进行不育症流行病学调查,采用随机抽样方法对400对不育夫妇进行问卷调查。结果:育龄夫妇共93119对,不育夫妇共4692对,不育症患病率为(5.04±2.14)％,其中原发不育3.37％,继发不育1.67％。不育夫妇以年龄大于30岁、中学文化程度、工人和结婚5年以上者为多(P值均<0.05)。不育夫妇中,40.0％女性有盆腔炎史,81.0％继发不育女性有人工流产史;6.2％男性有酗酒和药物成瘾,39.4％性生活异常,14.1％为无精症,仅3.8％作过生殖系统检查。50％以上不育夫妇对生殖保健信息不了解,需要专家咨询等服务。结论:不育症的防治是生育调节和生殖保健工作的重要内容。盆腔炎性疾病是造成不育的重要因素,而人工流产是导致女性继发不育的主要因素。不良生活习惯、性功能障碍等均影响男性生育功能,男性对生殖健康缺乏足够重视。不育对不育夫妇社会心理因素有一定影响,建议利用计划生育各级服务网络对不育夫妇进行宣教及提供相应的服务。     

不育妇女心理因素的相关性研究

不育症是指正常性生活、未怀孕、同居3a以上(我国以2a为标准)仍未有妊娠或未有活产者。欧美国家育龄夫妇不育症患病率为15%～20%,我国不育症患病率约为10%。无论是男性不育患者还是女性不育患者,不育的压力严重影响了他们的生活质量和家庭幸福。我国作为一个发展中国家,传统的观念多将不育归咎于女方,在这种特定的社会文化背景下,我国不育妇女的社会心理状况与哪些因素相关,本文通过相关性研究旨在加深对不育妇女社会心理方面的认识,为更加适宜、有针对性的对不育妇女进行健康教育心身治疗提供一定的参考依据。1 材料与方法1.1 资料来源 不育妇女的病例选自就诊于济宁市第一人民医院、市中区妇幼保健院、济宁医学院附属医院确诊为不育的患     

贵州省农村育龄夫妇预防出生缺陷知识、态度、行为的现状及需求调查

目的:了解贵州省农村育龄夫妇预防出生缺陷知识、态度、行为的现状及需求,为建立出生缺陷干预模式提供依据。方法:采用多阶段随机与整群相结合抽样方法,抽取贵州省内8个县中2360个家庭为对象进行问卷调查,问卷分为妻子回答部分和丈夫回答部分。结果:收回有效问卷2318份,出生缺陷知识总分及格率仅为46.15%;70%以上的育龄妇女对预防出生缺陷持有积极态度;在预防出生缺陷行为调查项目中,仅有56.38%的妇女及66.65%的丈夫得分及格。结论:调查地区育龄妇女对出生缺陷知识的知晓率低,知识的匮乏直接影响到育龄夫妇对预防出生缺陷的态度,不能主动形成有益于预防出生缺陷的行为,提示农村地区预防出生缺陷知识普及宣传不到位,育龄人群预防出生缺陷的意识和行为亟待提高。     

贵州省水族地区夫妇原发不孕率调查分析

目的:了解贵州省水族地区夫妇的原发不孕率及可能的影响因素。方法:采用随机整群抽样的方法,在贵州省三都水族自治县随机抽取10个乡镇作为研究现场,以在该10个乡镇居住的18~49岁初婚育龄妇女或其丈夫为研究对象,于2011年9月~2012年4月开展横断面调查。结果:共调查7 445位已婚育龄妇女或其丈夫,7 153份问卷合格。该地育龄夫妇的原发不孕率为11.37%。多因素分析显示,妇女计划妊娠年龄小、月经初潮年龄较大、文化程度低、职业为在机关事业单位工作,以及丈夫为以工为主的农民、有饮酒、吸烟习惯是原发不孕的危险因素。结论:贵州水族地区夫妇的原发不孕率为11.37%,夫妇的人口学特征及不良生活习惯是不孕的影响因素。     

2000～2011年贵州省6市县≥18岁居民高血压流行趋势分析

目的:分析2000~2011年贵州省6市县≥18岁居民高血压流行趋势,为当地居民高血压的科学防控提供参考依据。方法:采用2000、2004、2006、2009、2011年"中国居民健康与营养调查"项目资料,对贵州省6市县≥18岁居民根据不同年份、年龄、地区、性别分析高血压的流行趋势。结果:贵州省6市县居民高血压患病率从2000年的13.2%(标化率为15.6%)增至2011年的20.1%(标化率为18.2%),增长速度为52.3%,11年间平均增长率为3.9%。在各调查年份中,高血压患病率随着年龄增长逐渐增高,60岁~组居民高血压患病率均高于其他年龄组居民(P<0.05)。在2000~2011年间农村地区居民高血压患病率增长速度高于城市居民,男性居民高血压患病率增长速度低于女性居民。结论:贵州省6市县≥18岁居民高血压患病率总体呈上升趋势,应进一步加强对本省居民开展高血压防控措施的健康宣教,有效减少高血压的发生。     

甘肃省已婚育龄妇女不孕症现况调查与分析

目的:通过对甘肃省已婚育龄妇女不孕症患病情况进行现况调查,比较甘肃省不同地区不孕症患病率,探讨不孕症患病的影响因素。方法:采取分层与整群抽样相结合的方法,于2008年2月～2009年10月抽取甘肃省西部、中部、东部地区10个县(市)的40个社区及乡村妇女作为研究对象,开展面询式婚育及不孕症情况问卷调查。结果:共调查育龄妇女10500例,不孕夫妇528对,不孕症患病率为5.54%,患病率最高的地区为合作县,最低的为高台县,地区经济水平不同不孕症患病率差异有统计学意义(P<0.05)。不同年龄组不孕症患病率存在差异,其中患病率由高到低年龄组排序依次为26～30岁组、31～35岁组、18～25岁组、41～45岁组、36～40岁组。原发不孕48.1%,继发不孕51.9%。女方因素占58.1%,男方因素占29.9%,双方因素占13.7%。不孕年限在2～5年、6～10年比例居多,合计占所有不孕患者的62.5%。结论:经济状况、地理条件、民族、年龄等对甘肃省育龄夫妇不孕症患病率有一定的影响,且患者的患病年限长,就诊率较低,应加强宣传、早期诊断、早期治疗,以提高治愈率。     

四川农村地区活动性惊厥性癫痫的患病率与治疗缺口

目的调查四川省农村地区活动性惊厥性癫痫的患病率与治疗缺口,为更好的开展活动性惊厥性癫痫的预防和治疗工作提供良好的依据。方法共覆盖了四川省农村地区6个示范点的354.1万农村人口。从2005年6月至2010年6月,以村为基本的调查单位,根据当地初级卫生系统的乡村医生所提供的线索,入户进行活动性惊厥性癫痫患者的筛查。收集了基本的人口学资料和诊治现状,并计算了患病率、知晓率和治疗缺口。结果通过调查共筛查复核出活动性惊厥性癫痫患者6 547例,其中男性患者占55.08%,女性患者占44.92%,活动性惊厥性癫痫的患病率为1.8‰,男性的患病率为2.0‰,女性的患病率为1.7‰。活动性惊厥性癫痫的患者知晓率为63.9%。在筛查出的活动性惊厥性癫痫患者中,治疗缺口为66.33%,其中男性的治疗缺口为66.60%,女性的治疗缺口为66.00%。结论调查发现四川农村地区活动性惊厥性癫痫现状不容乐观,调查发现3/5以上的患者没有得到正规的治疗,治疗缺口巨大。     

贵州省成人高血压合并抑郁症的现状调查

目的:了解贵州省成人高血压合并抑郁症的流行现状。方法:采取分层多阶段整群随机抽样的方法随机抽取9070名18岁及以上常住人口作为调查对象。使用病人健康状况问卷抑郁模块-9(简称PHQ-9)为筛查工具对调查对象进行问卷调查,并对调查对象进行血压测量。结果:贵州省成人抑郁症患病率为11.6%。高血压患病率为27.7%。既往诊断为高血压的患者中抑郁症的患病率为15.3%,高于非高血压人群的抑郁症患病率11.9%(P0.05)。其中,女性高血压患者的抑郁症患病率为18.2%,男性为11.8%,女性高于男性(P0.05);城市高血压患者的患病率为23.5%,农村为10.3%,城市高于农村(P0.05)。新发现的高血压患者中抑郁症的患病率为9.3%,低于非高血压人群的抑郁症患病率(11.9%)(P0.05)。结论:高血压患者更易患抑郁症,对高血压合并抑郁症的患者应予以重视,综合干预,提高疗效。     

Prevalence of infertility in rural areas of Kafr El-Sheikh-Egypt: a community-based study

The current study was carried out in Desok district-Kafr El Sheikh province, to measure the prevalence of primary and secondary infertility among rural women and to study some risk factors as well. The study included 1125 married women between 15-49 years. The results of the study showed that; 7.9% reported secondary infertility 2.5% experienced primary infertility, the prevalence of primary infertility is higher among women under 30 years than older ages, and secondary infertility increases with advance in age. Both types of infertility were higher among women married under the age of 16 or above 30 years. There was an insignificant difference between fertile group and infertile groups regarding age at menarche. Irregular menses was significantly higher among infertile groups compared to fertile group. Secondary infertility group had significant higher abortion and difficult labor than fertile group. There was an insignificant difference between the study groups regarding illiteracy rate. Chronic illnesses of women as well as husbands were significantly more reported among women with secondary infertility. In conclusion, the overall prevalence of infertility is 10.4 %.     

Motherhood in sub-Saharan Africa: the social consequences of infertility in an urban population in northern Tanzania

This paper examines the personal and social ramifications of infertility in an African urban population with low fertility. The study was conducted in Moshi, Tanzania, a multi-ethnic community with relatively high levels of education and a well developed health services infrastructure. The major question to be addressed was whether in a low fertility urban population, both primary and secondary infertility bring about serious personal ramifications for women similar to those in rural areas. The methodology included a survey of 2,019 women and in-depth interviews with 25 fertile and 25 infertile women. Of the 1,549 sexually active women in a regular union, 2.7% had never had a child in spite of trying to conceive for at least two years. Of the 1,352 women who had previously had a child, an additional 6.1% were subsequently infertile. The most important finding from the qualitative analysis concerns the major difference between childlessness and subsequent infertility (or primary and secondary infertility) in terms of implications for the effected women. These findings underline the importance of bearing a child in sub-Saharan African populations.     

Epidemiology of Infertility: A Population-Based Study in Babol,Iran

The aim of researchers in the present study was to determine the prevalence of infertility and self-reported cause of infertility in Babol, Iran and then identify the factors associated with infertility. A retrospective epidemiologic study was conducted of characteristics of urban and rural women related to infertility. A total of 1,140 women aged 20–45 years were selected using cluster sampling. Of these 1,140 women, 59 (5.2%) (CI 4.2, 6.2) were voluntarily childless. Of the remaining 1,081 women, 913 (84.5%) (CI 82.5, 86.5) reported no difficulties in having children, and the remaining 168 (15.5%) (CI 13.5, 17.5) experienced difficulty conceiving at some stage in their lives. The prevalence of ever having primary infertility was 4.3% (CI 2.3, 6.3). The most frequently self-reported causes of infertility in this study were ovulation problems (39.2%). Infertile women were significantly more likely to have a higher age at marriage (p = 0.001), lower education (p = 0.006), higher body mass index (p = 0.0001), long-term health problems (p = 0.0001), a partner who smoked (p = 0.029), and past history of tubal or ectopic pregnancy (p = 0.002). These risk factors may help inform reproductive health clinics and primary healthcare centers about factors associated with infertility.     

Primary and secondary infertility in sub-Saharan Africa

BACKGROUND: No previous study has provided national estimates of the prevalence of primary and secondary infertility in sizeable areas of sub-Saharan Africa. METHODS: Primary infertility is measured by the proportion childless among women who entered their first marriage at least 7 years before date of censoring. Secondary infertility is measured by the 'subsequently infertile estimator' from parous ever-married women. Exposure begins at the age of the woman at the birth of her first child, and exposure ends when the woman is of an age, which is 5 years lower than her age at censoring. These last 5 years are used to determine her status as infertile or fertile at the last observation 5 years before censoring. A woman is considered infertile at last observation if she has had no livebirths during the last 5 years before censoring, otherwise she is considered fertile. A woman who has not given birth at age a or later is defined as being 'infertile subsequent to age a'. The index of the proportion subsequently infertile at age a is estimated as the number of women infertile subsequent to age a, divided by the total number of women observed at that age. Infertility is estimated for women age 20-44. RESULTS: Primary infertility is relatively low and it exceeds 3% in less than a third of the 28 African countries analysed. In contrast, elevated levels of secondary infertility prevail in most countries. Secondary infertility for women age 20-44 ranges from 5% in Togo to 23% in Central African Republic. CONCLUSIONS: It is feasible to gauge national levels of primary and secondary infertility from population based surveys including a birth history. The prevalence of infertility of pathological origin is so high in sub-Saharan Africa that infertility is not merely an individual concern, it is a public health problem.     

检测不孕症妇女宫颈分泌物、盆腔液解脲支原体和沙眼衣原体的临床意义

目的:探讨检测不孕症妇女体内解脲支原体和沙眼衣原体的临床意义。方法:选择近期在不孕症门诊收治的不孕症妇女90例,另收集120例正常妇女临床文献资料作为对照组。检测两组妇女宫颈分泌物、盆腔液中解脲支原体和沙眼衣原体情况,比较两组妇女UU与CT感染率差异,并分析原发性不孕与继发性不孕感染率差异。结果:90例不孕症妇女宫颈分泌物UU感染检出率为28.9%,显著高于健康对照组的8.3%(P<0.05);继发性不孕妇女宫颈分泌物UU、CT病原体检出率分别为37.7%(23/61)、9.8%(6/61),比原发不孕组显著增高,且继发性不孕妇女盆腔液UU检出率也较原发不孕组明显增高。结论:解脲支原体和沙眼衣原体是导致不孕症发生的重要因素,定期检测解脲支原体和沙眼衣原体具有重要的临床意义。     

未产妇人工流产与输卵管性不孕关系的研究

目的:研究未产妇人工流产后继发不孕的可能性。方法:对继发不孕患者375例及同期原发不孕患者380例常规妇科检查沙眼衣原体(CT)、解脲支原体(UU),并行盆腔子宫输卵管碘油造影(HSG),造影剂为40%碘化油。结果:继发不孕组中有254例(67.8%)、原发不孕组中有98例(25.8%)存在不同程度的输卵管梗阻,两组因输卵管梗阻引起的不孕有极显著性差异(P<0.001),继发不孕组中CT、UU的阳性率均高于原发不孕组相对应的阳性率(P<0.05),输卵管梗阻的发生率也明显高于原发不孕组(P<0.05)。结论:输卵管梗阻是继发不孕症的主要原因。     

The quest of infertile women in squatter settlements of Karachi, Pakistan: a qualitative study.

OBJECTIVES: There is a dearth of knowledge regarding Pakistani women's perceptions and treatment seeking behavior for infertility. We conducted this study to explore the contextual factors that influence the health-seeking behavior of infertile women in the lower socio-economic group. METHODS: In-depth interviews were conducted with 17 women, identified from clinics and community using pre-tested interview guidelines covering issues as the chronological sequence of the number and types of the health care providers consulted for infertility, household dynamics regarding decision making, perceived causes and social and psychological effects of infertility on the woman and her family. RESULTS: 14 of the 17 women interviewed presented with primary infertility and three with secondary infertility. Reasons reported for seeking treatment for primary infertility were: someone to carry on the family name, feeling alone and akhrat par maan bap bun kar uthna (getting up as a parent on judgment day). Two of the three women suffering from secondary infertility were seeking treatment because they did not have any male offspring. Of the 14 women, 11 initially sought treatment within the first two years of marriage; one woman reported that she was "coerced" by her mother-in-law to seek treatment following the first week of marriage. On average, a woman went to three health care providers (general practitioners, gynecologists and Traditional Birth Attendants) in her quest for assistance. The effects that infertility had on these women ranged from social pressure, coercion by in-laws and/or social isolation. Only one woman reported being put off by sex because it was not giving her what she 'desired'. CONCLUSION: Women in Pakistan seek care for infertility early and go to various types of health care providers. Infertility is usually treated as a clinical disease by the health care providers without considering its social ramifications.     

新疆鄯善县不孕症患者相关情况分析

目的:了解新疆鄯善县不孕症患者的相关心理及需求情况。方法:随机抽取新疆鄯善县20～45岁育龄期妇女610例,采用面访方法,由被调查人员到计划生育服务站接受调查,由调查员填写调查表。结果:在鄯善县及其3个乡中,筛查出不孕症妇女144例。其中原发不孕91例,继发不孕53例。大多数不孕症患者有治疗的愿望,但由于经济情况、路途遥远及不知道去哪里就医等原因;很多人没有得到及时的诊断及治疗,甚至放弃了就医。并且,不孕症患者在心理上存在压力,结论:目前鄯善县不孕症患者有获取知识和治疗的需求,有一定的心理压力,应加强对不孕人群的生殖健康教育。