城市妇女产后哺乳期闭经和避孕行为的随访研究

为探讨城市妇女在产后1年内的哺乳类型、闭经状况和避孕行为,本研究采用前瞻性随访研究方法,对1996年6月起在山东省淄博市5所区级医院分娩的496名产妇进行登记,并对其中有活产的494名妇女于产后42天、4个月和1年时进行访视。1年访视率为98.8％。被访视对象96.1％为初产妇。访视结果显示,完全母乳喂养妇女产后4个月时月经恢复率为14.7％,而混合喂养者为29.2％(P<0.05)。产后第1个月37.7％的妇女避孕,第2个月为62.3％,前3个月以使用避孕套为主。自产后3个月起宫内节育器使用率逐渐增加。寿命表法分析表明,依产后顺序月为序,完全哺乳概率与产后闭经概率的降低呈一致趋势。在产后4个月时产后闭经概率仍为68.2％,提示提高完全母乳喂养率,有助于哺乳期自然避孕的可行性。为保护母婴健康,防止产后非意愿妊娠的发生,应加强服务网络间联系和适时地为产后妇女提供优质服务。妇幼保健与计划生育服务相结合应成为我国基层初级生殖保健的方向。

A follow-up study on the contraceptive practice and breastfeeding amenorrhea among postpartum women in Zibo city, China.

Using Data used in this paper is from the research of WHO project No. 94124 ent:thed"The Determinants of Family Planning Practice among postpartum Women in China". A hospital based longitudinal study was carried out in Zibo city, Shandong province,China in June 1996. Information was obtained from 500 new parturient women who gave birth in the hospital where they were first interviewed. They were then followed up three timings for interview at 42 days, four months and one year after delivery, respectively. The follow up rate of one year was 98.8%.96.1% of women were nulli-para.The results showed that at 4 months after delivery the menstruation resumption rate among women who were being in full breastfeeding was 29.2%. The percentages of women started to use contraceptive methods at the first and second month after delivery were 37.7% and 62.3% respectively. Majority of women used condom within the first 3 months during postpartum period, afterwards, most of them switched to IUD. Life table analysis showed that the continuation rates of full breastfeeding and amenorrhea decline rapidly after 3 months of delivery. The rate of amenorrhea at 4 months after delivery was 68.2% , this implied that if the full breastfeeding rate is increased further, there would be feasible for Chinese urban women using the Lactational Amenorrhea Method(LAM) for contraception. In order to prevent pregnancy after delivery and to improve both postpartum women and their babies' health, There is a need to enhance the contraceptive methods information providing services and for postpartum women.