中国妇女流产后计划生育服务与实施效果的系统评价与Meta分析

目的系统评价中国妇女流产后计划生育服务与重复流产和意外妊娠等的相关性,为提高中国妇女的避孕率和降低流产率提供参考依据。方法计算机系统检索了PubMed、Cochrane Library、CNKI、万方数据库(Wanfang Data)、中国生物医学文献数据库(CBM),查找与中国妇女流产后计划生育服务相关的随机对照试验(RCT)。严格按照纳入和排除标准筛除文献并提取相关数据。质量评价后,用Rev Man5.3和Stata12.1软件进行Meta分析。结果最终纳入17项研究,共涉及15 436名人工流产妇女,并且纳入的文献不存在发表偏倚。研究结果表明,人工流产的主要原因是未采取避孕措施和避孕失败,并且中国目前存在相对较高的重复流产率。与未实施流产后计划生育服务的妇女相比,流产后计划生育服务可以提高避孕率,降低意外妊娠率(OR=0.27,95%CI=0.20~0.35,P0.000 01)和重复流产率(OR=0.21,95%CI=0.18~0.24,P0.000 01)。结论合理的流产后计划生育服务可以提高无生育要求女性的避孕率,降低意外妊娠的发生率和重复流产率。

Intervention effect of post abortion family planning care in China: a systematic review and Meta-analysis

Objective To explore the correlation between post abortion family planning care and repeat abortion,unintentional pregnancy,in order to provide a reference to increase contraception and reduce the repeat abortion.Methods The electronic databases,such as PubMed,the Cochrane Library,CNKI,Wanfang Data and China Biology Medicine disc (CBM) were systematically searched to find the randomized control trails (RTCs) related to post abortion family planning care in China.The studies were selected strictly according to the inclusion and exclusion criteria,followed by extracting data.After quality assessment,the Meta-analysis was performed using RevMan5.3 and Statal2.0 software.Results A total of 17 articles were reviewed and the 15 426 participants were involved.Besides,there is no public bias in the reviewed studies.The results showed that the main induced abortion reasons were not using contraceptive methods and contraceptive failure and the rate of repeated abortions was higher in China.Compared with no PAC group,post abortion family planning care can increase the contraception rate,reduce the unintentional pregnancies (OR=0.27,95％ CI=0.20-0.35),P＜0.00001) and repeat abortions (OR=0.21,95％ CI=0.18-0.24,P＜0.00001).Conclusion Post abortion family planning care in China can increase the rate of using contraception measures.In addition,it can reduce the unwanted pregnancy rate and occurrence of repeated abortion.