Contraceptive behavior among women after abortion in Nepal
Contraceptive behavior among women after abortion in Nepal
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DOI：
10.1016/j.ijgo.2014.05.012
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发表时间：
2014-11-01
影响因子：
3.8
通讯作者：
Thapa, Shyam
中科院分区：
文献类型：
--
作者：
Padmadas, Sabu S.;Lyons-Amos, Mark;Thapa, Shyam
目的：调查人工流产、活产、死产后避孕方法的使用时机，并估计临时避孕方法的停用率。方法：根据2011年尼泊尔人口与健康调查中提取的日历数据，对有详细孕产史和避孕史的已婚妇女样本进行以人口为基础的横断面研究。使用Kaplan-Meier累积风险模型和离散时间风险模型来估计临时方法使用者中避孕用具的使用时间和停用率。结果：最终分析样本为3190名女性。在684名堕胎妇女中，298名(43.6%)在堕胎后12个月内没有开始使用任何避孕措施。妇女在流产后更早开始使用避孕药具(风险比[HR]2.25；95%可信区间1.96-2.59；P<；0.001)。人工流产后避孕用药者的停药率显著高于流产后组(HR 132；95%CI，1.05~1.65；P<；0.05)。受过教育、更富有、在指标怀孕前使用过避孕药具、有两个儿子、有自主权的妇女在堕胎后开始使用避孕药具的时间比她们的同龄人要早得多。结论：尼泊尔堕胎后避孕药使用率较低。应通过系统监测和后续干预措施，加强堕胎后计划生育咨询和相关服务。(C)2014年国际妇产科联合会。爱思唯尔爱尔兰有限公司出版。版权所有。
Objective: To investigate the timing of contraceptive use and estimate the discontinuation rates of temporary methods among women after abortion, or a live birth or stillbirth. Methods: A sample of married women with detailed pregnancy and contraceptive histories was analyzed in a population-based cross-sectional study based on calendar data extracted from the 2011 Nepal Demographic and Health Survey. Kaplan-Meier cumulative and discrete-time hazard models were used to estimate the timing of contraceptive use and discontinuation rates among users of temporary methods. Results: The final analysis sample included 3190 women. Of 684 women who had had an abortion, 298 (43.6%) had not initiated any contraceptive use in the 12 months afterwards. Women initiated contraceptive use significantly earlier after abortion (hazard ratio [HR] 2.25; 95% CI, 1.96-2.59; P< 0.001). The rate of discontinuation among contraceptive users was significantly higher in the post-abortion group (HR 132; 95% Cl, 1.05-1.65; P < 0.05). Women who were educated, wealthier, had used contraceptives before the index pregnancy, had two sons and had autonomy initiated contraceptive use significantly earlier in the post-abortion period than their counterparts. Conclusion: Postabortion contraceptive use is low in Nepal. Postabortion family-planning counseling and related services should be strengthened with systematic monitoring and follow-up interventions. (C) 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.