Self-reported Physical Health of Women Who Did and Did Not Terminate Pregnancy After Seeking Abortion Services A Cohort Study
Self-reported Physical Health of Women Who Did and Did Not Terminate Pregnancy After Seeking Abortion Services A Cohort Study
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DOI：
10.7326/m18-1666
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发表时间：
2019-08-20
影响因子：
39.2
通讯作者：
Foster, Diana Greene
中科院分区：
文献类型：
--
作者：
Ralph, Lauren J.;Schwarz, Eleanor Bimla;Foster, Diana Greene
背景资料：研究表明，与堕胎相比，分娩相关的短期发病率和死亡率更高，但很少有研究对堕胎与分娩后意外怀孕妇女的长期身体健康进行研究。目的：检查寻求和接受堕胎或被拒绝堕胎的妇女的身体健康。设计：前瞻性队列研究。设置：2008年至2010年的30家美国堕胎机构。参与者：在1132名同意参与的寻求堕胎的妇女中，874名被纳入本分析（328例妊娠早期流产，383例妊娠中期流产，163例分娩）。测量：自我报告的总体健康状况;慢性腹部、骨盆、背部和关节疼痛;慢性头痛或偏头痛;肥胖;哮喘;妊娠期和非妊娠期高血压和糖尿病;和高脂血症每半年进行一次评估，持续5年。死亡率进行了评估，通过使用口头尸检和公共records.Results：没有显着差异，观察到自评健康或慢性疼痛后，第一个三个月与第二个三个月流产。5年时，27%（95% CI，21%至34%）的分娩妇女报告健康状况一般或较差，而20%（CI，16%至24%）的妊娠早期流产妇女和21%（CI，18%至25%）的妊娠中期流产妇女报告健康状况一般或较差。分娩的女性也报告了更多的慢性头痛或偏头痛和关节疼痛，但其他类型的慢性疼痛和肥胖的水平相似。9.4%的分娩参与者报告了妊娠期高血压。1132名参与者中有8名在随访期间死亡，2名在产后期间死亡。产妇死亡率没有统计学差异group.Limitation：自我报告的结果措施，不确定的普遍性，和41%的损失，以后续在5 years.Conclusion：虽然有些人认为，堕胎是有害的妇女的健康，这些研究数据表明，身体健康是没有更糟的妇女谁寻求和接受堕胎比妇女谁被拒绝堕胎。事实上，出现的差异表明生育者的健康状况更差。
Background: Research demonstrates worse short-term morbidity and mortality associated with childbirth than with abortion, but little research has examined long-term physical health in women with unwanted pregnancies after abortion versus childbirth.Objective: To examine the physical health of women who seek and receive or are denied abortion.Design: Prospective cohort study.Setting: 30 U.S. abortion facilities from 2008 to 2010.Participants: Of 1132 women seeking abortion who consented to participate, 874 were included in this analysis ( 328 who had first-trimester abortion, 383 who had second-trimester abortion, and 163 who gave birth).Measurements: Self-reported overall health; chronic abdominal, pelvic, back, and joint pain; chronic headaches or migraines; obesity; asthma; gestational and nongestational hypertension and diabetes; and hyperlipidemia were assessed semiannually for 5 years. Mortality was assessed by using verbal autopsy and public records.Results: No significant differences were observed in self-rated health or chronic pain after first-trimester versus second-trimester abortion. At 5 years, 27% ( 95% CI, 21% to 34%) of women who gave birth reported fair or poor health compared with 20% ( CI, 16% to 24%) of women who had first-trimester abortion and 21% ( CI, 18% to 25%) who had second-trimester abortion. Women who gave birth also reported more chronic headaches or migraines and joint pain, but experienced similar levels of other types of chronic pain and obesity. Gestational hypertension was reported by 9.4% of participants who gave birth. Eight of 1132 participants died during follow-up, 2 in the postpartum period. Maternal mortality did not differ statistically by group.Limitation: Self-reported outcome measures, uncertain generalizability, and 41% loss to follow-up at 5 years.Conclusion: Although some argue that abortion is detrimental to women's health, these study data indicate that physical health is no worse in women who sought and underwent abortion than in women who were denied abortion. Indeed, differences emerged suggesting worse health among those who gave birth.