Family Planning and the Burden of Unintended Pregnancies
Family Planning and the Burden of Unintended Pregnancies
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DOI：
10.1093/epirev/mxq012
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发表时间：
2010-04-01
影响因子：
5.5
通讯作者：
Burke, Anne E.
中科院分区：
文献类型：
--
作者：
Tsui, Amy O.;McDonald-Mosley, Raegan;Burke, Anne E.
计划生育被誉为上个世纪最伟大的公共卫生成就之一，全世界接受计划生育的夫妇已经上升到五分之三。然而，在许多国家，现代避孕药具的采用受到获取途径有限和服务提供薄弱的制约，意外怀孕的负担仍然很大。本综述的重点是计划生育在预防意外怀孕及其健康负担方面的有效性。作者首先描述了生殖行为和妊娠意向的流行病学框架，并使用它来指导最近21项关于妊娠意向、健康结局和避孕的个人水平研究的综述。然后，他们审查人口水平的研究计划生育的关系，生殖，孕产妇和新生儿的健康福利。计划生育的目的是防止艾滋病毒的母婴传播，促进生育间隔，降低婴儿死亡风险，减少堕胎，特别是不安全堕胎的数量。它还表明，与意外怀孕有关的孕产妇死亡率和孕产妇发病率显著降低。尽管如此，仍需要进行新一代的研究，调查意外怀孕与避孕药具使用率之间的适度相关性，以获得经过验证的具有成本效益的生殖技术的全部健康益处。
Family planning is hailed as one of the great public health achievements of the last century, and worldwide acceptance has risen to three-fifths of exposed couples. In many countries, however, uptake of modern contraception is constrained by limited access and weak service delivery, and the burden of unintended pregnancy is still large. This review focuses on family planning's efficacy in preventing unintended pregnancies and their health burden. The authors first describe an epidemiologic framework for reproductive behavior and pregnancy intendedness and use it to guide the review of 21 recent, individual-level studies of pregnancy intentions, health outcomes, and contraception. They then review population-level studies of family planning's relation to reproductive, maternal, and newborn health benefits. Family planning is documented to prevent mother-child transmission of human immunodeficiency virus, contribute to birth spacing, lower infant mortality risk, and reduce the number of abortions, especially unsafe ones. It is also shown to significantly lower maternal mortality and maternal morbidity associated with unintended pregnancy. Still, a new generation of research is needed to investigate the modest correlation between unintended pregnancy and contraceptive use rates to derive the full health benefits of a proven and cost-effective reproductive technology.