Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country
Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country
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DOI：
10.1503/cmaj.071399
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发表时间：
2009-02-03
影响因子：
14.6
通讯作者：
Holmes, King K.
中科院分区：
文献类型：
--
作者：
Bernabe-Ortiz, Antonio;White, Peter J.;Holmes, King K.
背景资料：秘密人工流产是许多发展中国家的一个公共卫生问题，因为在这些国家，获得堕胎服务受到法律限制。我们估计的患病率和发病率，和风险因素，秘密人工流产在拉丁美洲county.Methods：我们进行了一个大型的人口为基础的调查，年龄在18-29岁的妇女在20个城市在秘鲁。我们询问了有关她们自然流产和人工流产史的问题，并使用技术鼓励她们披露。结果：在8242名符合条件的女性中，7992名（97.0%）同意参与。在参与调查的7962名妇女中，报告的人工流产患病率为11.6%（95%置信区间[CI] 10.9%-12.4%）。在6559名报告性活跃的妇女中，这一比例为13.6%（95%CI 12.8%-14.5%）。有性生活史的妇女人工流产年发生率为3.1%（95%CI 2.9%~ 3.3%）。在多变量分析中，人工流产的危险因素是调查时年龄较大（比值比[OR] 1.11，95% CI 1.07-1.15），首次性交时年龄较低（OR 0.87，95% CI 0.84-0.91），地理区域（高地：OR 1.56，95% CI 1.23-1.97;丛林：OR 1.81，95% CI 1.41-2.31 [v.沿海地区]），有子女（OR 0.82，95%CI 0.68-0.98），一生中有1个性伴侣以上（2名伴侣：OR 1.61，95% CI 1.23-2.09; ≥ 3名伴侣：OR 2.79，95% CI 2.12-3.67），并且在调查前一年有1名或多名性伴侣（1名伴侣：OR 1.36，95% CI 1.01-1.72; > 2名伴侣：OR 1.54，95% CI 1.14-2.02）。总体而言，49.0%（95%CI 47.6%-50.3%）的妇女报告说，目前性活跃的不使用controlling.Interpretation：在秘鲁的秘密，潜在的不安全人工流产的发病率是一样高或高于人工流产是法律的和安全的许多国家的利率。需要大力改进向需要者提供避孕药具和安全性行为教育的工作，这有可能降低人工流产率。
Background: Clandestine induced abortions are a public health problem in many developing countries where access to abortion services is legally restricted. We estimated the prevalence and incidence of, and risk factors for, clandestine induced abortions in a Latin American country.Methods: We conducted a large population-based survey of women aged 18-29 years in 20 cities in Peru. We asked questions about their history of spontaneous and induced abortions, using techniques to encourage disclosure.Results: Of 8242 eligible women, 7992 (97.0%) agreed to participate. The prevalence of reported induced abortions was 11.6% (95% confidence interval [CI] 10.9%-12.4%) among the 7962 women who participated in the survey. It was 13.6% (95% CI 12.8%-14.5%) among the 6559 women who reported having been sexually active. The annual incidence of induced abortion was 3.1% (95% CI 2.9%-3.3%) among the women who had ever been sexually active. In the multivariable analysis, risk factors for induced abortion were higher age at the time of the survey (odds ratio [OR] 1.11, 95% CI 1.07-1.15), lower age at first sexual intercourse (OR 0.87, 95% CI 0.84-0.91), geographic region (highlands: OR 1.56, 95% CI 1.23-1.97; jungle: OR 1.81, 95% CI 1.41-2.31 [v. coastal region]), having children (OR 0.82, 95% CI 0.68-0.98), having more than 1 sexual partner in lifetime (2 partners: OR 1.61, 95% CI 1.23-2.09; >= 3 partners: OR 2.79, 95% CI 2.12-3.67), and having 1 or more sexual partners in the year before the survey (1 partner: OR 1.36, 95% CI 1.01-1.72; > 2 partners: OR 1.54, 95% CI 1.14-2.02). Overall, 49.0% (95% CI 47.6%-50.3%) of the women who reported being currently sexually active were not using contraception.Interpretation: The incidence of clandestine, potentially unsafe induced abortion in Peru is as high as or higher than the rates in many countries where induced abortion is legal and safe. The provision of contraception and safer-sex education to those who require it needs to be greatly improved and could potentially reduce the rate of induced abortion.