The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)
The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)
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DOI：
10.1016/s0140-6736(13)62071-1
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发表时间：
2013-11-30
期刊：
影响因子：
168.9
通讯作者：
Johnson, Anne M.
中科院分区：
文献类型：
--
作者：
Wellings, Kaye;Jones, Kyle G.;Johnson, Anne M.
背景：计划外怀孕是一项重要的公共卫生指标。我们描述了英国一般人群样本中意外怀孕的流行率及其相关因素方法我们做了一个概率抽样调查，第三次全国性态度和生活方式调查（Natsal-3），15162名年龄在16-74岁的英国男性和女性，包括5686名育龄妇女，2010年9月6日至2012年8月31日期间纳入妊娠分析的16-44岁受试者。我们描述了在过去一年中已知结果的怀孕的计划状态，并使用经过验证的，多标准，多结果的措施（非计划怀孕的伦敦措施）报告非计划怀孕的年度人口患病率。我们将调查结果置于生殖健康相关事件的长期趋势和整个生命过程的模式的背景下。结果9.7%的16-44岁女性在访谈前一年有已知结果的妊娠，其中16.2%（95% CI 13.1-19.9）被评为计划外妊娠，29.0%（25.2-33.2）被评为矛盾妊娠，54.8%（50.3-59.2）被评为计划内妊娠，因此，计划外妊娠的年患病率估计为1.5%（1.2-1.9）。16-19岁女性的妊娠最常见于计划外（45.2% [30.8-60.5]）。然而，大多数计划外怀孕发生在20-34岁的女性中（62.4% [50.2-73.2]）。与非计划怀孕密切相关的因素是16岁之前的首次性交（年龄调整优势比2.85 [95%CI 1.77-4.57]），目前吸烟（2.47 [1.46-4.18]），最近使用大麻以外的药物（3.41 [1.64-7.11]）和较低的教育程度。计划外怀孕也与首次性交时缺乏性能力有关（1.90 [1.14-3.08]），报告性生活频率较高（2.11 [1.25-3.57]在过去4星期内曾接受5次或以上的性教育），主要是从学校以外的途径接受性教育（1.84 [1.12-3.00]）和当前抑郁症（1.96 [1.10-3.47]）。解释第一次性行为、同居和生育之间的间隔越来越长，这意味着英国女性平均要花30年的时间来避免意外怀孕。我们的数据提供了初级预防的范围，旨在降低计划外怀孕的比率，以及二级预防，旨在改变可能对母亲和儿童有害的计划外怀孕中的健康行为和健康障碍。
Background Unplanned pregnancy is a key public health indicator. We describe the prevalence of unplanned pregnancy, and associated factors, in a general population sample in Britain (England, Scotland, and Wales).Method We did a probability sample survey, the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), of 15 162 men and women aged 16-74 years in Britain, including 5686 women of child-bearing age (16-44 years) who were included in the pregnancy analysis, between Sept 6, 2010, and Aug 31, 2012. We describe the planning status of pregnancies with known outcomes in the past year, and report the annual population prevalence of unplanned pregnancy, using a validated, multicriteria, multi-outcome measure (the London Measure of Unplanned Pregnancy). We set the findings in the context of secular trends in reproductive health-related events, and patterns across the life course.Findings 9.7% of women aged 16-44 years had pregnancies with known outcome in the year before interview, of which 16.2% (95% CI 13.1-19.9) scored as unplanned, 29.0% (25.2-33.2) as ambivalent, and 54.8% (50.3-59.2) as planned, giving an annual prevalence estimate for unplanned pregnancy of 1.5% (1.2-1.9). Pregnancies in women aged 16-19 years were most commonly unplanned (45.2% [30.8-60.5]). However, most unplanned pregnancies were in women aged 20-34 years (62.4% [50.2-73.2]). Factors strongly associated with unplanned pregnancy were first sexual intercourse before 16 years of age (age-adjusted odds ratio 2.85 [95% CI 1.77-4.57], current smoking (2.47 [1.46-4.18]), recent use of drugs other than cannabis (3.41 [1.64-7.11]), and lower educational attainment. Unplanned pregnancy was also associated with lack of sexual competence at first sexual intercourse (1.90 [1.14-3.08]), reporting higher frequency of sex (2.11 [1.25-3.57] for five or more times in the past 4 weeks), receiving sex education mainly from a non-school-based source (1.84 [1.12-3.00]), and current depression (1.96 [1.10-3.47]).Interpretation The increasing intervals between first sexual intercourse, cohabitation, and childbearing means that, on average, women in Britain spend about 30 years of their life needing to avert an unplanned pregnancy. Our data off er scope for primary prevention aimed at reducing the rate of unplanned conceptions, and secondary prevention aimed at modification of health behaviours and health disorders in unplanned pregnancy that might be harmful for mother and child.