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目的了解湖北省恩施州已婚育龄妇女意外妊娠状况及其原因,为开展有针对性的干预以提高育龄妇女生殖健康状况提供依据。方法在湖北省恩施州进行多阶段分层随机整群抽样,采用自行设计的自填式问卷对8 096名18~49岁已婚育龄妇女进行调查。结果 34.8%的已婚育龄妇女报告有意外妊娠史,累积次数1~9次,其中42.7%有2次及以上意外妊娠。5.6%的妇女报告近1年有意外妊娠,其中18~30岁妇女较高,为9.5%。近1年有意外妊娠的妇女报告最近1次意外妊娠发生原因为:没有采取避孕措施(37.0%)、带环受孕(19.2%)、环脱落(16.7%)、安全期计算错误(10.0%)、忘记服避孕药(8.7%)、体外射精失败(2.2%)和其他原因(6.2%);不采取避孕措施的主要原因是事先没有准备(38.8%)、认为偶尔1次性行为不会怀孕(24.2%)、认为在哺乳期不会怀孕(15.8%)。有意外妊娠经历的妇女中,78.6%报告最近1次意外妊娠结局为手术流产,14.7%为药物流产,4.1%选择继续妊娠,2.5%为自然流产。结论已婚育龄妇女中意外妊娠较为常见,手术及药物流产为意外妊娠主要结局,未采取避孕措施以及宫内节育器失效是意外妊娠发生的主要原因。应加强对育龄妇女避孕节育知识的宣传教育以及对采用宫内节育器的妇女进行随访与定期检查。
Objective To understand the status and causes of unwanted pregnancies in married women of childbearing age in Enshi prefecture of Hubei Province and to provide basis for carrying out targeted interventions to improve their reproductive health status. Methods A multistage stratified random cluster sampling was conducted in Enshi prefecture of Hubei Province. 8 096 married women of childbearing age from 18 to 49 years old were investigated by self-designed self-designed questionnaire. Results 34.8% of married women of childbearing age reported an unidentified pregnancy history, accumulating 1 to 9 times, of which 42.7% had 2 or more unwanted pregnancies. 5.6% of women reported having unwanted pregnancies in nearly a year, of whom women aged 18-30 were higher at 9.5%. Women with unwanted pregnancies in the past year reported the most frequent unintended pregnancies because of contraception (37.0%), convalescent ring (19.2%), circumcision (16.7%), miscalculated safety period (10.0%), (8.7%), unsuccessful in vitro ejaculation (2.2%), and other causes (6.2%). The main reason for not adopting contraception was that it was unprepared (38.8%), and that occasional sexual activity was not likely to result in pregnancy (24.2%), not pregnant during lactation (15.8%). Of the women with unwanted pregnancies, 78.6% reported the last unintended pregnancy outcome as surgical abortion, 14.7% were medical abortion, 4.1% chose to continue with pregnancy, and 2.5% were spontaneous abortions. Conclusions Unexpected pregnancies in married women of reproductive age are more common. Surgical and medical abortion are the main outcomes of unplanned pregnancy. The failure to take contraception and the failure of IUD are the main causes of unwanted pregnancies. Publicity and education on contraceptive knowledge among women of childbearing age should be strengthened and follow-up and regular inspections should be conducted on women using IUD.