孕期至产后干预对产后意外妊娠影响  

Effect of intervention during pregnancy and postpartum on unintended pregnancy

作　　者：于传宁[1] 黄鹰[2] 张治萍[2] 范晓芳 俞琦华 儲莉鸣 顾丽芳[2] 柯豫[2] 

机构地区：[1]上海复旦大学计划生育科学研究所国家人口和计划生育委员会计划生育药具重点实验室,上海200032 [2]上海市浦东新区妇幼保健院 [3]上海市普陀区妇婴保健院

出　　处：《中国公共卫生》2015年第11期1392-1395,共4页Chinese Journal of Public Health

基　　金：上海市局管科技发展基金(2011JG05)

摘　　要：目的分析从孕期至产后开展综合干预对产后避孕知识及意外妊娠的影响。方法于2011年7月—2012年7月对上海市浦东新区妇幼保健院和普陀区妇婴保健院3 542名孕产妇进行干预,按医院分为干预组和对照组,采取结构式问卷进行调查。结果产后开始避孕时间、产后恢复性生活时间和排卵期计算方法相关知识,对照组回答正确人数分别为364人(45.50%)、622人(77.75%)和374人(46.75%),干预组分别为1 905人(69.47%)、2 504人(91.32%)和1 152人(42.01%);不同避孕方法中,产后意外妊娠103人(3.09%),对照组为35人(4.57%),干预组为68人(2.65%);2组导致产后意外妊娠发生比例最高的分别为口服避孕药和紧急避孕药,其次分别为安全期和体外排精避孕;多因素分析结果显示,干预组产后意外妊娠发生比例较对照组降低45%,文化程度、产后恢复性生活时间与避孕时间的交互作用对产后意外妊娠有影响。结论以医院为基础的综合干预可有效降低产后意外妊娠发生的可能性。Objective To evaluate the effect of comprehensive intervention during pregnancy and postpartum on un- intended pregnancy. Methods In total,3 542 pregnant women in two Maternal and Child hospitals at Pudong New Dis- trict and Putuo district participated in this intervention survey. The participants were divided into a control（ 1 013 ） and an intervention group（3 136） by the hospital they were recruited from and a structured questionnaire was adopted in the survey. The participants in the intervention group received a comprehensive intervention on postpartum contraception, while those in the control group received only the routine pregnancy and postpartum health care. Results After the intervention, the correct answer rates for the time of initiating contraception after giving birth, time of resuming intercourse, and knowledge about ovulatory period calculation were 69.47%, 91.32%, and 42. 01% for the intervention group and 45.50% ,77. 75%, and 46. 75% for the control group, respectively, with significant differences in the rates between the tow groups （ all P 〈 0. 000 1 ）. One year after the intervention, the prevalence of postpartum unintended pregnancy was 2.65% for the intervention group and 4.57% for the control group. The participants adopting oral contraceptive and emergency contraception had a higher postpartum unintended pregnancy rate than those using safe period contraception and coitus interruptus. Multivariate analysis showed that postpartum unintended pregnancy in intervention group reduced by 45% compared to that in the control group. The incidence of postpartum unintended pregnancy was influenced by edu- cation level and the interaction between the time of initiating contraception and the time of resuming intercourse after giv- ing birth. Conclusion The hospital-based comprehensive intervention has a positive effect on the reduction of postpartum unintended pregnancy.

关 键 词：意外妊娠 产后避孕 干预 

分 类 号：R173[医药卫生—妇幼卫生保健]