河南省育龄妇女产后2年内再次妊娠及结局分析  

Analysis of re-pregnancy and outcome of women of childbearing age within 2 years after delivery in Henan province

作　　者：蒋丽芳 孙盼盼 张军喜 柴健 董玮 王雨虹 纪鹏慧 JIANG Lifang;SUN Panpan;ZHANG Junxi;CHAI Jian;DONG Wei;WANG Yuhong;JI Penghui(Henan Provincial Research Institute for Population and Family Planning, National Health and Family Planning Commission key laboratory of birth defects prevention, Key Laboratory of Population Defect Intervention Technology of Henan Province, Zhengzhou, Henan Province, 450002)

机构地区：[1]河南省人口和计划生育科学技术研究院,国家卫生健康委出生缺陷预防重点实验室,河南省人口缺陷干预技术研究重点实验室,郑州450002

出　　处：《中国计划生育学杂志》2020年第5期634-637,640,共5页Chinese Journal of Family Planning

基　　金：河南省省属科研单位社会公益项目预研专项资金(2017YY0071)。

摘　　要：目的:了解河南省育龄妇女产后2年内再次妊娠发生情况及结局。方法:对本省7个省辖市13家医院2015年7月-2016年12月住院分娩妇女,以随机抽样方式抽取5900名为调查对象,通过电话调查其分娩后至随访日期间再次妊娠、避孕、月经恢复及再次妊娠结局等情况。结果:5860例调查对象中有675例(占11.5%)再次妊娠。产后3,6,9,12,15,18,21和24个月内累积妊娠率分别为0.0%、0.7%、2.4%、4.4%、8.4%、11.0%、14.2%和17.5%,农村妇女高于城市妇女(χ^2=20.058,P<0.001);自然分娩后妇女高于剖宫产后妇女(χ^2=30.878,P<0.001)。产后再次妊娠的主要原因有未避孕、避孕失败和计划妊娠,分别占42.8%、27.3%和25.9%,非意愿妊娠占70.1%。未避孕的主要原因依次为哺乳期、觉得偶尔一次不会怀孕、不知道怎么避孕、没有合适的避孕方法;避孕失败者主要的避孕方法依次为安全期、避孕套和体外排精;避孕失败和未避孕妇女再次妊娠的结局为人工流产,分别占59.24%和50.17%。结论:产后2年内再次妊娠中以非意愿妊娠为主,非意愿妊娠以人工流产结局为主;产后再次妊娠者避孕意识淡薄,避孕知识缺乏。建议加强产后避孕服务干预,减少非意愿妊娠发生。Objective:To understand the occurrence and outcome of re-pregnancy of women of childbearing age within 2 years after delivery in Henan Province.Methods:5900 maternity women were randomly selected for investigation from 13 hospitals in 7 cities under the jurisdiction of Henan province from July 2015 to Dec 2016.The survey respondents were investigated by phone for their situations and outcomes of re-pregnancy,contraception,and menstrual recovery after delivery until to the follow-up date.Results:Among the 5,860 respondents,675(11.5%)were pregnant again after last delivery.The cumulative re-pregnancy rates of respondents 3,6,9,12,15,18,21 and 24 months after delivery were 0.0%,0.7%,2.4%,4.4%,8.4%,11.0%,14.2%,and 17.5%,respectively,the cumulative re-pregnancy rates of rural women were significant higher than those of urban women(χ^2=20.058,P<0.001),and the cumulative re-pregnancy rates of women with natural delivery were significant higher than those of urban women with caesareans(χ^2=30.878,P<0.001).No contraception,contraceptive failure,and planned pregnancy were the main reasons of postpartum re-pregnancy,which accounted for 42.8%,27.3%and 25.9%,respectively.And among these women with postpartum re-pregnancy,unwanted pregnancy accounted for 70.1%.The main reasons for the lack of contraception included that lactation without contraception,misunderstand on once sex in a while won’t get pregnant,without knowledge on how to contraception,and had no suitable contraception.Among contraceptive losers,the main contraception used in the order was safety period,condoms,or in vitro ejaculation.The abortion rate of re-pregnancy women in contraceptive losers or women with contraceptive failure were 59.24%and 50.17%,respectively.Conclusion:Unwilling pregnancy was the main cases of re-pregnancy women within 2 years after delivery,and most of them chose to artificial abortion.The postpartum re-pregnancy women have weak sense on contraception and lack of contraceptive knowledge,so postpartum contraceptive interventions should

关 键 词：产后 再次妊娠 结局 避孕 

分 类 号：R71[医药卫生—妇产科学]