产后2年内妇女避孕方法使用及保健现况调查  

A cross-sectional study of contraceptive use and healthcare status among women at different times in the postpartum period

作　　者：秦鸣妍 徐伟清 梁霁[1] 钱序[1] QIN Mingyan;XU Weiqing;LIANG Ji;QIAN Xu(School of Public Health,Fudan University,Key Laboratory of Health Technology Assessment of the Ministry of Health,Shanghai 200032,China;Hongkou District Mental Health Center,Shanghai 200083,China;Shanghai Pudong Center for Women and Children’s Health,Shanghai 201399,China)

机构地区：[1]复旦大学公共卫生学院,国家卫生健康委员会卫生技术评估重点实验室,上海200032 [2]上海市虹口区精神卫生中心,上海200083 [3]上海市浦东新区妇幼保健中心,上海201399

出　　处：《上海预防医学》2024年第1期72-77,共6页Shanghai Journal of Preventive Medicine

基　　金：上海市第五轮公共卫生体系建设三年行动计划重点学科资助项目(GWV-10.1-XK08);上海市浦东新区第二轮医学学科建设项目(PWYgts2021-02)。

摘　　要：【目的】调查上海市浦东新区产后2年内妇女的避孕方法使用现况和相关保健服务利用情况。【方法】2021年6—11月,对陪同婴幼儿到社区卫生服务中心接受儿童系统保健的产后2年内不同时期的妇女进行问卷调查。数据分析采用χ2检验和logistics回归分析等方法。【结果】调查的1946位产后妇女中,有1934位属于已婚或未婚同居,其中1430位已恢复性生活。产后4、6、12、18和24个月妇女的避孕普及率分别为92.34%(193/209)、92.16%(235/255)、87.31%(282/323)、91.95%(297/323)和90.00%(288/320);现代避孕方法使用率分别为87.08%(182/209)、87.06%(222/255)、82.04%(265/323)、83.09%(271/323)和85.31%(273/320);未满足的避孕需求率分别为7.66%(16/209)、7.84%(20/255)、11.46%(37/323)、6.81%(22/323)和10.00%(32/320);产后6、12、18和24个月妇女的长效可逆避孕方法使用率分别为0.39%(1/255)、2.17%(7/323)、0.31%(1/323)和2.81%(9/320)。全部调查对象中,32.17%(626/1946)仅接受过1次产后避孕服务,27.85%(542/1946)没有接受过任何产后避孕服务。二分类logistic回归分析结果显示,产后避孕方法使用情况与分娩后(出院前)和产后家庭访视时有无接受过相关宣教服务有关(P<0.05)。【结论】产后妇女有未满足的避孕需求;分娩后(出院前)以及产后访视乃至产后检查时的避孕宣教质量和效果有待进一步研究。[Objective]To investigate the use of contraceptive methods,and to evaluate maternal healthcare services utilization among women within 2 years in Pudong New Area of Shanghai.[Methods]A cross-sectional survey was conducted using a questionnaire for women at different postpartum periods who visited a community health clinic with their children from June to November 2021.Data were analyzed usingχ2 test and binary logistic regression.[Results]Among the 1946 postpartum women surveyed,1934 were either married or cohabiting,and 1430 had resumed their sexual life.Among women at 4,6,12,18 and 24 months postpartum,the contraceptive prevalence rates(CPR)were 92.34%(193/209),92.16%(235/255),87.31%(282/323),91.95%(297/323)and 90.00%(288/320),respectively.The modern contraceptive prevalence rates(mCPR)were 87.08%(182/209),87.06%(222/255),82.04%(265/323),83.09%(271/323)and 85.31%(273/320),respectively,while the unmet contraceptive needs(UMNs)were 7.66%(16/209),7.84%(20/255),11.46%(37/323),6.81%(22/323)and 10.00%(32/320),respectively.The use rates of long-acting reversible contraceptive(LARC)methods among women at 6,12,18 and 24 months postpartum period were 0.39%(1/255),2.17%(7/323),0.31%(1/323),and 2.81%(9/320),respectively.Among all surveyed subjects,32.17%(626/1946)had received postpartum contraceptive services only once,while 27.85%(542/1946)had not received any postpartum contraceptive services.Binary logistic regression analysis indicated that the use of contraceptive methods among postpartum women was associated with whether relevant educational services were received after childbirth and during postpartum home visits(all P<0.05).[Conclusion]Postpartum women have unmet needs for contraception.Contraceptive guidance at the 42-day postnatal healthcare visit needs to be further strengthened and postpartum contraceptive education could be integrated into the pregnancy care.The quality and effectiveness of contraceptive education during delivery and postpartum home visits,and even at the 42-day postnatal healthcare visit nee

关 键 词：产后妇女 产后避孕 需求 卫生服务利用 

分 类 号：R172[医药卫生—妇幼卫生保健] R19[医药卫生—公共卫生与预防医学]