摘要
目的探讨人工流产对中国女性继发性不孕风险的影响。方法本研究为多中心病例对照研究。经过培训的调查员采用自主设计的调查表,按照统一的标准,在研究对象知情同意情况下开展面对面问卷调查。调查采用两阶段整群抽样方法进行抽样,通过SPSS 19.0软件完成数据分析。结果在4家医疗机构就诊的898例(25~35岁)女性的调查信息纳入了本次研究,其中242例继发性不孕患者,656例自然怀孕女性。经多因素校正后,有人工流产经历的女性与无人工流产史的女性相比,继发性不孕发生风险的OR值及其95%可信区间(95%CI)为3.28(2.17,4.97)。与无人工流产史的女性相比,流产1次的女性继发性不孕发生风险的OR(95%CI)为3.04(1.96,4.71),流产2次及以上的女性继发性不孕发生风险的OR(95%CI)为3.44(2.13,5.58)。此外,年龄较大的女性(≥30岁)以及月经不规律的女性,其继发性不孕发生风险更易受人工流产的影响。结论根据本次研究结果,人工流产增加中国育龄女性(25~35岁)继发性不孕的发生风险;重复人工流产对中国女性继发性不孕发生的影响更大;应开展更多的研究丰富相关研究证据,为政府决策提供科学依据。
Objective:To explore the impact of induced abortion on the risk of secondary infertility in Chinese women.Methods:This study is a multicenter case-control study.The trained investigators conducted the face to face questionnaire survey with the informed consent of the subjects by using the self-designed questionnaire.Two-stage cluster sampling was used to select the participants.Data analysis was conducted though SPSS 19.0 software.Results:A total of 898 Chinese women(25-35 years)including 242 female secondary infertility patients and 656 natural pregnant women were involved in the survey.After multivariate adjustment,the OR value and 95%confidence interval(95%CI)of the risk of secondary infertility were 3.28(2.17,4.97)in women with induced abortion compared with those without induced abortion.Compared with women without induced abortion,the OR(95%CI)of women with one abortion was 3.04(1.96,4.71),and OR(95%CI)of women with two or more abortions was 3.44(2.13,5.58).In addition,the risk of secondary infertility in elder women(≥30 years)and women with irregular menstruation was more likely to be affected by inducted abortion.Conclusions:The study results show that induced abortion increase the risk of secondary infertility among Chinese women with childbearing age(25-35 years).Repeat induced abortion has a greater impact on the occurrence of secondary infertility in Chinese women.More research should be carried out to enrich relevant research evidence and provide scientific basis for government decision-making.
作者
茅群霞
刘庆
张维宏
张巧
刘晓红
王建梅
刘明星
程丽娜
MAO Qun-xia;LIU Qing;ZHANG Wei-hong;ZHANG Qiao;LIU Xiao-hong;WANG Jian-mei;LIU Ming-xing;CHENG Li-na(National Research Institute for Family Planning,Beijing 100081;Department of Public Health & Primary Care,International Centre for Reproductive Health(ICRH),Ghent University,9000 Ghent,Belgium B-9000;Beijing Hospital,Beijing 100730;Haidian Maternal & Child Health Hospital,Beijing 100080;The Second Hospital of Tianjin Medical University,Tianjin 300211;The Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150;Anhui Provincial Research Institute for Family Planning,Hefei 230009)
出处
《生殖医学杂志》
CAS
2021年第6期721-727,共7页
Journal of Reproductive Medicine
基金
国家卫生健康委资助(2014BWWT002)
中央级公益性科研院所基本科研业务费(2018GJZ10)。
关键词
人工流产
中国女性
女性继发性不孕
病例对照研究
多中心调查
Induced abortion
Chinese women
Female secondary infertility
Case-control study
Multi-center survey
作者简介
茅群霞,女,江苏人,博士,副研究员,流行病与卫生统计学专业;通讯作者:刘庆,Email:liuqing2@nrifp.org.cn。
