摘要
目的探讨停用避孕措施后再生育人群不良妊娠结局的发生情况。方法采取双向性队列研究方法,对2014年1月—2015年12月参加江苏省溧阳市、泰兴市、沛县3个县级妇幼保健计划生育服务机构的孕前优生健康检查家庭进行筛选,以计划生育二孩的2 435人为研究对象,将末次避孕措施为宫内节育器(IUD)定义为研究组,避孕套为对照组,随访比较2组队列妊娠结局的发生情况。采用多因素logistic回归模型进行统计分析。结果本研究共纳入2 435名研究对象,其中研究组1 252人,对照组1 183人。发生不良妊娠结局273例,发生率为11.21%。其中研究组和对照组不良妊娠结局分别为141例和132例,发生率分别为11.26%和11.16%,差异无统计学意义(P=0.935),调整人群基本特征、月经问题、女性生殖系统方面特征以及子女健康状况等混杂因素后,IUD组不良妊娠结局的发生风险是避孕套组的1.06倍(95%CI=0.81~1.39),差异仍无统计学意义。结论使用IUD未增加不良妊娠结局的风险。
Objective To explore the occurrence of adverse pregnancy outcomes in fertile population after discontinuation of contraceptive measures.Methods Totally 2435 women(mean age=29.69 years)intending to have their second child after discontinuation of contraceptive measures were recruited when taking pre-pregnancy health examinations at maternal and child health care institutions in 3 counties of Jiangsu province from January 2014 to December 2015.The women using intrauterine device(IUD)before terminating contraception were assigned into an observation group(n=1252)and those using condoms were assigned into a control group(n=1183).First follow-up interviews for pregnancy outcomes among all the women were carried out 30 months after the pre-pregnancy health examinations and continuous follow-ups every 3-month were conducted till September 30,2017.Multivariate logistic regression model was adopted in analyses on correlates of pregnancy outcomes.Results Among all the women during the follow up study,a total of 273 adverse pregnancy outcomes(APOs)were observed;the incidence of APOs was 11.21%and the incidence was not significantly different between the observation and control groups(11.26%vs 11.16%,P=0.935).After adjusting potential confounding factors such as demographics,menstrual disorder,characteristics of female reproductive system,and children′s health conditions,the risk of APOs of the women with IUD(odds ratio=1.06,95%confidence interval:0.81-1.38)was slight higher but not significant than that of women with condoms.Conclusion Usage of intrauterine device does not increase the risk of adverse pregnancy outcomes among child-bearing women.
作者
王冠融
周健
孙志明
张敏
张学宁
林洁
施雯慧
许豪勤
杨月华
WANG Guan-rong;ZHOU Jian;SUN Zhi-ming(Jiangsu Provincial Institute of Planned Parenthood Research,Nanjing,Jiangsu Province 210036,China;不详)
出处
《中国公共卫生》
CAS
CSCD
北大核心
2020年第12期1780-1784,共5页
Chinese Journal of Public Health
基金
江苏省卫计委科研课题(Q201603)
2018年江苏省科技厅省属公益类科研院所自主科研经费项目(BM2018033–2)
江苏省卫生健康委科研课题(H2018095)。
关键词
生育力恢复
双向性队列研究
妊娠结局
宫内节育器
fertility recovery
ambispective cohort study
pregnancy outcome
intrauterine device
