广州市2015—2019年青少年人工流产状况

钟银莉; 罗惠佳; 汤柳英; 方俊

doi:10.16835/j.cnki.1000-9817.2022.02.008

广州市2015—2019年青少年人工流产状况

doi: 10.16835/j.cnki.1000-9817.2022.02.008

广东省妇幼保健院保健部，广州 511442

基金项目:

广东省医学科学技术研究基金项目 201942592018230

详细信息

作者简介:
钟银莉(1989-)，女，广东韶关人，大学本科，统计师，主要从事妇幼卫生工作

通讯作者:
方俊，E-mail: 20925944398@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R173 R193
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- 被引次数: 0
出版历程
- 收稿日期: 2021-10-16
- 修回日期: 2021-12-01
- 网络出版日期: 2022-02-24
- 刊出日期: 2022-02-25

Analysis of induced abortion among adolescents in Guangzhou from 2015 to 2019

Department of Health Care, Guangdong Women and Children Hospital, Guangzhou (511442), China

摘要

摘要: 目的探讨2015—2019年广州市青少年人工流产状况，为减少青少年人工流产，促进女性青少年的生殖健康提供参考资料。方法回顾性分析2015—2019年到某三甲妇幼保健院人工流产的7 648例12~24岁女性的一般情况、人工流产次数及高危因素等，并对年龄、孕次等变量进行χ²趋势检验，观察5年内各变量的变化趋势。结果首次妊娠、未育和首次流产的青少年占比较高，分别为61.28%，81.63%，71.82%。12~19岁人工流产青少年1 251例，占16.36%；20~24岁6 397例，占83.64%；20~24岁年龄组孕次、产次、人工流产次数均高于12~19岁年龄组，差异均有统计学意义(P值均＜0.05)。12~19岁年龄组各年度所占比例总体呈下降趋势，20~24岁年龄组各年度所占比例总体呈上升趋势, 两组的比例趋势变化差异有统计学意义(χ²_趋势=22.99，P<0.01)；首次妊娠者(孕次=1)占61.28%，不同孕次所占比例总体呈上升趋势(χ²_趋势=9.06，P<0.05)；重复人工流产所占比例无明显升高，但短期内重复流产(1年内)者所占比例总体呈上升趋势(χ²_趋势=6.69，P<0.05)。患生殖道感染者所占比例总体呈下降趋势(χ²_趋势=4.91，P<0.01)。结论首次妊娠和未育青少年人工流产占比较高且呈上升趋势，可能与女性青少年的生殖健康知识掌握和社会、学校、家庭对女性青少年的生殖健康教育不足有关。应重点关注短期重复流产青少年，加大对其宣教力度、流产关爱和医疗资源的投入。
- 流产, 人工 /
- 健康教育 /
- 回顾性研究 /
- 青少年
Abstract: Objective To explore trends of adolescent induced abortion in Guangzhou, and to provide a reference for female adolescents induced abortion prevention and reproductive health promotion. Methods A retrospective survey was conducted to collect information regarding basic characteristics, frequency of induced abortion and risk factors of 7 648 adolescents aged 12-24 years who received induced abortion in one maternal and child health care hospital during 2015 to 2019. Chi-square test and trend analysis were carried out for data analysis. Results Adolescents with first pregnancy, nulliparity and first abortion accounted for 61.28%, 81.63%, 71.82%, respectively; a total of 1 251 adolescents aged 12-19 had induced abortion, accounting for 16.36%, and 6 397 adolescents aged 20-24 had induced abortion, accounting for 83.64%, the number of pregnancy, parity, and induced abortion in aged 20-24 was higher than that in the aged 12-19, and the differences were statistically significant (P<0.05). The proportion of the aged 12-19 showed an overall downward trend in each year, while that of aged 20-24 showed an overall upward trend, and there was a statistically significant difference between the two groups (χ²_trend=22.99, P<0.01); the first pregnancy accounted for 61.28%, and the number of pregnancies showed an overall upward trend (χ²_trend=9.06, P<0.05). The proportion of repeated abortion did not increase significantly, but the proportion of recurrent repeated abortion (within one year) showed an upward trend (χ²_trend=6.69, P<0.05). The proportion of adolescents with reproductive tract infection showed a downward trend (χ²_trend=4.91, P<0.01). Conclusion The proportion of induced abortion in first pregnancy and nulliparrous female adolescents is relatively high and showed an upward trend, which may be related to insufficient reproductive health knowledge and the lack of reproductive health education from society, school and family. Necessary resources should be devoted to adolescents with recurrent repeated abortion, as well as adolescent reproductive health education, post-abortion and medical care, the decrease in the rate of reproductive tract infection in adolescents suggests that the awareness of reproductive tract infection prevention has been improved.
- Abortion, induced /
- Health education /
- Retrospective studies /
- Adolescent
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表 1 2015—2019年不同年龄组青少年人工流产特征比较

Table 1. Comparison of induced abortion characteristics of adolescents in different age groups from 2015 to 2019

年龄/岁	人数	孕次/次		产次/次				人工流产/次
年龄/岁	人数	1	≥2	0	1	2		1	2	≥3
12~19	1 251	971(77.62)	280(22.38)	1 175(93.92)	74(5.92)	2(0.16)		1 028(82.17)	193(15.34)	30(2.40)
20~24	6 397	3 716(58.09)	2 681(41.91)	5 068(79.22)	1 009(15.77)	320(5.00)		4 465(69.80)	1 395(21.81)	537(8.39)
χ²/Z值		168.18		4.33				4.60
P值		< 0.01		< 0.01				< 0.01

年龄/岁	人数	人工流产高危因素		短期内重复流产		瘢痕子宫			生殖道感染
年龄/岁	人数	是	否	是	否	是	否		有	无
12~19	1 251	75(6.00)	1 176(94.00)	59(4.72)	1 192(95.28)	19(1.52)	1 232(98.48)		111(8.87)	1 140(91.13)
20~24	6 397	592(9.25)	5 805(90.75)	297(4.64)	6 100(95.36)	323(5.05)	6 074(94.95)		835(13.05)	5 562(86.95)
χ²/Z值		13.96		0.01		30.53			16.87
P值		＜0.01		0.91		＜0.01			＜0.01

年龄/岁	人数	宫颈炎		阴道炎		盆腔炎			外阴瘙痒
年龄/岁	人数	有	无	有	无	有	无		有	无
12~19	1 251	13(1.04)	1 015(81.14)	94(7.51)	934(74.66)	2(0.16)	1 249(99.84)		2(0.16)	1 249(99.84)
20~24	6 397	128(2.00)	6 269(98.00)	683(10.68)	5 714(89.32)	13(0.20)	6 384(99.80)		11(0.17)	6 386(99.83)
χ²/Z值		2.20		1.34		< 0.01			< 0.01
P值		0.14		0.25		＞0.05			＞0.05
注：()内数字为构成比/%。

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表 2 青少年人工流产基本特征在不同年份间比较情况

Table 2. Comparison of basic characteristics of adolescents with induced abortion in fifferent years

组别	选项	2015年(n=1 194)	2016年(n=1 213)	2017年(n=1 320)	2018年(n=1 681)	2019年(n=2 240)	χ²_趋势值	P值
年龄/岁	12~19	228(19.10)	212(17.48)	242(18.33)	274(16.30)	295(13.17)	22.99	< 0.01
	20~24	966(80.90)	1 001(82.52)	1 078(81.67)	1 407(83.70)	1 945(86.83)
孕次/次	1	695(58.21)	726(59.85)	790(59.85)	1 083(64.43)	1 393(62.19)	9.06	＜0.05
	≥2	499(41.79)	487(40.15)	530(40.15)	598(35.57)	847(37.81)
产次/次	0	962(80.65)	962(79.31)	1 076(81.53)	1 396(83.05)	1 847(82.46)	20.25	＜0.05
	1	195(16.25)	199(16.41)	180(13.70)	220(13.09)	289(12.90)
	≥2	37(3.10)	52(4.28)	64(4.77)	65(3.86)	104(4.64)
人工流产/次	1	839(70.35)	880(72.55)	937(71.01)	1 234(73.41)	1 603(71.56)	0.92	0.34
	2	253(21.11)	249(20.53)	279(21.12)	340(20.23)	467(20.85)
	≥3	102(8.54)	84(6.92)	104(7.87)	107(6.36)	170(7.59)
短期内重复流产	是	30(2.51)	65(5.36)	64(4.85)	83(4.94)	115(5.13)	6.69	＜0.05
	否	1 164(97.49)	1 148(94.64)	1 256(95.15)	1 598(95.06)	2 125(94.87)
瘢痕子宫	有	61(5.11)	69(5.69)	57(4.32)	63(3.75)	92(4.11)	7.94	0.94
	无	1 133(94.89)	1 144(94.31)	1 263(95.68)	1 618(96.25)	2 148(95.89)
生殖道感染	有	133(11.14)	159(13.11)	206(15.60)	246(14.63)	202(9.01)	4.91	< 0.01
	无	1 061(88.86)	1 054(86.89)	1 114(84.39)	1 435(85.37)	2 038(90.99)
宫颈炎	有	17(1.42)	24(1.98)	42(3.18)	30(1.78)	28(1.25)	17.08	0.05
	无	1 177(98.58)	1 189(98.02)	1 278(96.82)	1 651(98.22)	2 212(98.75)
阴道炎	有	111(9.30)	134(11.05)	159(12.04)	211(12.55)	162(7.23)	4.57	< 0.01
	无	1 083(90.70)	1 079(88.95)	1 161(87.96)	1 470(87.45)	2 078(92.77)
注：()内数字为构成比/%。

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