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
计量
- 文章访问数: 547
- HTML全文浏览量: 314
- PDF下载量: 36
- 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
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

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/%。

下载: 导出CSV

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/%。

下载: 导出CSV

参考文献(22)

[1]	WHO. Health for the world's adolescents: a second chance in the second decade: summary[R]. Geneva: WHO, 2014.
[2]	DUNN S, WISE M, JOHNSON L, et al. Chapter 10: Reproductive and gynaecological health Bierman AS, editor[R]. Ontario women's health equity report. Vol. 2 Toronto: Project for an Ontario Women's Health Evidence-Based Report, 2011: 74-92.
[3]	MCKAY A, BARRETT B. Trends in teen pregnancy rates from 1996-2006: a comparison of Canada, Sweden, U.S.A., and England/Wales[J]. Can J Hum Sex, 2010, 19: 43-52.
[4]	DING R, GUO C, SONG X, et al. Male knowledge, attitude and practice and partner pregnancy among Chinese unmarried youth[J]. PLoS One, 2019, 14(3): e0214452. doi: 10.1371/journal.pone.0214452
[5]	程利南. 推进人工流产后避孕避免重复流产[J]. 实用妇产科杂志, 2012, 28(4): 241-242. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ201204004.htm CHENG L N. Promoting contraception after induced abortion to avoid repeated abortion[J]. J Pract Obstet Gynecol, 2012, 28(4): 241-242. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ201204004.htm
[6]	周洁琼, 杜玉开. 人工流产与再次妊娠结局之间的关系研究[J]. 医学与社会, 2005(9): 6-8. https://www.cnki.com.cn/Article/CJFDTOTAL-YXSH200509002.htm ZHOU J Q, DU Y K. Study on The relationship between induced abortion and the outcome of second pregnancy[J]. Med Soc, 2005(9): 6-8. https://www.cnki.com.cn/Article/CJFDTOTAL-YXSH200509002.htm
[7]	黄丹. 青少年重复人工流产焦虑抑郁情绪及PAC干预探讨[J]. 心理月刊, 2019, 14(5): 24. https://www.cnki.com.cn/Article/CJFDTOTAL-XLYK201905019.htm HUANG D. Discussion on anxiety, depression and PAC intervention of adolescents with repeated induced abortion[J]. Psychol Monthly, 2019, 14(5): 24. https://www.cnki.com.cn/Article/CJFDTOTAL-XLYK201905019.htm
[8]	周敏, 张小松, 赵更力, 等. 中国四城市医院未婚人流女青年生殖道感染状况研究[J]. 生殖与避孕, 2005(3): 163-168. https://www.cnki.com.cn/Article/CJFDTOTAL-SZBB200503007.htm ZHOU M, ZHANG X S, ZHAO G L, et al. Study on reproductive tract infection of unmarried young women with abortion in four urban hospitals in China[J]. Reprod Contrac, 2005(3): 163-168. https://www.cnki.com.cn/Article/CJFDTOTAL-SZBB200503007.htm
[9]	罗振宇, 汪文荣, 柴冬宁, 等. 2014—2018年厦门市人工流产妇女特征及其变化趋势[J]. 中华生殖与避孕杂志, 2020, 40(6): 490-495. LUO Z Y, WANG W R, CHAI D N, et al. Characteristics and change trend of induced abortion women in Xiamen from 2014 to 2018[J]. Chin J Reprod Contrac, 2020, 40(6): 490-495.
[10]	LIANG M, SIMELANE S, FORTUNY F G, et al. The state of adolescent sexual and reproductive health[J]. J Adolesc Health, 2019, 65(6s): 3-15.
[11]	王玉, 杨清. 2003年和2013年人工流产患者高危因素的变化及分析[J]. 中国医科大学学报, 2015, 44(11): 1035-1039, 1041. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYK201511018.htm WANG Y, YANG Q. Changes and analysis of high risk factors in patients with induced abortion in 2003 and 2013[J]. J China Med Univ, 2015, 44(11): 1035-1039, 1041. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYK201511018.htm
[12]	孙云燕. 青少年女性生殖状况分析[J]. 实用妇科内分泌电子杂志, 2015, 2(4): 196-197. https://www.cnki.com.cn/Article/CJFDTOTAL-FKDZ201504149.htm SUN Y Y. Analysis of adolescent female reproductive status[J]. Electron J Practic Gynecol Endocrinol, 2015, 2(4): 196-197. https://www.cnki.com.cn/Article/CJFDTOTAL-FKDZ201504149.htm
[13]	冯经喜, 洪燕, 练丽娟. 青少年人工流产者的状况及分析[J]. 中国医药指南, 2014, 12(34): 116-117. https://www.cnki.com.cn/Article/CJFDTOTAL-YYXK201434085.htm FENG J X, HONG Y, LIAN L J. Status and analysis of adolescent induced abortion[J]. Chin Med Guide, 2014, 12(34): 116-117. https://www.cnki.com.cn/Article/CJFDTOTAL-YYXK201434085.htm
[14]	李俊. 武汉市武昌区已婚育龄妇女流产情况及影响因素分析[J]. 当代医学, 2017, 23(11): 96-98. https://www.cnki.com.cn/Article/CJFDTOTAL-DDYI201711050.htm LI J. Analysis of abortion and its influencing factors among married women of childbearing age in Wuchang District, Wuhan[J]. Contemp Med, 2017, 23(11): 96-98. https://www.cnki.com.cn/Article/CJFDTOTAL-DDYI201711050.htm
[15]	赵芮, 张磊, 富晓星, 等. 中国11省市青少年性与生殖健康知识、态度及行为调查[J]. 中国公共卫生, 2019, 35(10): 1330-1338. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201910012.htm ZHAO R, ZHANG L, FU X X, et al. Investigation on adolescent sexual and reproductive health knowledge, attitude and behavior in 11 provinces and cities of China[J]. Chin J Public Health, 2019, 35(10): 1330-1338. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201910012.htm
[16]	王晓英, 陈文菊, 叶素云. 未婚妊娠实施人工流产的女青少年性教育方式及途径的研究[J]. 中国当代医药, 2018, 25(8): 67-69, 73. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGUD201808063.htm WANG X Y, CHEN W J, YE S Y. Study on the ways and means of sex education for female adolescents with induced abortion in unmarried pregnancy[J]. Chin Contemp Med, 2018, 25(8): 67-69, 73. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGUD201808063.htm
[17]	胡玉坤. 庞大群体的生殖健康危机: 中国人工流产低龄化问题透视[J]. 社会科学论坛, 2015(11): 206-218. https://www.cnki.com.cn/Article/CJFDTOTAL-SKLU201511020.htm HU Y K. Reproductive health crisis of large groups: a perspective on the younger age of induced abortion in China[J]. Soc Sci Forum, 2015(11): 206-218. https://www.cnki.com.cn/Article/CJFDTOTAL-SKLU201511020.htm
[18]	袁虹, 杨家义, 刘念. 人工流产相关高危因素分析[J]. 检验医学与临床, 2016, 13(9): 1204-1206. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYL201609020.htm YUAN H, YANG J Y, LIU N. Analysis of high risk factors related to induced abortion[J]. Laborat Med Clin, 2016, 13(9): 1204-1206. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYL201609020.htm
[19]	LIU J, WU S, XU J, et al. Is repeat abortion a public health problem among Chinese adolescents? A cross-sectional survey in 30 provinces[J]. Int J Environ Res Public Health, 2019, 16(5): 794.
[20]	ASSIFI A R, KANG M, SULLIVAN E A, et al. Abortion care pathways and service provision for adolescents in high-income countries: a qualitative synthesis of the evidence[J]. PLoS One, 2020, 15(11): e0242015.
[21]	BRITTAIN A W, TEVENDALE H D, MUELLER T, et al. The teen access and quality initiative: improving adolescent reproductive health best practices in publicly funded health centers[J]. J Commun Health, 2020, 45(3): 615-625.
[22]	QUAST T, GONZALEZ F, ZIEMBA R. Abortion facility closings and abortion rates in texas[J]. Inquiry, 2017, 54: 46958017700944.