非户籍妇女以医院为基础的避孕节育及意外妊娠的现状研究
|
摘要
人口流动是改革开放以来伴随着工业化、城镇化进程而必然产生的社会现象,也是我国社会发展与进步的重要体现。进入新世纪,我国的人口流动进入一个新的发展时期。上海的非户籍人口已从1984年的60万,上升到2005年的587万,占上海市总人口的1/3,成为全国跨省流动人口比例最高的地区。约63.1%的非户籍人口年龄在20到39岁之间,男性和女性人数所占比例相近。外来流动人口进入大城市会产生物质和文化两方面的冲击,对年轻妇女而言,与性和生育相关的问题尤为突出。上海市户籍育龄妇女总人工流产率呈下降趋势,但非户籍妇女人工流产率居高不下。
本研究通过定量和定性研究相结合的方法,对非户籍妇女避孕现状、意外妊娠情况、避孕认知等方面进行总结,分析影响非户籍妇女避孕知识认知度和避孕方法选择的因素,探讨人工流产发生的原因,从社区医院的功能出发,探讨非户籍妇女避孕节育服务的提供和管理对策,为改善非户籍妇女避孕节育保健提供基础信息和政策建议。
第一部分非户籍妇女避孕现状及影响因素分析
目的:了解非户籍妇女避孕节育现状,并分析其影响因素,为进一步完善非户籍人口避孕节育服务提供依据。
方法:选取2007年7月至2008年12月间在黄浦区半淞园街道社区卫生服务中心妇科就诊的所有非户籍育龄妇女,剔除复诊妇女,共430例。对所有研究对象进行统一设计的问卷调查。描述对象的一般情况、孕产史情况、避孕情况。采用多元Logistic回归模型,深入分析影响非户籍妇女避孕状况的因素。
结果:430例研究对象的平均年龄为29.17±6.19岁,79.3%的妇女目前或曾经采取过避孕措施,已婚妇女以IUD(宫内节育器)为主,占50.8%;未婚妇女以避孕套为主,占61.3%。避孕方法的选择方式上,双方协商决定占64.8%;妇女本人决定占24.3%;另有4.7%由男方决定;6.2%由计生部门规定。获取避孕药具的途径上,90.3%的未婚者通过自行购买获得,免费获取的仅占9.7%。71.3%的妇女对所采取的避孕方法满意,低于国内的其他研究结果,单因素分析不同避孕方法满意度不同。多因素分析结果显示,流产次数1次及以下者避孕的可能性高于流产2次及以上者,(OR=2.367);随着年龄的增长,选择IUD的可能性增加(OR=1.804);由妇女本人决定避孕方式的比例也增加(OR=1.136);原户籍地为农村者选择IUD的可能性高于城镇者(OR=3.047);而无业者避孕的可能性显著低于在业者(OR=0.307)。
结论:仍有一部分非户籍妇女无法自己决定避孕方法;对避孕的总体满意度低于以往的研究;对计划生育部门提供的免费避孕药具和免费计划生育技术服务利用率低。应加强对免费计划生育技术服务(包括避孕药具的获取、计划生育验证等)的宣传,有利于提高菲户籍妇女的避孕率和降低非意愿妊娠率。
第二部分非户籍妇女避孕节育知识态度调查
目的:了解非户籍妇女对避孕节育知识的掌握程度,并分析其影响因素,为探索适合非户籍妇女特点的避孕节育健康教育方式提供依据。
方法:选取2007年7月至2008年12月间在黄浦区半淞园街道社区卫生服务中心妇科就诊的所有非户籍育龄妇女,剔除复诊妇女,共430例。对所有研究对象进行统一设计的问卷调查。描述研究对象避孕节育的知识和态度得分情况,单因素分析采用t检验和单因素方差分析,多因素分析采用二分类Logistic回归模型。
结果:在总分为12分的知识问卷中,430例研究对象避孕节育知识得分均数为7.17±2.65分,最高得分12分,最低0分;52.8%的妇女对未婚同居持赞同态度;调查中有65.1%的妇女曾经获得过避孕节育的知识;84.7%的妇女希望更进一步了解这方面的知识;其中86.7%的妇女乐意与专业人士进行面对面的咨询。多因素分析结果显示,年龄为25～岁的妇女避孕节育知识得分明显高于年龄≥35岁的妇女(OR=2.192);小学及以下文化程度的妇女避孕节育知识得分明显低于初中及以上文化程度的妇女(OR=0.2l0);EC知晓率也明显低(OR=0.180);采取临时避孕方法的妇女EC知晓率明显高于不避孕的妇女(OR=2.137)。
结论:非户籍妇女对避孕节育基本知识了解不全面;性观念开放,容易导致婚前性行为和未婚同居的发生;健康教育应来自专业人士多渠道的宣传,教育内容应更加深入。
第三部分非户籍妇女意外妊娠调查及人工流产原因分析目的:了解非户籍女意外妊娠情况,探讨人工流产发生的原因,从社区医院的功能出了,为改善非户籍妇女避孕节育保健提供基础信息和政策建议。方法:选取2007年7月至2008年12月间在黄浦区半淞园街道社区卫生服务中心要求做人工流产手术(负压吸引术)的所有非户籍育龄妇女,剔除在此期间重复流产者,共127例。对所有研究对象进行统一设计的面对面问卷调查。描述研究对象的一般情况、孕产史、意外妊娠情况等分布特征。并以x~2检验比较各亚组间的差别,以相关分析来反映社会人口学特征和妊娠、孕产史与人工流产间的关系。
结果:127例研究对象平均年龄为27.93±6.73岁,20岁以下的青少年占3.9%;平均人工流产次为1.98±1.46次,最多为14次;平均怀孕时间为52.23±9.65天;手术原因中未采取避孕措施的占63.0%,其中侥幸心理所占比例最大,占53.8%;避孕失败占33.9%,其中避孕套失误的比例最大,占34.9%。52.0%的妇女合并有常见生殖道感染;有55.9%的人工流产者听说过紧急避孕。单因素分析结果显示,年龄为35～岁妇女2次及以上人工流产的比例明显高于其他各年龄组(P<0.001);已婚者的人流比例明显高于未婚者(P<0.001);有孩子者的人流比例明显高于无孩子者(P<0.001);未婚者的平均流产年龄明显小于已婚者(F=26.533,P<0.001);已婚受术者中小学及以下文化程度、无业所占比例明显大于未婚受术者,P值分别为0.012、0.041。
结论:未采取避孕措施而导致此次人工流产的比例仍居高,其最主要原因为侥幸心理;避孕失败中最主要的是避孕套失误;未婚者的平均流产年龄明显小于已婚者。非户籍妇女生殖道感染的发病率高,对紧急避孕的了解较少,对避孕方法的正确使用有待提高,因此要加强开展生殖健康和避孕知识的宣传教育,同时建议扩大计划生育服务对象的范围,如未婚人群以及已婚妇女的配偶。
Industrialization and urbanization drove transient population from rural areas to urban areas after the Open-door policy in 1970's,which has been considered as a proxy of social development and advancing of China.The population floating became more significant in the 21th century.It was reported that Shanghai became the leading area absorbing transient population across provinces in China,of which the population of non-residents increased from 0.6 million in 1984 to 5.87 million in 2005,the latter one was almost one third of registered residents of Shanghai.In this population,about 63.1% aged between 20-39 years old,gender ratio(male vs.female) was close to 1.Issues related to sex and reproduction were the most prominent to female non-resident among the economic and cultural conflicts which non-resident could encounter.Other studies showed that the rate of artificial abortion has remained high in female non-residents,while the rate declined in female residents in Shanghai for years.
With quantitative and qualitative analyses,the current study summarized the status of birth control,unintended pregnancy and knowledge on birth control in female non-residents.Factors affecting knowledge and birth control options were also evaluated to discover causes of artificial abortion.Community health center based services and related management approaches on family planning for female non-residents were also discussed to improve maternal health care in this target population.
PartⅠPrevalence study on birth control and related factors in female non-residents
Object:To describe status of birth control options and related contributors in female non-residents to improve family planning service for the target population.
Methods:430 females at reproductive age visiting the gynaecology department of the Ban Song Community Health Services Center,Huang Pu District,Shanghai,were recruited during the period from July of 2007 to December of 2008.Cases with repeated visiting were excluded.A structured questionnaire was used to collect information on general information,maternal history,birth control options of the participants.Multiple Logistic regression models were constructed to analyze factors contributing to birth control options.
Results:The average age of the 430 participants was 29.17±6.19 years old(mean±sd). 79.3%participants were currently employing a birth control option or employed a birth control option before.The leading birth control option was interuterine devices(IUD, 50.8%) in married females and condom(61.3%) in unmarried females.In making decision of birth control options,64.8%of participants picked options after spouse consultation, 24.3%by female partner,4.7%by male partner,6.2%by family planning services.90.3% of unmarried female purchased contraceptive devices,and only 9.7%obtained free devices from family planning services.71.3%of females were satisfied with the birth control option employed,which were lower than the results from other domestic studies. With univariate analysis,rates of satisfaction to birth control options varied by options employed.In the results of multivariate analysis,females with no more than one abortion showed higher possibility to employ a birth control option comparing to those with more than two abortions(OR=2.367).The possibility of employing IUD increased by age (OR=1.804),as well as ratio of decision on options by female(OR=1.136).IUD was more employed by female resident registered in rural areas than in urban areas;Unemployed females have significantly lower conceptive application than employed females (OR=0.307).
Conclusions:Birth control options were not determined by all female non-residents and the satisfaction rate to birth control options was lower than the results from previous studies.Low utility of free conceptive devices and services by family planning institutes were also found.Free conceptive services(including conceptive devices offering,birth control verification) should be enhanced in publicizing,which may improve the rate of conception employment and lower the unintended pregnancy rate.
PartⅡA Survey on knowledge and attitude to birth control options in female non-residents
Objective:To understand the knowledge and attitude to birth control options in female non-residents for improving efficiency of health education on birth control to the target population.
Methods:430 females at reproductive age visiting the gynaecology department of the Ban Song Community Health Services Center,Huang Pu District,Shanghai,were recruited during the period from My of 2007 to December of 2008.Cases with repeated visiting were excluded.A structured questionnaire was used to collect information on knowledge and attitude on birth control options which were assessed by a scoring system.Student t-test,oneway anova and dichotomous Logistic regression were applied to the data analysis.
Results:The average score was 7.17±2.65(range 0-12) in the 430 participants.52.8%of participant agreed on pre-marital cohabitation;65.1%obtained knowledge on birth control options;84.7%were willing to have further knowledge,in which 86.7%preferred face-to-face consultancy by professionals.In the results of multivariate analysis,the scores of knowledge on birth control options were higher in females aged less than 25 than in aged over 35(OR=2.19).However,the scores were lower in female having not-higher-than-primary school education than having at-least-junior-high-school education(OR=0.210).The same pattern was also presented in scores of knowledge to EC (OR=0.180).Females adopted emergency conceptions showed higher score in knowledge to EC than females without conceptions(OR=2.137).
Conclusions:The knowledge on birth control options was not comprehensive in female non-residents.The target population showed highly possibility to adopt pre-marital sex behaviors and cohabitations.The results suggested that health education services should provided by professionals via multiple channels and with broader contents.
PartⅢA survey on unintended pregnancy and cause analysis of abortion in female non-residents
Objective:To describe unintended pregnancy in female non-residents and discover causes of abortion to improve basic information for policy making in birth control aiming female non-residents.
Methods:127 females at reproductive age requested abortion(vacuum extraction) in the Ban Song Community Health Services Center,Huang Pu District,Shanghai,were recruited during the period from July of 2007 to December of 2008.Face-to-face interview was performed with a structured questionnaire collecting information on general information,maternal history and unintended pregnancy of participants.Chi-square test was applied to comparison between groups and correlation analysis was to discover relationship among demographic characters,pregnancy,maternal history and abortion.
Results:A total of 127 participants with average age of 27.93±6.73 years old were recruited.3.9%of participants were younger than age of 20.The average frequency of abortion was 1.98±1.46 times with a maximum of 14.The average gestation period was 52.23±9.65 days.The leading cause of operation was intercourse without conceptions (63.0%),in which take-a-chance was the leading cause for not adopting conception (53.8%).The following cause of operation was failure of conception(33.9%),in which the major contributor was failure of condom(34.9%).Genital tract infections were found in 52.0%of participants.55.9%of them learnt about emergency conception.In the results of univariate analysis,females aged over 35 showed higher possibility to have twice or more abortion than other age groups(P＜0.001);married females experienced more abortions than unmarried females;females having child/children had more abortions than females without child(P＜0.001).The average age performing abortion of unmarried females was younger than married females(F =26.533,P＜0.001).There were more married females with under high school education or unemployed experienced abortions than unmarried female with P value of 0.012 and 0.041 respectively.
Conclusion:Intercourse without conception was the major cause of abortion,in which take-a-chance was the leading cause to not taking action.Condom failure accounted for the majority of conception failure.The average age having abortion was much younger in unmarried females than married females.High infection rate in genital tract was found in female non-residents.The target population also showed lack of knowledge in emergency conception and corrective usage of birth control devices.The current study suggested that health education should be enhanced on reproductive health and birth control,expand scope of family planning service to unmarried group and spouses of married females.
本研究通过定量和定性研究相结合的方法,对非户籍妇女避孕现状、意外妊娠情况、避孕认知等方面进行总结,分析影响非户籍妇女避孕知识认知度和避孕方法选择的因素,探讨人工流产发生的原因,从社区医院的功能出发,探讨非户籍妇女避孕节育服务的提供和管理对策,为改善非户籍妇女避孕节育保健提供基础信息和政策建议。
第一部分非户籍妇女避孕现状及影响因素分析
目的:了解非户籍妇女避孕节育现状,并分析其影响因素,为进一步完善非户籍人口避孕节育服务提供依据。
方法:选取2007年7月至2008年12月间在黄浦区半淞园街道社区卫生服务中心妇科就诊的所有非户籍育龄妇女,剔除复诊妇女,共430例。对所有研究对象进行统一设计的问卷调查。描述对象的一般情况、孕产史情况、避孕情况。采用多元Logistic回归模型,深入分析影响非户籍妇女避孕状况的因素。
结果:430例研究对象的平均年龄为29.17±6.19岁,79.3%的妇女目前或曾经采取过避孕措施,已婚妇女以IUD(宫内节育器)为主,占50.8%;未婚妇女以避孕套为主,占61.3%。避孕方法的选择方式上,双方协商决定占64.8%;妇女本人决定占24.3%;另有4.7%由男方决定;6.2%由计生部门规定。获取避孕药具的途径上,90.3%的未婚者通过自行购买获得,免费获取的仅占9.7%。71.3%的妇女对所采取的避孕方法满意,低于国内的其他研究结果,单因素分析不同避孕方法满意度不同。多因素分析结果显示,流产次数1次及以下者避孕的可能性高于流产2次及以上者,(OR=2.367);随着年龄的增长,选择IUD的可能性增加(OR=1.804);由妇女本人决定避孕方式的比例也增加(OR=1.136);原户籍地为农村者选择IUD的可能性高于城镇者(OR=3.047);而无业者避孕的可能性显著低于在业者(OR=0.307)。
结论:仍有一部分非户籍妇女无法自己决定避孕方法;对避孕的总体满意度低于以往的研究;对计划生育部门提供的免费避孕药具和免费计划生育技术服务利用率低。应加强对免费计划生育技术服务(包括避孕药具的获取、计划生育验证等)的宣传,有利于提高菲户籍妇女的避孕率和降低非意愿妊娠率。
第二部分非户籍妇女避孕节育知识态度调查
目的:了解非户籍妇女对避孕节育知识的掌握程度,并分析其影响因素,为探索适合非户籍妇女特点的避孕节育健康教育方式提供依据。
方法:选取2007年7月至2008年12月间在黄浦区半淞园街道社区卫生服务中心妇科就诊的所有非户籍育龄妇女,剔除复诊妇女,共430例。对所有研究对象进行统一设计的问卷调查。描述研究对象避孕节育的知识和态度得分情况,单因素分析采用t检验和单因素方差分析,多因素分析采用二分类Logistic回归模型。
结果:在总分为12分的知识问卷中,430例研究对象避孕节育知识得分均数为7.17±2.65分,最高得分12分,最低0分;52.8%的妇女对未婚同居持赞同态度;调查中有65.1%的妇女曾经获得过避孕节育的知识;84.7%的妇女希望更进一步了解这方面的知识;其中86.7%的妇女乐意与专业人士进行面对面的咨询。多因素分析结果显示,年龄为25～岁的妇女避孕节育知识得分明显高于年龄≥35岁的妇女(OR=2.192);小学及以下文化程度的妇女避孕节育知识得分明显低于初中及以上文化程度的妇女(OR=0.2l0);EC知晓率也明显低(OR=0.180);采取临时避孕方法的妇女EC知晓率明显高于不避孕的妇女(OR=2.137)。
结论:非户籍妇女对避孕节育基本知识了解不全面;性观念开放,容易导致婚前性行为和未婚同居的发生;健康教育应来自专业人士多渠道的宣传,教育内容应更加深入。
第三部分非户籍妇女意外妊娠调查及人工流产原因分析目的:了解非户籍女意外妊娠情况,探讨人工流产发生的原因,从社区医院的功能出了,为改善非户籍妇女避孕节育保健提供基础信息和政策建议。方法:选取2007年7月至2008年12月间在黄浦区半淞园街道社区卫生服务中心要求做人工流产手术(负压吸引术)的所有非户籍育龄妇女,剔除在此期间重复流产者,共127例。对所有研究对象进行统一设计的面对面问卷调查。描述研究对象的一般情况、孕产史、意外妊娠情况等分布特征。并以x~2检验比较各亚组间的差别,以相关分析来反映社会人口学特征和妊娠、孕产史与人工流产间的关系。
结果:127例研究对象平均年龄为27.93±6.73岁,20岁以下的青少年占3.9%;平均人工流产次为1.98±1.46次,最多为14次;平均怀孕时间为52.23±9.65天;手术原因中未采取避孕措施的占63.0%,其中侥幸心理所占比例最大,占53.8%;避孕失败占33.9%,其中避孕套失误的比例最大,占34.9%。52.0%的妇女合并有常见生殖道感染;有55.9%的人工流产者听说过紧急避孕。单因素分析结果显示,年龄为35～岁妇女2次及以上人工流产的比例明显高于其他各年龄组(P<0.001);已婚者的人流比例明显高于未婚者(P<0.001);有孩子者的人流比例明显高于无孩子者(P<0.001);未婚者的平均流产年龄明显小于已婚者(F=26.533,P<0.001);已婚受术者中小学及以下文化程度、无业所占比例明显大于未婚受术者,P值分别为0.012、0.041。
结论:未采取避孕措施而导致此次人工流产的比例仍居高,其最主要原因为侥幸心理;避孕失败中最主要的是避孕套失误;未婚者的平均流产年龄明显小于已婚者。非户籍妇女生殖道感染的发病率高,对紧急避孕的了解较少,对避孕方法的正确使用有待提高,因此要加强开展生殖健康和避孕知识的宣传教育,同时建议扩大计划生育服务对象的范围,如未婚人群以及已婚妇女的配偶。
Industrialization and urbanization drove transient population from rural areas to urban areas after the Open-door policy in 1970's,which has been considered as a proxy of social development and advancing of China.The population floating became more significant in the 21th century.It was reported that Shanghai became the leading area absorbing transient population across provinces in China,of which the population of non-residents increased from 0.6 million in 1984 to 5.87 million in 2005,the latter one was almost one third of registered residents of Shanghai.In this population,about 63.1% aged between 20-39 years old,gender ratio(male vs.female) was close to 1.Issues related to sex and reproduction were the most prominent to female non-resident among the economic and cultural conflicts which non-resident could encounter.Other studies showed that the rate of artificial abortion has remained high in female non-residents,while the rate declined in female residents in Shanghai for years.
With quantitative and qualitative analyses,the current study summarized the status of birth control,unintended pregnancy and knowledge on birth control in female non-residents.Factors affecting knowledge and birth control options were also evaluated to discover causes of artificial abortion.Community health center based services and related management approaches on family planning for female non-residents were also discussed to improve maternal health care in this target population.
PartⅠPrevalence study on birth control and related factors in female non-residents
Object:To describe status of birth control options and related contributors in female non-residents to improve family planning service for the target population.
Methods:430 females at reproductive age visiting the gynaecology department of the Ban Song Community Health Services Center,Huang Pu District,Shanghai,were recruited during the period from July of 2007 to December of 2008.Cases with repeated visiting were excluded.A structured questionnaire was used to collect information on general information,maternal history,birth control options of the participants.Multiple Logistic regression models were constructed to analyze factors contributing to birth control options.
Results:The average age of the 430 participants was 29.17±6.19 years old(mean±sd). 79.3%participants were currently employing a birth control option or employed a birth control option before.The leading birth control option was interuterine devices(IUD, 50.8%) in married females and condom(61.3%) in unmarried females.In making decision of birth control options,64.8%of participants picked options after spouse consultation, 24.3%by female partner,4.7%by male partner,6.2%by family planning services.90.3% of unmarried female purchased contraceptive devices,and only 9.7%obtained free devices from family planning services.71.3%of females were satisfied with the birth control option employed,which were lower than the results from other domestic studies. With univariate analysis,rates of satisfaction to birth control options varied by options employed.In the results of multivariate analysis,females with no more than one abortion showed higher possibility to employ a birth control option comparing to those with more than two abortions(OR=2.367).The possibility of employing IUD increased by age (OR=1.804),as well as ratio of decision on options by female(OR=1.136).IUD was more employed by female resident registered in rural areas than in urban areas;Unemployed females have significantly lower conceptive application than employed females (OR=0.307).
Conclusions:Birth control options were not determined by all female non-residents and the satisfaction rate to birth control options was lower than the results from previous studies.Low utility of free conceptive devices and services by family planning institutes were also found.Free conceptive services(including conceptive devices offering,birth control verification) should be enhanced in publicizing,which may improve the rate of conception employment and lower the unintended pregnancy rate.
PartⅡA Survey on knowledge and attitude to birth control options in female non-residents
Objective:To understand the knowledge and attitude to birth control options in female non-residents for improving efficiency of health education on birth control to the target population.
Methods:430 females at reproductive age visiting the gynaecology department of the Ban Song Community Health Services Center,Huang Pu District,Shanghai,were recruited during the period from My of 2007 to December of 2008.Cases with repeated visiting were excluded.A structured questionnaire was used to collect information on knowledge and attitude on birth control options which were assessed by a scoring system.Student t-test,oneway anova and dichotomous Logistic regression were applied to the data analysis.
Results:The average score was 7.17±2.65(range 0-12) in the 430 participants.52.8%of participant agreed on pre-marital cohabitation;65.1%obtained knowledge on birth control options;84.7%were willing to have further knowledge,in which 86.7%preferred face-to-face consultancy by professionals.In the results of multivariate analysis,the scores of knowledge on birth control options were higher in females aged less than 25 than in aged over 35(OR=2.19).However,the scores were lower in female having not-higher-than-primary school education than having at-least-junior-high-school education(OR=0.210).The same pattern was also presented in scores of knowledge to EC (OR=0.180).Females adopted emergency conceptions showed higher score in knowledge to EC than females without conceptions(OR=2.137).
Conclusions:The knowledge on birth control options was not comprehensive in female non-residents.The target population showed highly possibility to adopt pre-marital sex behaviors and cohabitations.The results suggested that health education services should provided by professionals via multiple channels and with broader contents.
PartⅢA survey on unintended pregnancy and cause analysis of abortion in female non-residents
Objective:To describe unintended pregnancy in female non-residents and discover causes of abortion to improve basic information for policy making in birth control aiming female non-residents.
Methods:127 females at reproductive age requested abortion(vacuum extraction) in the Ban Song Community Health Services Center,Huang Pu District,Shanghai,were recruited during the period from July of 2007 to December of 2008.Face-to-face interview was performed with a structured questionnaire collecting information on general information,maternal history and unintended pregnancy of participants.Chi-square test was applied to comparison between groups and correlation analysis was to discover relationship among demographic characters,pregnancy,maternal history and abortion.
Results:A total of 127 participants with average age of 27.93±6.73 years old were recruited.3.9%of participants were younger than age of 20.The average frequency of abortion was 1.98±1.46 times with a maximum of 14.The average gestation period was 52.23±9.65 days.The leading cause of operation was intercourse without conceptions (63.0%),in which take-a-chance was the leading cause for not adopting conception (53.8%).The following cause of operation was failure of conception(33.9%),in which the major contributor was failure of condom(34.9%).Genital tract infections were found in 52.0%of participants.55.9%of them learnt about emergency conception.In the results of univariate analysis,females aged over 35 showed higher possibility to have twice or more abortion than other age groups(P＜0.001);married females experienced more abortions than unmarried females;females having child/children had more abortions than females without child(P＜0.001).The average age performing abortion of unmarried females was younger than married females(F =26.533,P＜0.001).There were more married females with under high school education or unemployed experienced abortions than unmarried female with P value of 0.012 and 0.041 respectively.
Conclusion:Intercourse without conception was the major cause of abortion,in which take-a-chance was the leading cause to not taking action.Condom failure accounted for the majority of conception failure.The average age having abortion was much younger in unmarried females than married females.High infection rate in genital tract was found in female non-residents.The target population also showed lack of knowledge in emergency conception and corrective usage of birth control devices.The current study suggested that health education should be enhanced on reproductive health and birth control,expand scope of family planning service to unmarried group and spouses of married females.
引文
1、中国国家统计局.2005年全国1%人口抽样调查主要数据公报[EB].中华人们共和国国家统计局网站,http://www.stats.gov.cn/tjgb/rkpcgb/qgrkpcgb/t20060316402310923.htm,2006
2、乔晓春.从“五普”数据分析城市暂住人口状况[J].社会学研究,2003,1:87-94
3、2005年全国1%人口抽样调查资料[M].国家统计局编.北京:中国统计出版社
4、袁新敏.上海市外来流动人口现状与问题的实证分析[J].华东经济管理,2008,22(7):4-8
5、楼超华,赵双玲,高尔生.城市外来青年女工的生殖健康状况与需求[J].人口研究,2001,3(25):61-64
6、上海市人口与计划生育委员会.全球生殖健康状况[EB].上海市人口与计划生育委员会网站,http://www.popinfo.gov.cn/popinfo%5Cpop wsjx.nsf/v dbml other/CDA283DBCC2A25034825683000218037#h,2001
7、国家人口和计划生育委员会.2006年全国人口和计划生育抽样调查主要数据公报(2007年第2号)[EB].上海市人口与计划生育委员会网站,http://www.popinfo,gov.cn/popinfo/pop docrkxx.nsf/v tizl/4E2DC42F0CED32EC482573D8000FECC5,2008
8、HRP.Progress in Reproductive Health Research.Geneva[R]:WHO,2003,(62):1-4
9、童传良,陈军玲,程立南.上海市人工流产原因现况调查[J].上海医学,1996,06:345-348
10、乔晓春.中国妇女人工流产状况分析[J].人口研究,2002,26(3):16-25
11、童传良,吴愉等.上海市户籍育龄妇女人工流产原因动态检测[J].上海医学,2002,25(8):154-157
12、周云芳.上海市2000年人口与计划生育形式分析[R].上海市人口与计划生育委员会网站,http://www.shrkjsw.gov.cn/dr/stat/sother/2003-04-21/0037046.html?spfp/stat/sother,2003
13、周剑萍.进一步降低上海人工流产率[J].上海医学,2002,8:449-450
14、钟烨,周利锋等.未婚青年避孕知识状况分析[J].中国公共卫生,2001,11:972-974
15、Fohns Hopkins Population Information Program:Family planning programs improving quality.Family planning Program[R].Population reports series,1998,6(47):17
16、高尔生,赵双玲,楼超华,等.人工流产妇女对紧急避孕方法的可接受性研究[J].生殖与避孕,2001,21(2):104-108
17、何晓明,张振钧.人工流产对其后再次妊娠结局的影响[J].中国实用妇科与产 科杂志,1996,5(12):287-288
18、张二力,祝君平等.在计划生育工作先进地区开展优质服务试点的思考[J].人口研究,1996,1:16-20
19、熊源发.避孕措施知情选择的计划生育工作方案[J].中国计划生育学杂志,2000,1:5-10
20、毛京沭等.广州市流动人口避孕方法现状及影响因素[J].南京人口管理干部学院学报,2007,1,1(23):13-16
21、陶建国,武俊青等.上海市流动人口节育模式的分析[J].中国公共卫生,2000,1(16):12-13
22、刘鸿雁,汝小美,丁峰.流动人口的生殖健康服务[J].人口研究,2004,(9):92-96
23、武俊青,陶建国,高尔生.上海市流动人口中育龄妇女的避孕知识及避孕状况调查[J].生殖医学杂志,2001,,10(3):154-163
24、童琦,李红,谭桂群.重庆市农村未婚年轻成人父母对给未婚青年提供生殖健康服务的态度调查[J].中国计划生育杂志,2002,10(7):407-409
25、钟烨,周利锋,丁吟秋.未婚青年避孕知识状况分析[J].中国公共卫生,2001,17(11):972-974
26、王炳顺,钟烨,高尔生.未婚青年对避孕方法的选择[J].中国公共卫生,2002,7(18):869-870
27、刘云嵘,常勇杰.中国已婚育龄妇女性权利现状与评价[J].中国计划生育学杂志,2002,10(6):341
28、Johns Hopkins.Population Information Program:Family planning programs improving quality.Family Planning Programs[R].Population Reports Series,1998,6(47):17
29、黄伟栋等.农村已婚育龄妇女避孕方法满意度分析[J].复旦学报(医学版),2004,31(3):254-258
30、于建春等.已婚育龄妇女避孕方法满意度影响因素分析[J].中国妇幼保健,2008,23:5623-7623
31、武俊青,陈锡宽,高尔生.已婚育龄妇女先用避孕方法的满意度及其影响因素分析[J].中华流行病学杂志,2001,4(22):314-315
32、冯琪,王倩,游丽琴等.流动人口避孕节育现状及需求分析[J].中国性科学,2008,10(17):35-39
33、张惜阴主编.《上海市妇产科诊疗常规》[M].上海科学技术出版社,1999:273
34、黄江涛,余森泉,王奇玲.广东省城市流动人口年轻女性避孕现况调查[J].中国计划生育杂志,2004,12(11):669
35、毛荷明.流动人口育龄妇女基本情况及意外妊娠情况分析[J].中国妇幼保健, 2007,8:1079-1080
36、刘莹.流动人口与常住人口人工流产情况对比调查[J].中国计划生育学杂志,2000,6:264-266
37、武俊青,陶建国,高尔生.流动人口紧急避孕知识状况分析[J].中国计划生育杂志,2002,10(5):269-271
38、武俊青,姜综敏,李成福,李昊.我国流动人口的避孕节育现况[J].人口与发展,2008,14(1):54-62
39、黄江涛等.流动人口妇女生殖/避孕知识及行为的影响因素[J].中国妇幼保健,2008,21(23):3007-3009
40、马毅敏等.广州市流动人口已婚育龄妇女生殖保健相关知识的研究[J].中国妇幼保健,2006,18(21):2551-2553
41、林敏,黄丽敏.上海市闵行区未婚流动女性避孕措施的知识、行为调查[J].中国计划生育杂志,2008,7:416-418
42、Odutolu O,Adedime jia.Economic empovement and reproductive behavior of young women in Osun state,Negeria[J].Afr J Reprod Health,2003,7(3):92
43、曹泽毅主编.中华妇产科学[M].北京人民卫生出版社,1999,2536
44、George J,Turner J & Cooke E.Women Konwledge of emergency contraception[J].Br J Gen Pract,1994,44(387):451-460
45、Skolnick AA.Campaign launched to tell physician,public about emergency contraception[J].JAMA,1997,278(2):101-110
46、高峻,高尔生.中国育龄妇女紧急避孕知晓率及其影响因素分析[J].生殖与避孕,2004,4(24):226-230
47、楼超华,沈燕,高尔生等.未婚流动人口中性相关行为[J].生殖与避孕,2004,24(1):34-8
48、楼超华,沈燕,高尔生等.未婚流动人口对性相关问题的态度和看法[J].生殖与避孕,2005,25(4):223-228
49、赵更力,周敏,陈丽君.城市妇女非意愿妊娠的原因及避孕知识态度和行为调查[J].中国妇幼保健,2006,21:522-523
50、上海市人口与计划生育委员会.知情选择的定义和意义[EB].http://www.popinfo.gov.cn/popinfo/pop wsix.nsf/33de2f65279da6ae48256c37002cad35/4Off79e333de64e248256c3200231c177?OpenDocument#h,2002
51、童传良,陈军玲,程利南.上海市人工流产原因现况调查[J].上海医学,1999,22(6):345-348
52、张加伟,余倩倩,杜福阶.武汉市黄陂地区农村已婚育龄妇女人工流产原因分 析[J].中国计划生育杂志.2008,10:612-614
53、王潇艳,程怡民.男性因素对人工流产妇女避孕措施使用的影响[J].中国计划生育学杂志,2007,6:345-348
54、赵更力,张小松等.中国部分城市流动人口未婚人工流产女青年生殖健康状况分析[J].生殖医学杂志,2005,5(14):268-271
55、陈少君,戴新民等.流动人口的性观念与性行为——对武汉市汉正街流动人口的性剖析[J].中国性科学,2008,2(17):15-21
56、黄文鸳,钱序.上海市某工厂外来未婚女工生殖健康知识现状及需求[J].中国妇幼保健,2005,21(25):2823-2825
57、楼超华,沈燕等.未婚流动人口性相关行为[J].生殖与避孕,2004,24(1):35
58、崔念,李民享,田爱平等.成都市未婚流动人群性和生殖健康状况与需求调查[J].中国计划生育学杂志,2004,12(3):155
59、张建端等.广州市未婚女性流动人口性健康状况调查[J].中国妇幼保健,2007,32(22):4581-4583
60、王萍,尹平.国内外青少年生殖健康现状[J].中国社会医学杂志,2008,1(25):33-34
61、童琦,李红,谭植群.重庆市农村未婚年轻人父母对给未婚青年提供生殖健康服务的态度调查[J].中国计划生育学杂志,2002,7:407
62、刘永良.青少年性和生殖健康教育动态和进展[J].中国性科学,2001,10(4):7-10
63、Mahmoud Fathalla.Human Reproduction[R].Parthenon Publishing,2002:12-21
64、刘刚,吴赤蓬,王声勇.流动人口妇女生殖道感染症状就医行为研究[J].现代预防医学,2006,9(33):1583-1585
65、Linbderg CE,Women's knowledge of emergency contraception[J].Obstet Gynecol Neonatal NURS,1997,26(2):145-153
66、肖碧莲.关于药物流产的Ballagio会议及会后感想[J].生殖医学杂志,2001,10(6):344-350
67、Trussel J & Stewart F.The effectiveness of postcoital hormonal contraception[J].Fam Plan Perspect 1992,24:262-271
68、程怡民.中国重复流产状况和规范化流产后服务的必要性[J].中国实用妇科与产科杂志,2004,20(9):571-573
69、Henshsw KS Singh S,Haas T.Resent trends in abortion rates wordwide Int[J].Fam Pian Perspect,1999,25(1):44-48
1、上海的流动人口.上海年鉴2004
2、周剑萍.进一步降低上海人工流产率.上海医学,2002,8:449-450
3、时俊新.武汉市已婚女性流动人口人工流产状况调查分析.中国妇幼保健,2000,11
4、刘莹.流动人口与常住人口人工流产情况对比调查.中国计划生育学杂志,2000,6
5、沈敏.北京妇产医院1996-2003年人工流产手术的回顾性分析.中国计划生育学杂志,2004,7
6、黄江涛.广东省城市流动人口年轻女性避孕现况调查.中国计划生育杂志,2004,11
7、毛荷明.流动人口育龄妇女基本情况及意外妊娠情况分析.中国妇幼保健,2007,8
8、武俊青.流动人口紧急避孕知识状况分析.中国计划生育杂志,2002,5
9、武俊青,陶建国.上海市流动人口中育龄妇女避孕知识及避孕状况调查.生殖医学杂志,2001,6(10)
10、赵凤敏.人工流产与生殖道感染及影响因素分析.中国公共卫生,2007,23(1)
11、楼超华.上海市未婚流动人口对性相关问题的态度和看法.生殖与避孕,2005,25(4)
12、戴鱼兵.流动人口计划生育管理与服务研究.中国计划生育学杂志,2003,1
13、杨菊.昆山市流动人口卫生服务需求及利用和影响因素研究.全科医疗,2007,10(1)
14、张玲华.流动已婚妇女人工流产累积发生率及其危险因素探讨.中国妇幼保健,2007,22:1227-1229
15、程怡民.中国重复流产状况和规范化流产后服务的必要性.中国实用妇科与产科杂志,2004,20(9)
16、武俊青.上海市闵行区流动人口婚育观念与行为的研究.医学与社会,1999,12(1)
17、徐辉.强化社区调节功能搞好流动人口计划生育管理.人口与计划生育,1995,4
2、乔晓春.从“五普”数据分析城市暂住人口状况[J].社会学研究,2003,1:87-94
3、2005年全国1%人口抽样调查资料[M].国家统计局编.北京:中国统计出版社
4、袁新敏.上海市外来流动人口现状与问题的实证分析[J].华东经济管理,2008,22(7):4-8
5、楼超华,赵双玲,高尔生.城市外来青年女工的生殖健康状况与需求[J].人口研究,2001,3(25):61-64
6、上海市人口与计划生育委员会.全球生殖健康状况[EB].上海市人口与计划生育委员会网站,http://www.popinfo.gov.cn/popinfo%5Cpop wsjx.nsf/v dbml other/CDA283DBCC2A25034825683000218037#h,2001
7、国家人口和计划生育委员会.2006年全国人口和计划生育抽样调查主要数据公报(2007年第2号)[EB].上海市人口与计划生育委员会网站,http://www.popinfo,gov.cn/popinfo/pop docrkxx.nsf/v tizl/4E2DC42F0CED32EC482573D8000FECC5,2008
8、HRP.Progress in Reproductive Health Research.Geneva[R]:WHO,2003,(62):1-4
9、童传良,陈军玲,程立南.上海市人工流产原因现况调查[J].上海医学,1996,06:345-348
10、乔晓春.中国妇女人工流产状况分析[J].人口研究,2002,26(3):16-25
11、童传良,吴愉等.上海市户籍育龄妇女人工流产原因动态检测[J].上海医学,2002,25(8):154-157
12、周云芳.上海市2000年人口与计划生育形式分析[R].上海市人口与计划生育委员会网站,http://www.shrkjsw.gov.cn/dr/stat/sother/2003-04-21/0037046.html?spfp/stat/sother,2003
13、周剑萍.进一步降低上海人工流产率[J].上海医学,2002,8:449-450
14、钟烨,周利锋等.未婚青年避孕知识状况分析[J].中国公共卫生,2001,11:972-974
15、Fohns Hopkins Population Information Program:Family planning programs improving quality.Family planning Program[R].Population reports series,1998,6(47):17
16、高尔生,赵双玲,楼超华,等.人工流产妇女对紧急避孕方法的可接受性研究[J].生殖与避孕,2001,21(2):104-108
17、何晓明,张振钧.人工流产对其后再次妊娠结局的影响[J].中国实用妇科与产 科杂志,1996,5(12):287-288
18、张二力,祝君平等.在计划生育工作先进地区开展优质服务试点的思考[J].人口研究,1996,1:16-20
19、熊源发.避孕措施知情选择的计划生育工作方案[J].中国计划生育学杂志,2000,1:5-10
20、毛京沭等.广州市流动人口避孕方法现状及影响因素[J].南京人口管理干部学院学报,2007,1,1(23):13-16
21、陶建国,武俊青等.上海市流动人口节育模式的分析[J].中国公共卫生,2000,1(16):12-13
22、刘鸿雁,汝小美,丁峰.流动人口的生殖健康服务[J].人口研究,2004,(9):92-96
23、武俊青,陶建国,高尔生.上海市流动人口中育龄妇女的避孕知识及避孕状况调查[J].生殖医学杂志,2001,,10(3):154-163
24、童琦,李红,谭桂群.重庆市农村未婚年轻成人父母对给未婚青年提供生殖健康服务的态度调查[J].中国计划生育杂志,2002,10(7):407-409
25、钟烨,周利锋,丁吟秋.未婚青年避孕知识状况分析[J].中国公共卫生,2001,17(11):972-974
26、王炳顺,钟烨,高尔生.未婚青年对避孕方法的选择[J].中国公共卫生,2002,7(18):869-870
27、刘云嵘,常勇杰.中国已婚育龄妇女性权利现状与评价[J].中国计划生育学杂志,2002,10(6):341
28、Johns Hopkins.Population Information Program:Family planning programs improving quality.Family Planning Programs[R].Population Reports Series,1998,6(47):17
29、黄伟栋等.农村已婚育龄妇女避孕方法满意度分析[J].复旦学报(医学版),2004,31(3):254-258
30、于建春等.已婚育龄妇女避孕方法满意度影响因素分析[J].中国妇幼保健,2008,23:5623-7623
31、武俊青,陈锡宽,高尔生.已婚育龄妇女先用避孕方法的满意度及其影响因素分析[J].中华流行病学杂志,2001,4(22):314-315
32、冯琪,王倩,游丽琴等.流动人口避孕节育现状及需求分析[J].中国性科学,2008,10(17):35-39
33、张惜阴主编.《上海市妇产科诊疗常规》[M].上海科学技术出版社,1999:273
34、黄江涛,余森泉,王奇玲.广东省城市流动人口年轻女性避孕现况调查[J].中国计划生育杂志,2004,12(11):669
35、毛荷明.流动人口育龄妇女基本情况及意外妊娠情况分析[J].中国妇幼保健, 2007,8:1079-1080
36、刘莹.流动人口与常住人口人工流产情况对比调查[J].中国计划生育学杂志,2000,6:264-266
37、武俊青,陶建国,高尔生.流动人口紧急避孕知识状况分析[J].中国计划生育杂志,2002,10(5):269-271
38、武俊青,姜综敏,李成福,李昊.我国流动人口的避孕节育现况[J].人口与发展,2008,14(1):54-62
39、黄江涛等.流动人口妇女生殖/避孕知识及行为的影响因素[J].中国妇幼保健,2008,21(23):3007-3009
40、马毅敏等.广州市流动人口已婚育龄妇女生殖保健相关知识的研究[J].中国妇幼保健,2006,18(21):2551-2553
41、林敏,黄丽敏.上海市闵行区未婚流动女性避孕措施的知识、行为调查[J].中国计划生育杂志,2008,7:416-418
42、Odutolu O,Adedime jia.Economic empovement and reproductive behavior of young women in Osun state,Negeria[J].Afr J Reprod Health,2003,7(3):92
43、曹泽毅主编.中华妇产科学[M].北京人民卫生出版社,1999,2536
44、George J,Turner J & Cooke E.Women Konwledge of emergency contraception[J].Br J Gen Pract,1994,44(387):451-460
45、Skolnick AA.Campaign launched to tell physician,public about emergency contraception[J].JAMA,1997,278(2):101-110
46、高峻,高尔生.中国育龄妇女紧急避孕知晓率及其影响因素分析[J].生殖与避孕,2004,4(24):226-230
47、楼超华,沈燕,高尔生等.未婚流动人口中性相关行为[J].生殖与避孕,2004,24(1):34-8
48、楼超华,沈燕,高尔生等.未婚流动人口对性相关问题的态度和看法[J].生殖与避孕,2005,25(4):223-228
49、赵更力,周敏,陈丽君.城市妇女非意愿妊娠的原因及避孕知识态度和行为调查[J].中国妇幼保健,2006,21:522-523
50、上海市人口与计划生育委员会.知情选择的定义和意义[EB].http://www.popinfo.gov.cn/popinfo/pop wsix.nsf/33de2f65279da6ae48256c37002cad35/4Off79e333de64e248256c3200231c177?OpenDocument#h,2002
51、童传良,陈军玲,程利南.上海市人工流产原因现况调查[J].上海医学,1999,22(6):345-348
52、张加伟,余倩倩,杜福阶.武汉市黄陂地区农村已婚育龄妇女人工流产原因分 析[J].中国计划生育杂志.2008,10:612-614
53、王潇艳,程怡民.男性因素对人工流产妇女避孕措施使用的影响[J].中国计划生育学杂志,2007,6:345-348
54、赵更力,张小松等.中国部分城市流动人口未婚人工流产女青年生殖健康状况分析[J].生殖医学杂志,2005,5(14):268-271
55、陈少君,戴新民等.流动人口的性观念与性行为——对武汉市汉正街流动人口的性剖析[J].中国性科学,2008,2(17):15-21
56、黄文鸳,钱序.上海市某工厂外来未婚女工生殖健康知识现状及需求[J].中国妇幼保健,2005,21(25):2823-2825
57、楼超华,沈燕等.未婚流动人口性相关行为[J].生殖与避孕,2004,24(1):35
58、崔念,李民享,田爱平等.成都市未婚流动人群性和生殖健康状况与需求调查[J].中国计划生育学杂志,2004,12(3):155
59、张建端等.广州市未婚女性流动人口性健康状况调查[J].中国妇幼保健,2007,32(22):4581-4583
60、王萍,尹平.国内外青少年生殖健康现状[J].中国社会医学杂志,2008,1(25):33-34
61、童琦,李红,谭植群.重庆市农村未婚年轻人父母对给未婚青年提供生殖健康服务的态度调查[J].中国计划生育学杂志,2002,7:407
62、刘永良.青少年性和生殖健康教育动态和进展[J].中国性科学,2001,10(4):7-10
63、Mahmoud Fathalla.Human Reproduction[R].Parthenon Publishing,2002:12-21
64、刘刚,吴赤蓬,王声勇.流动人口妇女生殖道感染症状就医行为研究[J].现代预防医学,2006,9(33):1583-1585
65、Linbderg CE,Women's knowledge of emergency contraception[J].Obstet Gynecol Neonatal NURS,1997,26(2):145-153
66、肖碧莲.关于药物流产的Ballagio会议及会后感想[J].生殖医学杂志,2001,10(6):344-350
67、Trussel J & Stewart F.The effectiveness of postcoital hormonal contraception[J].Fam Plan Perspect 1992,24:262-271
68、程怡民.中国重复流产状况和规范化流产后服务的必要性[J].中国实用妇科与产科杂志,2004,20(9):571-573
69、Henshsw KS Singh S,Haas T.Resent trends in abortion rates wordwide Int[J].Fam Pian Perspect,1999,25(1):44-48
1、上海的流动人口.上海年鉴2004
2、周剑萍.进一步降低上海人工流产率.上海医学,2002,8:449-450
3、时俊新.武汉市已婚女性流动人口人工流产状况调查分析.中国妇幼保健,2000,11
4、刘莹.流动人口与常住人口人工流产情况对比调查.中国计划生育学杂志,2000,6
5、沈敏.北京妇产医院1996-2003年人工流产手术的回顾性分析.中国计划生育学杂志,2004,7
6、黄江涛.广东省城市流动人口年轻女性避孕现况调查.中国计划生育杂志,2004,11
7、毛荷明.流动人口育龄妇女基本情况及意外妊娠情况分析.中国妇幼保健,2007,8
8、武俊青.流动人口紧急避孕知识状况分析.中国计划生育杂志,2002,5
9、武俊青,陶建国.上海市流动人口中育龄妇女避孕知识及避孕状况调查.生殖医学杂志,2001,6(10)
10、赵凤敏.人工流产与生殖道感染及影响因素分析.中国公共卫生,2007,23(1)
11、楼超华.上海市未婚流动人口对性相关问题的态度和看法.生殖与避孕,2005,25(4)
12、戴鱼兵.流动人口计划生育管理与服务研究.中国计划生育学杂志,2003,1
13、杨菊.昆山市流动人口卫生服务需求及利用和影响因素研究.全科医疗,2007,10(1)
14、张玲华.流动已婚妇女人工流产累积发生率及其危险因素探讨.中国妇幼保健,2007,22:1227-1229
15、程怡民.中国重复流产状况和规范化流产后服务的必要性.中国实用妇科与产科杂志,2004,20(9)
16、武俊青.上海市闵行区流动人口婚育观念与行为的研究.医学与社会,1999,12(1)
17、徐辉.强化社区调节功能搞好流动人口计划生育管理.人口与计划生育,1995,4