Abbott Jean, Feldhaus Kim M, Houry Debra, Lowenstein Steven R
Division of Emergency Medicine, Department of Surgery, University of Colorado School of Medicine, USA.
Ann Emerg Med. 2004 Mar;43(3):376-81. doi: 10.1016/j.annemergmed.2003.10.039.
Unintended pregnancy is a major medical, social, and public health problem. Emergency contraceptive pills can prevent 75% to 85% of unintended pregnancies if administered within 72 hours of intercourse. We perform this study to measure knowledge, attitudes, practices, and perceived needs about emergency contraception in a sample of women seeking emergency department (ED) care.
This was a prospective survey of women presenting to an inner-city ED during an 8-week study period. Women who were aged 18 to 45 years, English speaking, and not critically ill and who presented during 56 randomly generated 4-hour time blocks were eligible. Trained research assistants administered a 20-question survey that included questions on current sexual and contraceptive practices and knowledge, acceptance, and preferences about postcoital contraception.
Two hundred thirty-two women met eligibility criteria; 158 (68%) women agreed to participate. Participants and nonparticipants were similar in age, race, ethnicity, and insurance status. The participants' mean age was 30 years. Twenty-five percent were married, whereas 49% had never married and 25% were separated or divorced. Fifty-two percent (95% confidence interval [CI] 44% to 60%) reported at least 1 previous unintended pregnancy; 28% (95% CI 21% to 35%) had 1 or more previous elective abortions. Of women who had been sexually active in the past month, half (47%) reported unprotected intercourse during that time. Among all respondents, 122 (77%; 95% CI 71% to 84%) had heard of emergency contraception as a way of preventing pregnancy after unprotected intercourse. Of these respondents, one fourth to one half did not have enough knowledge to use emergency contraceptive pills effectively. Fifty-seven percent of women were willing to use emergency contraceptive pills in the future, and 16 women said they would consider a change in regular contraception to emergency contraceptive pills if widely available.
Sexually active women seeking ED care have high rates of unintended pregnancy and abortion. There is broad acceptance of emergency contraceptive pills to prevent pregnancy, but knowledge of availability, timing, and proper use is limited. Emergency contraceptive pills are a safe, effective, and low-cost primary preventive and emergency care intervention, and information about their use should be made available to ED patients. Patients should be advised not to abandon their use of barrier or other traditional contraceptives.
意外怀孕是一个重大的医学、社会和公共卫生问题。如果在性交后72小时内服用紧急避孕药，可预防75%至85%的意外怀孕。我们开展这项研究，以了解在寻求急诊科（ED）护理的女性样本中，她们对紧急避孕的知识、态度、行为及感知到的需求。
这是一项对在为期8周的研究期间前往市中心急诊科就诊的女性进行的前瞻性调查。年龄在18至45岁、会说英语且病情不危急，且在随机生成的56个4小时时间段内就诊的女性符合条件。经过培训的研究助理进行了一项包含20个问题的调查，问题涉及当前的性和避孕行为以及对性交后避孕的知识、接受程度和偏好。
232名女性符合入选标准；158名（68%）女性同意参与。参与者和未参与者在年龄、种族、民族和保险状况方面相似。参与者的平均年龄为30岁。25%已婚，49%从未结婚，25%分居或离婚。52%（95%置信区间[CI]44%至60%）报告至少有过1次既往意外怀孕；28%（95%CI21%至35%）有过1次或更多次既往人工流产。在过去一个月有过性行为的女性中，一半（47%）报告在此期间有过无保护性交。在所有受访者中，122名（77%；95%CI71%至84%）听说过紧急避孕是一种在无保护性交后预防怀孕的方法。在这些受访者中，四分之一到二分之一没有足够的知识来有效使用紧急避孕药。57%的女性愿意在未来使用紧急避孕药，16名女性表示，如果紧急避孕药广泛可得，她们会考虑将常规避孕方式改为紧急避孕药。
寻求急诊科护理的性活跃女性意外怀孕和流产率很高。紧急避孕药在预防怀孕方面得到广泛认可，但对其可得性、服用时间和正确使用方法的了解有限。紧急避孕药是一种安全、有效且低成本的初级预防和紧急护理干预措施，应向急诊科患者提供关于其使用的信息。应建议患者不要放弃使用屏障或其他传统避孕方法。
