Fisher William A, Singh Sukhbir S, Shuper Paul A, Carey Mark, Otchet Felicia, MacLean-Brine Deborah, Dal Bello Diane, Gunter Jennifer
Department of Psychology, Social Sciences Centre, University of Western Ontario, London, Ont.
CMAJ. 2005 Mar 1;172(5):637-41. doi: 10.1503/cmaj.1040341.
Although repeat induced abortion is common, data concerning characteristics of women undergoing this procedure are lacking. We conducted this study to identify the characteristics, including history of physical abuse by a male partner and history of sexual abuse, of women who present for repeat induced abortion.
We surveyed a consecutive series of women presenting for initial or repeat pregnancy termination to a regional provider of abortion services for a wide geographic area in southwestern Ontario between August 1998 and May 1999. Self-reported demographic characteristics, attitudes and practices regarding contraception, history of relationship violence, history of sexual abuse or coercion, and related variables were assessed as potential correlates of repeat induced abortion. We used chi2 tests for linear trend to examine characteristics of women undergoing a first, second, or third or subsequent abortion. We analyzed significant correlates of repeat abortion using stepwise multivariate multinomial logistic regression to identify factors uniquely associated with repeat abortion.
Of the 1221 women approached, 1145 (93.8%) consented to participate. Data regarding first versus repeat abortion were available for 1127 women. A total of 68.2%, 23.1% and 8.7% of the women were seeking a first, second, or third or subsequent abortion respectively. Adjusted odds ratios for undergoing repeat versus a first abortion increased significantly with increased age (second abortion: 1.08, 95% confidence interval [CI] 1.04-1.09; third or subsequent abortion: 1.11, 95% CI 1.07-1.15), oral contraceptive use at the time of conception (second abortion: 2.17, 95% CI 1.52-3.09; third or subsequent abortion: 2.60, 95% CI 1.51-4.46), history of physical abuse by a male partner (second abortion: 2.04, 95% CI 1.39-3.01; third or subsequent abortion: 2.78, 95% CI 1.62-4.79), history of sexual abuse or violence (second abortion: 1.58, 95% CI 1.11-2.25; third or subsequent abortion: 2.53, 95% CI 1.50-4.28), history of sexually transmitted disease (second abortion: 1.50, 95% CI 0.98-2.29; third or subsequent abortion: 2.26, 95% CI 1.28-4.02) and being born outside Canada (second abortion: 1.83, 95% CI 1.19-2.79; third or subsequent abortion: 1.75, 95% CI 0.90-3.41).
Among other factors, a history of physical or sexual abuse was associated with repeat induced abortion. Presentation for repeat abortion may be an important indication to screen for a current or past history of relationship violence and sexual abuse.
尽管重复人工流产很常见，但缺乏关于接受该手术女性特征的数据。我们开展这项研究以确定前来接受重复人工流产女性的特征，包括遭受男性伴侣身体虐待的历史和性虐待史。
我们对1998年8月至1999年5月期间在安大略省西南部一个广泛地理区域的一家地区堕胎服务提供者处前来接受初次或重复妊娠终止的一系列女性进行了调查。自我报告的人口统计学特征、关于避孕的态度和做法、关系暴力史、性虐待或胁迫史以及相关变量被评估为重复人工流产的潜在相关因素。我们使用卡方线性趋势检验来检查接受首次、第二次或第三次及后续人工流产女性的特征。我们使用逐步多变量多项逻辑回归分析重复流产的显著相关因素，以确定与重复流产独特相关的因素。
在接触的1221名女性中，1145名（93.8%）同意参与。1127名女性有首次与重复人工流产的数据。分别有68.2%、23.1%和8.7%的女性寻求首次、第二次或第三次及后续人工流产。与首次人工流产相比，接受重复人工流产的校正比值比随着年龄增加（第二次人工流产：1.08，95%置信区间[CI]1.04 - 1.09；第三次及后续人工流产：1.11，95%CI 1.07 - 1.15）、受孕时使用口服避孕药（第二次人工流产：2.17，95%CI 1.52 - 3.09；第三次及后续人工流产：2.60，95%CI 1.51 - 4.46）、遭受男性伴侣身体虐待的历史（第二次人工流产：2.04，95%CI 1.39 - 3.01；第三次及后续人工流产：2.78，95%CI 1.62 - 4.79）、性虐待或暴力史（第二次人工流产：1.58，95%CI 1.11 - 2.25；第三次及后续人工流产：2.53，95%CI 1.50 - 4.28）、性传播疾病史（第二次人工流产：1.50，95%CI 0.98 - 2.29；第三次及后续人工流产：2.26，95%CI 1.28 - 4.02）以及在加拿大境外出生（第二次人工流产：1.83，95%CI 1.19 - 2.79；第三次及后续人工流产：1.75，95%CI 0.90 - 3.41）而显著增加。
在其他因素中，身体或性虐待史与重复人工流产有关。前来接受重复流产可能是筛查当前或过去关系暴力和性虐待史的一个重要指征。
