Bennett Ian M, Culhane Jennifer F, McCollum Kelly F, Elo Irma T
Department of Family Practice and Community Medicine, University of Pennsylvania, Philadelphia, PA 19104-4283, USA.
Am J Obstet Gynecol. 2006 Mar;194(3):749-54. doi: 10.1016/j.ajog.2005.10.193.
The purpose of this study was to assess the contribution of depressive symptoms and poor contraceptive use early in the first postpartum year to the risk of unintended repeat pregnancy at the end of that year among adults with low educational status (< 12th grade or equivalence).
This was a prospective observational cohort study of 643 sexually active, low-income, inner-city adult women (age > or = 19) who enrolled prenatally (14.7 +/- 6.9 weeks gestational age) and were followed twice after delivery (3.3 +/- 1.3 months and 11.0 +/- 1.3 months). Associations were assessed by multivariate logistic regression.
Low educational status (odds ratio, 2.32; 95% CI, 1.25-4.33) and less effective contraceptive use (odds ratio, 2.31; 95% CI, 1.05-4.51) were associated with unintended pregnancy. Neither depressive symptoms nor contraceptive use reduced the risk of pregnancy that was associated with low educational status.
Low educational status was associated with more than twice the risk of unintended pregnancy 1 year after delivery. We found no evidence that depression or poor contraceptive use mediate this relationship.
本研究旨在评估产后第一年早期的抑郁症状及低效的避孕措施对低教育程度（<12年级或同等学历）成年人在该年末意外再次怀孕风险的影响。
这是一项前瞻性观察队列研究，研究对象为643名性活跃、低收入、来自市中心的成年女性（年龄≥19岁），她们在孕期（孕龄14.7±6.9周）入组，并在产后接受两次随访（产后3.3±1.3个月和11.0±1.3个月）。通过多因素逻辑回归评估相关性。
低教育程度（比值比，2.32；95%置信区间，1.25 - 4.33）和低效的避孕措施（比值比，2.31；95%置信区间，1.05 - 4.51）与意外怀孕相关。抑郁症状和避孕措施均未降低与低教育程度相关的怀孕风险。
低教育程度与产后1年意外怀孕风险增加两倍以上相关。我们没有发现证据表明抑郁或低效的避孕措施介导了这种关系。
