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人工流产后计划生育服务对中国年轻女性避孕措施使用及流产率的影响:一项整群随机试验

Impact of post-abortion family planning services on contraceptive use and abortion rate among young women in China: a cluster randomised trial.

作者信息

Zhu Jin Liang, Zhang Wei-Hong, Cheng Yimin, Xu Juncai, Xu Xiao, Gibson Diana, Støvring Henrik, Claeys Patricia, Temmerman Marleen

机构信息

The Danish Epidemiology Science Centre, University of Aarhus, Aarhus, Denmark.

出版信息

Eur J Contracept Reprod Health Care. 2009 Feb;14(1):46-54. doi: 10.1080/13625180802512994.

Abstract

OBJECTIVES

To compare two post-abortion family planning (FP) service packages on contraceptive use and repeat abortion rate among young women in three cities in China.

METHODS

In this cluster-randomized trial, one FP service package included provision of limited information and referral to existing FP services, and the other, more comprehensive, package consisted--in addition to the above simple package--of individual counselling, free provision of contraceptive materials, and involvement of the male partner. Eight matched pairs of hospitals were certified by centralized randomization. Women undergoing abortion were followed up for six months, and data were collected in two rounds, before and after the intervention.

RESULTS

We followed a total of 2336 women younger than 25 years (555 before and 555 after the simple intervention package; 634 before and 592 after the comprehensive intervention package). Both packages increased use of any contraceptive method, but the comprehensive approach also increased use of more effective methods. Odds ratios for consistent and correct use of condoms were 2.32 (95% confidence interval 1.55-3.46) and 2.78 (1.81-4.26), respectively, compared with the simple package. The rates of unwanted pregnancies and repeat abortions were somewhat reduced for both packages, with no significant statistical difference between them.

CONCLUSION

Couples who received the comprehensive post-abortion FP service appear to use more effective contraceptive methods and show better compliance.

摘要

目的

比较两种流产后计划生育(FP)服务套餐对中国三个城市年轻女性避孕措施使用情况及重复流产率的影响。

方法

在这项整群随机试验中,一种FP服务套餐包括提供有限信息并转介至现有FP服务机构,另一种更全面的套餐除上述简单套餐内容外,还包括个体咨询、免费提供避孕材料以及男性伴侣参与。通过集中随机化确定八对匹配的医院。对接受流产的女性进行为期六个月的随访,并在干预前后两个阶段收集数据。

结果

我们共随访了2336名25岁以下的女性(简单干预套餐组干预前555名,干预后555名;综合干预套餐组干预前634名,干预后592名)。两种套餐均增加了任何避孕方法的使用,但综合方法还增加了更有效方法的使用。与简单套餐相比,正确且持续使用避孕套的优势比分别为2.32(95%置信区间1.55 - 3.46)和2.78(1.81 - 4.26)。两种套餐的意外怀孕率和重复流产率均有所降低,但两者之间无显著统计学差异。

结论

接受综合流产后FP服务的夫妇似乎使用更有效的避孕方法,且依从性更好。

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