Population, Family and Reproductive Health Department, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W4041, Baltimore, MD 21205, USA.
Epidemiol Rev. 2010;32(1):152-74. doi: 10.1093/epirev/mxq012. Epub 2010 Jun 22.
Family planning is hailed as one of the great public health achievements of the last century, and worldwide acceptance has risen to three-fifths of exposed couples. In many countries, however, uptake of modern contraception is constrained by limited access and weak service delivery, and the burden of unintended pregnancy is still large. This review focuses on family planning's efficacy in preventing unintended pregnancies and their health burden. The authors first describe an epidemiologic framework for reproductive behavior and pregnancy intendedness and use it to guide the review of 21 recent, individual-level studies of pregnancy intentions, health outcomes, and contraception. They then review population-level studies of family planning's relation to reproductive, maternal, and newborn health benefits. Family planning is documented to prevent mother-child transmission of human immunodeficiency virus, contribute to birth spacing, lower infant mortality risk, and reduce the number of abortions, especially unsafe ones. It is also shown to significantly lower maternal mortality and maternal morbidity associated with unintended pregnancy. Still, a new generation of research is needed to investigate the modest correlation between unintended pregnancy and contraceptive use rates to derive the full health benefits of a proven and cost-effective reproductive technology.
计划生育被誉为上个世纪最伟大的公共卫生成就之一，全世界有五分之三的已暴露人群接受了计划生育。然而，在许多国家，现代避孕措施的普及受到可及性有限和服务提供薄弱的限制，意外怀孕的负担仍然很大。本综述重点关注计划生育在预防意外怀孕及其健康负担方面的效果。作者首先描述了生殖行为和怀孕意图的流行病学框架，并使用该框架指导对 21 项近期的个体水平妊娠意图、健康结果和避孕措施研究进行综述。然后，他们回顾了计划生育与生殖、孕产妇和新生儿健康益处的人群水平研究。有记录表明，计划生育可以预防母婴传播艾滋病毒，有助于生育间隔，降低婴儿死亡率风险，并减少堕胎数量，尤其是不安全的堕胎。它还显著降低了与意外怀孕相关的孕产妇死亡率和发病率。尽管如此，仍需要新一代的研究来调查意外怀孕和避孕措施使用率之间的适度相关性，以充分利用这一经过验证且具有成本效益的生殖技术的健康益处。
