Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA 30333, USA.
MMWR Surveill Summ. 2011 Feb 25;60(1):1-42.
PROBLEM/CONDITION: Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States.
Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City). This information is provided voluntarily. For 2007, data were received from 49 reporting areas. For the purpose of trend analysis, data were evaluated from the 45 areas that reported data every year during the preceding decade (1998-2007). Abortion rates (number of abortions per 1,000 women) and ratios (number of abortions per 1,000 live births) were calculated using census and natality data, respectively.
A total of 827,609 abortions were reported to CDC for 2007. Among the 45 reporting areas that provided data every year during 1998-2007, a total of 810,582 abortions (97.9% of the total) were reported for 2007; the abortion rate was 16.0 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 231 abortions per 1,000 live births. Compared with 2006, the total number and rate of reported abortions decreased 2%, and the abortion ratio decreased 3%. Reported abortion numbers, rates, and ratios were 6%, 7%, and 14% lower, respectively, in 2007 than in 1998. Women aged 20-29 years accounted for 56.9% of all abortions in 2007 and for the majority of abortions during the entire period of analysis (1998-2007). In 2007, women aged 20-29 years also had the highest abortion rates (29.4 abortions per 1,000 women aged 20-24 years and 21.4 abortions per 1,000 women aged 25-29 years). Adolescents aged 15-19 years accounted for 16.5% of all abortions in 2007 and had an abortion rate of 14.5 abortions per 1,000 adolescents aged 15-19 years; women aged ≥35 years accounted for a smaller percentage (12.0%) of abortions and had lower abortion rates (7.7 abortions per 1,000 women aged 35-39 years and 2.6 abortions per 1,000 women aged ≥40 years). During 1998-2007, the abortion rate increased among women aged ≥35 years but decreased among adolescents aged ≤19 years and among women aged 20-29 years. In contrast to the percentage distribution of abortions and abortion rates, abortion ratios were highest at the extremes of reproductive age, both in 2007 and throughout the entire period of analysis. During 1998-2007 abortion ratios decreased among women in all age groups except for those aged <15 years. In 2007, most (62.3%) abortions were performed at ≤8 weeks' gestation, and 91.5% were performed at ≤13 weeks' gestation. Few abortions (7.2%) were performed at 14-20 weeks' gestation, and 1.3% were performed at ≥21 weeks' gestation. During 1998-2007, the percentage of abortions performed at ≤13 weeks' gestation remained stable; however, abortions performed at ≥16 weeks' gestation decreased by 13%-14%, and among the abortions performed at ≤13 weeks' gestation, the percentage performed at ≤6 weeks' gestation increased 65%. In 2007, 78.1% of abortions were performed by curettage at ≤13 weeks' gestation, and 13.1% were performed by early medical abortion (a nonsurgical abortion at ≤8 weeks' gestation); 7.9% of abortions were performed by curettage at >13 weeks' gestation. Among the 62.3% of abortions that were performed at ≤8 weeks' gestation, and thus were eligible for early medical abortion, 20.3% were completed by this method. Deaths of women associated with complications from abortions for 2007 are being investigated under CDC's Pregnancy Mortality Surveillance System. In 2006, the most recent year for which data were available, six women were reported to have died as a result of complications from known legal induced abortions. No reported deaths were associated with known illegal induced abortions.
Among the 45 areas that reported data every year during 1998-2007, the total number, rate, and ratio of reported abortions decreased during 2006-2007. This decrease reversed the increase in reported abortion numbers and rates that occurred during 2005-2006; however, reported abortion numbers and rates for 2007 still were higher than they had been previously in 2005. In 2006, as in previous years, reported deaths related to abortion were rare.
Abortion surveillance in the United States continues to provide the data needed to examine trends in the number and characteristics of women obtaining abortions. Policymakers and program planners can use these data to guide and evaluate efforts to prevent unintended pregnancies.
问题/情况：自 1969 年以来，CDC 一直在进行堕胎监测，以记录在美国获得合法人工流产的女性人数和特征。
2007 年。
每年，CDC 都会从 52 个报告地区（50 个州、哥伦比亚特区和纽约市）的中央卫生机构请求堕胎数据。这些信息是自愿提供的。2007 年，收到了 49 个报告地区的数据。为了进行趋势分析，对在过去十年（1998-2007 年）每年都报告数据的 45 个地区的数据进行了评估。堕胎率（每千名妇女中的堕胎数）和比率（每千名活产中的堕胎数）分别使用人口普查和出生率数据进行计算。
2007 年，CDC 共收到 827609 例堕胎报告。在 1998-2007 年期间每年都提供数据的 45 个报告地区中，2007 年共报告了 810582 例堕胎（占总数的 97.9%）；堕胎率为每 1000 名 15-44 岁妇女中有 16.0 例，堕胎比为每 1000 名活产中有 231 例。与 2006 年相比，报告的堕胎总数和率下降了 2%，堕胎比下降了 3%。2007 年报告的堕胎数量、率和比分别比 1998 年低 6%、7%和 14%。2007 年，年龄在 20-29 岁的妇女占所有堕胎的 56.9%，并在整个分析期间（1998-2007 年）占大多数堕胎。2007 年，年龄在 20-29 岁的妇女的堕胎率也最高（每 1000 名 20-24 岁的妇女中有 29.4 例堕胎，每 1000 名 25-29 岁的妇女中有 21.4 例堕胎）。年龄在 15-19 岁的青少年在 2007 年占所有堕胎的 16.5%，堕胎率为每 1000 名 15-19 岁的青少年中有 14.5 例；年龄在≥35 岁的妇女占堕胎的比例较小（12.0%），堕胎率也较低（每 1000 名 35-39 岁的妇女中有 7.7 例堕胎，每 1000 名≥40 岁的妇女中有 2.6 例堕胎）。1998-2007 年，年龄在≥35 岁的妇女的堕胎率上升，但年龄在≤19 岁的青少年和年龄在 20-29 岁的妇女的堕胎率下降。与堕胎数量和堕胎率的百分比分布相反，2007 年和整个分析期间，生殖年龄的两端都有最高的堕胎比。1998-2007 年，除年龄在<15 岁的妇女外，所有年龄组的堕胎比都有所下降。2007 年，大多数（62.3%）堕胎发生在≤8 周妊娠时，91.5%发生在≤13 周妊娠时。少数（7.2%）堕胎发生在 14-20 周妊娠时，1.3%发生在≥21 周妊娠时。1998-2007 年，≤13 周妊娠时的堕胎率保持稳定；然而，≥16 周妊娠时的堕胎率下降了 13%-14%，并且在≤13 周妊娠时，≤6 周妊娠时的堕胎率增加了 65%。2007 年，78.1%的≤13 周妊娠的堕胎是通过刮宫术进行的，13.1%是通过早期药物流产（≤8 周妊娠的非手术堕胎）进行的；7.9%的堕胎是通过刮宫术在>13 周妊娠时进行的。在 62.3%的≤8 周妊娠且符合早期药物流产条件的堕胎中，有 20.3%是通过这种方法完成的。CDC 的妊娠死亡率监测系统正在调查与堕胎并发症相关的 2007 年妇女死亡人数。在 2006 年，即最近有数据可查的一年，有 6 名妇女报告因已知合法人工流产引起的并发症而死亡。没有报告的死亡与已知的非法人工流产有关。
在 1998-2007 年期间每年都报告数据的 45 个地区中，2006-2007 年期间报告的堕胎总数、率和比均有所下降。这一降幅扭转了 2005-2006 年报告的堕胎数量和率的上升趋势；然而，2007 年报告的堕胎数量和率仍高于此前的 2005 年。2006 年，与前几年一样，与堕胎相关的死亡人数很少。
美国的堕胎监测继续提供检查堕胎数量和特征的趋势所需的数据。政策制定者和规划者可以利用这些数据来指导和评估预防意外怀孕的努力。
