London School of Hygiene and Tropical Medicine, London, UK.
Lancet. 2012 Jul 14;380(9837):149-56. doi: 10.1016/S0140-6736(12)60609-6. Epub 2012 Jul 10.
Increasing contraceptive use in developing countries has cut the number of maternal deaths by 40% over the past 20 years, merely by reducing the number of unintended pregnancies. By preventing high-risk pregnancies, especially in women of high parities, and those that would have ended in unsafe abortion, increased contraceptive use has reduced the maternal mortality ratio--the risk of maternal death per 100,000 livebirths--by about 26% in little more than a decade. A further 30% of maternal deaths could be avoided by fulfilment of unmet need for contraception. The benefits of modern contraceptives to women's health, including non-contraceptive benefits of specific methods, outweigh the risks. Contraception can also improve perinatal outcomes and child survival, mainly by lengthening interpregnancy intervals. In developing countries, the risk of prematurity and low birthweight doubles when conception occurs within 6 months of a previous birth, and children born within 2 years of an elder sibling are 60% more likely to die in infancy than are those born more than 2 years after their sibling.
在过去的 20 年中，发展中国家增加避孕措施的使用，将孕产妇死亡人数减少了 40%，而这仅仅是通过减少意外怀孕的数量。通过防止高危妊娠，特别是多胎妊娠和可能导致不安全堕胎的妊娠，增加避孕措施的使用使孕产妇死亡率（每 10 万活产的死亡风险）在 10 多年内降低了约 26%。如果满足避孕需求，还可以避免另外 30%的孕产妇死亡。现代避孕药具对妇女健康的益处，包括特定方法的非避孕益处，超过了风险。避孕还可以改善围产期结局和儿童生存，主要是通过延长生育间隔。在发展中国家，当怀孕发生在上一次分娩后 6 个月内时，早产和低出生体重的风险会增加一倍，而且在哥哥或姐姐出生后 2 年内出生的儿童比在其哥哥或姐姐出生 2 年后出生的儿童在婴儿期死亡的风险高 60%。
