Nouhjah Sedighe, Amiri Elham, Khodai Azim, Yazdanpanah Azar, Nadi Baghu Maryam
Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran.
Iran Red Crescent Med J. 2013 Oct;15(10):e4414. doi: 10.5812/ircmj.4414. Epub 2013 Oct 5.
The prevalence of unintended pregnancy and associated risks are higher in late reproductive years. Limited studies have focused on contraceptive choices in these women. The aim of the study was to identify contraceptive choices and their related factors in women 35 years or older attending health centers of Khuzestan province.
Additionally, several line of evidence indicated relationship between increasing maternal age and poor pregnancy outcomes (1, 2). Pregnancies above the age of 35 are accompanied with more risks for complication related to pregnancy as compared to younger women (3-5). Risk of spontaneous abortion is 74.4% in mothers aged 45 years or more.
In a cross-sectional study 1584 women aged 35 years and older attending public health centers of four cities of Khuzestan were studied. We used an interviewer-administered questionnaire for data collection. Women investigators were recruited for interview and filling the questionnaire. Participants were assured of the confidentiality of their responses.
The mean age of women was 39.8 ± 4.2 years. The most popular contraceptive methods used in this age group were oral contraceptive pills (31.4%), condom (28.1%), and tubal ligation (14.8%). Less effective contraceptive methods were used in 41.5% of women. Significant associations were found between the use of effective methods and literacy of husband (OR = 0.80, 95% CI: 0.75, 0.91), city of residence (OR = 0, 92, 95%CI: 0.87-0.97), women age (OR = 0.97, 95% CI; 0.94-0.99), and women education (OR = 0.87, 95%CI: 0.76-0.99) (P < 0.01).
In spite of risk of pregnancy and unintended pregnancy in this age group, about a half of them used less effective contraceptive methods, hence family planning education, and counseling to older women should be a priority in health centers.
在生殖后期,意外怀孕的发生率及相关风险更高。针对这些女性的避孕选择的研究有限。本研究的目的是确定胡齐斯坦省各健康中心35岁及以上女性的避孕选择及其相关因素。
此外,多项证据表明产妇年龄增加与不良妊娠结局之间存在关联(1, 2)。与年轻女性相比,35岁以上的妊娠伴随更多与妊娠相关的并发症风险(3 - 5)。45岁及以上母亲的自然流产风险为74.4%。
在一项横断面研究中,对胡齐斯坦省四个城市公共卫生中心的1584名35岁及以上女性进行了研究。我们使用由访谈员管理的问卷进行数据收集。招募女性调查员进行访谈并填写问卷。参与者的回答得到保密保证。
女性的平均年龄为39.8±4.2岁。该年龄组最常用的避孕方法是口服避孕药(31.4%)、避孕套(28.1%)和输卵管结扎(14.8%)。41.5%的女性使用了效果较差的避孕方法。在有效避孕方法的使用与丈夫的识字率(OR = 0.80,95%CI:0.75, 0.91)、居住城市(OR = 0, 92,95%CI:0.87 - 0.97)、女性年龄(OR = 0.97,95%CI;0.94 - 0.99)以及女性教育程度(OR = 0.87,95%CI:0.76 - 0.99)之间发现了显著关联(P < 0.01)。
尽管该年龄组存在怀孕和意外怀孕的风险,但其中约一半人使用了效果较差的避孕方法,因此在健康中心,对老年女性的计划生育教育和咨询应成为优先事项。