突尼斯莫纳斯提尔地区寻求多次堕胎的女性的产科和心理特征：横断面研究结果
Obstetric and psychological characteristics of women seeking multiple abortions in the region of Monastir (Tunisia): results of a cross-sectional design.
作者信息
El Mhamdi Sana, Ben Salah Arwa, Bouanene Ines, Hlaiem Imen, Hadhri Saloua, Maatouk Wahiba, Soltani Mohamed
机构信息
Department of Community Medicine, Faculty of Medicine of Monastir, Monastir, Tunisia.
Reproductive Health Center of Monastir, Monastir, Tunisia.
出版信息
BMC Womens Health. 2015 May 10;15:40. doi: 10.1186/s12905-015-0198-x.
BACKGROUND
Repeat abortion is a public health concern favored by many obstetric and social factors. The purpose of our study was to identify associated factors to repeated abortion in the region of Monastir (Tunisia). Common mental disorders (CMD) such as anxiety and depression were also evaluated in women seeking voluntary repeated abortion.
METHODS
We carried out a cross sectional study between January and April 2013 in the Reproductive Health Center (RHC) of the region of Monastir in Tunisia (This study is part of a prospective design on mental disorders and intimate partner violence among women seeking abortions in the RHC). Among women referred to the RHC we selected those seeking voluntary abortion (medical or surgical method). Data on women's demographic characters, knowledge and practices about contraceptive methods and abortion were collected the abortion day via a structured questionnaire. Data about anxiety and depression status were evaluated during the post-abortal control visit at 3-4 weeks following pregnancy termination.
RESULTS
Of the 500 interviewed women, 211 (42.2 %; CI95% [37.88 - 46.52]) were seeking repeated abortions. Multivariate analysis showed that increased age, lower level of women school education, single status, poor knowledge about birth control methods and history of conflict/abuse by a male partner, were uniquely associated with undergoing repeat compared with initial abortion. CMD were significantly higher in women undergoing second or subsequent abortion (51.1 %) single and lower educated women. Women relating a history of conflicts/abuse report more CMD than others (30.6 % vs 20.8 %).
CONCLUSION
Health facilities providing abortion services need to pay more attention to women seeking repeat abortion. Further studies are needed to well establish the relation between the number of abortion and the occurrence and the severity of CMD.
背景
重复流产是一个受多种产科和社会因素影响的公共卫生问题。我们研究的目的是确定突尼斯莫纳斯提尔地区重复流产的相关因素。同时，对寻求自愿重复流产的女性的焦虑和抑郁等常见精神障碍也进行了评估。
方法
2013年1月至4月，我们在突尼斯莫纳斯提尔地区的生殖健康中心开展了一项横断面研究（本研究是该生殖健康中心寻求流产女性精神障碍及亲密伴侣暴力前瞻性设计的一部分）。在转诊至该生殖健康中心的女性中，我们选取了寻求自愿流产（药物或手术方法）的女性。通过结构化问卷在流产当天收集了有关女性人口统计学特征、避孕方法和流产的知识及行为的数据。在终止妊娠后3 - 4周的流产后复查中评估焦虑和抑郁状态的数据。
结果
在500名接受访谈的女性中，211名（42.2%；95%置信区间[37.88 - 46.52]）寻求重复流产。多因素分析显示，与首次流产相比，年龄增长、女性受教育程度较低、单身状态、对避孕方法了解不足以及有男性伴侣冲突/虐待史与重复流产显著相关。在接受第二次或后续流产的女性中，常见精神障碍显著更高（51.1%），单身且受教育程度较低的女性也是如此。有冲突/虐待史的女性报告的常见精神障碍比其他女性更多（30.6%对20.8%）。
结论
提供流产服务的卫生机构需要更加关注寻求重复流产的女性。需要进一步研究以明确流产次数与常见精神障碍的发生及严重程度之间的关系。
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