Mosher William, Jones Jo, Abma Joyce
Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD.
National Center for Health Statistics, 3311 Toledo Road, Hyattsville, MD 20782.
Contraception. 2015 Aug;92(2):170-6. doi: 10.1016/j.contraception.2015.05.004. Epub 2015 May 19.
This paper seeks to determine factors associated with nonuse of contraception by women at risk of unintended pregnancy in the United States. This nonuse may be associated with about 900,000 unintended births in the US each year.
The 2002 and 2006-2010 National Surveys of Family Growth were combined to yield a nationally representative sample of 9,445 women at risk of unintended pregnancy. Logistic regression analyses identified factors associated with nonuse of contraception.
This analysis reveals previously undocumented patterns of nonuse: controlling for confounding variables, cohabiting women [adjusted odds ratio (AOR)=2.3, 95% confidence interval (CI)=1.45-3.52] had higher odds of nonuse than married women; women who reported a difficulty getting pregnant (AOR=2.5, 95% CI=2.01-3.01) had higher odds of nonuse than those who did not. Nonuse was also more common among women with a master's degree or more (AOR=1.5, 95% CI=1.11-2.08) compared with those with some college or bachelor's degree, and it was more common among women in their first year after first intercourse than after the first year (AOR 1.6, 95% CI=1.12-2.22). Among women who had a recent unintended birth, the most common reason for not using contraception prior to conception was that she did not think she could get pregnant.
This study establishes national estimates of reasons for nonuse of contraception and identifies some new subgroups at risk of nonuse.
These results may help better understand factors affecting nonuse of contraception and develop strategies for preventing unintended pregnancy in the United States.
本文旨在确定美国有意外怀孕风险的女性不使用避孕措施的相关因素。这种不使用避孕措施的情况可能与美国每年约90万例意外分娩有关。
将2002年以及2006 - 2010年的全国家庭成长调查合并，以产生一个具有全国代表性的9445名有意外怀孕风险女性的样本。逻辑回归分析确定了与不使用避孕措施相关的因素。
该分析揭示了以前未记录的不使用避孕措施的模式：在控制混杂变量后，同居女性[调整后的优势比（AOR）=2.3，95%置信区间（CI）=1.45 - 3.52]不使用避孕措施的几率高于已婚女性；报告怀孕困难的女性（AOR = 2.5，95% CI = 2.01 - 3.01）不使用避孕措施的几率高于未报告怀孕困难的女性。与有大专或本科学历的女性相比，拥有硕士及以上学位的女性不使用避孕措施的情况也更常见（AOR = 1.5，95% CI = 1.11 - 2.08），并且首次性交后第一年的女性不使用避孕措施的情况比一年后更常见（AOR 1.6，95% CI = 1.12 - 2.22）。在近期有意外分娩的女性中，怀孕前不使用避孕措施的最常见原因是她认为自己不会怀孕。
本研究确定了全国范围内不使用避孕措施的原因估计，并识别了一些有不使用避孕措施风险的新亚组。
这些结果可能有助于更好地理解影响不使用避孕措施的因素，并制定美国预防意外怀孕的策略。
