Chin Helen B, Kramer Michael R, Mertens Ann C, Spencer Jessica B, Howards Penelope P
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Aflac Cancer Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
J Rural Health. 2017 Jan;33(1):41-49. doi: 10.1111/jrh.12172. Epub 2016 Jan 14.
Our goal was to determine if there are differences by place of residence in visiting a doctor for help getting pregnant in a population-based study.
Using data from the Furthering Understanding of Cancer, Health, and Survivorship in Adult (FUCHSIA) Women's Study, a cohort study of fertility outcomes in reproductive-aged women in Georgia, we fit models to estimate the association between geographic type of residence and seeking help for becoming pregnant.
The prevalence of visiting a doctor for help getting pregnant ranged from 13% to 17% across geographic groups. Women living in suburban counties were most likely to seek medical care for help getting pregnant compared with women living in urbanized counties (adjusted prevalence ratio (aPR) = 1.14, 95% CI: 0.74-1.75); among women who reported infertility this difference was more pronounced (aPR = 1.59, 95% CI: 1.00-2.53). Women living in rural counties were equally likely to seek fertility care compared with women in urbanized counties in the full sample and among women who experienced infertility.
Women living in urban and rural counties were least likely to seek infertility care, suggesting that factors including but not limited to physical proximity to providers are influencing utilization of this type of care. Increased communication about reproductive goals and infertility care available to meet these goals by providers who women see for regular care may help address these barriers.
在一项基于人群的研究中,我们的目标是确定在寻求怀孕帮助时,就医情况是否因居住地点不同而存在差异。
利用来自“增进对成年女性癌症、健康与生存的理解”(FUCHSIA)女性研究的数据,这是一项对佐治亚州育龄女性生育结局的队列研究,我们建立模型来估计居住地理类型与寻求怀孕帮助之间的关联。
不同地理组中寻求怀孕帮助而就医的患病率在13%至17%之间。与居住在城市化县的女性相比,居住在郊区县的女性最有可能因寻求怀孕帮助而就医(调整患病率比(aPR)=1.14,95%置信区间:0.74 - 1.75);在报告不孕的女性中,这种差异更为明显(aPR = 1.59,95%置信区间:1.00 - 2.53)。在整个样本以及经历不孕的女性中,居住在农村县的女性与居住在城市化县的女性寻求生育护理的可能性相同。
居住在城市和农村县的女性寻求不孕治疗的可能性最小,这表明包括但不限于与医疗服务提供者的实际距离等因素正在影响这类医疗服务的利用。增加关于生殖目标的沟通,以及为女性定期就诊的医疗服务提供者提供可满足这些目标的不孕治疗,可能有助于消除这些障碍。