González-Rábago Yolanda, Rodriguez-Alvarez Elena, Borrell Luisa N, Martín Unai
Department of Sociology 2, University of the Basque Country UPV/EHU, Barrio Sarriena s/n 48940, Leioa, Spain.
Social Determinants of Health and Demographic Change - Opik, Leioa, Spain.
BMC Public Health. 2017 Jan 13;17(1):69. doi: 10.1186/s12889-016-3984-y.
Induced abortion (IA) has shown social inequality related to birthplace and education with higher rates of IAs in immigrant and in less educated women relative to their native and highly educated counterparts. This study examined the independent and joint effects of birthplace and education on IA, repeated and IA performed during the 2nd trimester of pregnancy among women residing in the Basque Country, Spain.
We conducted a cross-sectional population-based study of IA among women aged 25-49 years residing in the Basque Country, Spain, between 2011 and 2013. Log-binomial regression was used to quantify the independent and joint effects of birthplace and education attainment on all outcomes.
Immigrant women exhibited higher probability of having an IAs (PR: 5.31), a repeated (PR: 7.23) or a 2nd trimester IAs (PR: 4.07) than women born in Spain. We observed higher probabilities for all outcomes among women with a primary or less education relative to those with a graduate education (All IAs PR: 2.51; repeated PR: 6.00; 2nd trimester PR: 3.08). However, no significant heterogeneity was observed for the effect of education on the association of birthplace with IAs, repeated or 2nd trimester IAs.
Birthplace and education are key factors to explain not only an IA decision but also having a repeated or a 2nd trimester IA. However, the effects of birthplace and education may be independent from each other on these outcomes. A better understanding of these factors on IAs is needed when designing programs for sexual and reproductive health aimed to reduce inequalities among women.
人工流产（IA）呈现出与出生地和教育程度相关的社会不平等现象，相对于本地出生和受过高等教育的女性，移民女性和受教育程度较低的女性人工流产率更高。本研究调查了出生地和教育程度对西班牙巴斯克地区女性人工流产、重复人工流产以及孕期第二阶段人工流产的独立影响和联合影响。
我们对2011年至2013年间居住在西班牙巴斯克地区、年龄在25至49岁的女性进行了一项基于人群的横断面人工流产研究。采用对数二项回归来量化出生地和教育程度对所有结局的独立影响和联合影响。
与西班牙出生的女性相比，移民女性进行人工流产（风险比：5.31）、重复人工流产（风险比：7.23）或孕期第二阶段人工流产（风险比：4.07）的可能性更高。我们观察到，与受过研究生教育的女性相比，小学及以下教育程度的女性在所有结局方面的可能性更高（所有人工流产风险比：2.51；重复人工流产风险比：6.00；孕期第二阶段风险比：3.08）。然而，在教育程度对出生地与人工流产、重复人工流产或孕期第二阶段人工流产之间关联的影响方面，未观察到显著的异质性。
出生地和教育程度不仅是解释人工流产决策的关键因素，也是解释重复人工流产或孕期第二阶段人工流产的关键因素。然而，在这些结局方面，出生地和教育程度的影响可能相互独立。在设计旨在减少女性之间不平等现象的性与生殖健康项目时，需要更好地了解这些因素对人工流产的影响。
