University of Illinois at Chicago, College of Nursing, Chicago, Illinois.
University of California, San Francisco, School of Nursing, San Francisco, California.
Womens Health Issues. 2017 Jul-Aug;27(4):407-413. doi: 10.1016/j.whi.2017.02.002. Epub 2017 Mar 9.
Each year, nearly one-half of all pregnancies in the United States are unintended. Risk factors of unintended pregnancy have been studied without attention to whether the pregnancy was the woman's first unintended pregnancy or whether she had had more than one. Little is known about the prevalence, incidence, and risk factors for multiple unintended pregnancies. The purpose of this paper is to present a systematic review of the extant literature on the risk factors for multiple unintended pregnancies in women in the United States, and whether these factors are specific to multiple unintended pregnancies.
PubMed, PsychInfo, CINAHL, Web of Science, and JSTOR databases were searched for empirical research studies performed after 1979, in the United States, with a primary outcome of multiple unintended pregnancies. Articles that did not establish the intendedness of the studied pregnancies were excluded.
Seven studies were identified. For multiple unintended pregnancies, incidence rates ranged from 7.4 to 30.9 per 100 person-years and prevalence rates ranged from 17% to 31.6%. Greater age; identifying as Black or Hispanic; nonvoluntary first intercourse, particularly at a young age; sex trade involvement; and previous abortion were found to be associated with multiple unintended pregnancies. Use of intrauterine devices or combined oral contraceptives were found to decrease the risk of multiple unintended pregnancies.
This review suggests a small number of modifiable factors that may be used to better predict and manage multiple unintended pregnancies.
美国每年近一半的怀孕是意外怀孕。尽管已经对意外怀孕的风险因素进行了研究，但并没有关注怀孕是否是女性的第一次意外怀孕，或者她是否已经有过多次意外怀孕。对于多次意外怀孕的流行率、发生率和风险因素，我们知之甚少。本文旨在对美国女性多次意外怀孕的风险因素进行系统回顾，并探讨这些因素是否特定于多次意外怀孕。
检索了 1979 年后在美国进行的实证研究，主要结局为多次意外怀孕，使用 PubMed、PsychInfo、CINAHL、Web of Science 和 JSTOR 数据库。排除了未确定所研究妊娠是否为计划妊娠的文章。
确定了 7 项研究。对于多次意外怀孕，发生率范围为每 100 人年 7.4 至 30.9 例，患病率范围为 17%至 31.6%。年龄较大；被认定为黑人或西班牙裔；非自愿的第一次性行为，尤其是在年轻时；性交易参与；以及先前的堕胎，与多次意外怀孕有关。使用宫内节育器或复方口服避孕药被发现可降低多次意外怀孕的风险。
这项综述表明，有一些可改变的因素可能用于更好地预测和管理多次意外怀孕。
