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中国女性妇科医生避孕使用的实践和知识:一项真实世界的调查。

Practices and knowledge of female gynecologists regarding contraceptive use: a real-world Chinese survey.

机构信息

Department of Obstetrics and Gynecology, Peking University People's Hospital, Xicheng District, Beijing, 100044, China.

Department of Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, Xinhua District, Beijing, Hebei Province, China.

出版信息

Reprod Health. 2018 Jun 26;15(1):115. doi: 10.1186/s12978-018-0557-9.

Abstract

BACKGROUND

There is no evidence of the practices of obstetricians and gynecologists (OB/GYNs) regarding contraceptive use and determinants influencing contraceptive choices, including emergency methods such as combined oral contraceptives (COCs) and levonorgestrel intrauterine system (LNGIUS). This survey determines the practices and knowledge among Chinese female OB/GYNs regarding modern contraceptive methods.

METHODS

A multicenter questionnaire was completed by 2000 female OB/GYNs participating in training courses organized by the gynecological endocrinology training committee of the Chinese Medical Doctor Association from February to May 2013.

RESULTS

This survey achieved a response rate of 51.4%. The rate of induced abortion among this group was 56.3%; this may be attributable to unreliable contraceptive methods (55.5%) and failure of reliable contraceptive methods (18.9%). Intrauterine devices (IUDs) were more commonly used by parous women than nulliparous women (42.6% vs 1.7%; p < 0.0001), followed by condom and rhythm method (24.2% vs 20.8%). However, nulliparous women commonly used rhythm method (48.3% vs 3.3%; p < 0.0001) and condoms (19.2% vs 10.5%; p = 0.008). OB/GYNs demonstrated misconceptions of OB/GYNs about COCs, such as the risk of breast cancer, amenorrhea and premature ovarian failure, and decreased fertility as reported by 37.10, 10.6, and 7.5% of the respondents, respectively.

CONCLUSIONS

IUDs were commonly used by parous Chinese OB/GYNs. Unreliable contraceptive methods and misconceptions about the side effects of COCs may result in the high rate of unintended pregnancies. Hence, awareness of safe and effective contraceptive methods should be strengthened among OB/GYNs in China.

摘要

背景

目前尚无关于妇产科医生(OB/GYN)在避孕措施使用方面的实践以及影响避孕选择的决定因素的相关证据,包括紧急避孕方法,如复方口服避孕药(COC)和左炔诺孕酮宫内节育系统(LNGIUS)。本研究旨在确定中国女性 OB/GYN 对现代避孕方法的实践和认知。

方法

2013 年 2 月至 5 月,参加中国医师协会妇科内分泌培训委员会组织的培训课程的 2000 名女性 OB/GYN 完成了多中心问卷。

结果

本研究的应答率为 51.4%。该组的人工流产率为 56.3%;这可能归因于不可靠的避孕方法(55.5%)和可靠避孕方法的失败(18.9%)。经产妇中宫内节育器(IUD)的使用率高于初产妇(42.6% vs 1.7%;p<0.0001),其次是避孕套和自然避孕法(24.2% vs 20.8%)。然而,初产妇常使用自然避孕法(48.3% vs 3.3%;p<0.0001)和避孕套(19.2% vs 10.5%;p=0.008)。OB/GYN 对 COC 的误解,如乳腺癌、闭经和卵巢早衰的风险,以及生育能力下降的风险,分别有 37.10%、10.6%和 7.5%的受访者报告。

结论

经产妇中宫内节育器的使用率较高。不可靠的避孕方法和对 COC 副作用的误解可能导致意外怀孕率较高。因此,应加强中国 OB/GYN 对安全有效的避孕方法的认识。

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