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罗马尼亚青少年妊娠相关问题:一项横断面研究。

The problems associated with adolescent pregnancy in Romania: A cross-sectional study.

机构信息

Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

Department Obstetrics Gynecology "Sf Pantelimon" Clinical Emergency Hospital, Bucharest, Romania.

出版信息

J Eval Clin Pract. 2019 Feb;25(1):117-124. doi: 10.1111/jep.13036. Epub 2018 Oct 17.

Abstract

RATIONALE

The extent of pregnancy in adolescents and young adults, especially in low and middle-income countries, is a source of increasing concern given its social and economic impact.

AIMS AND OBJECTIVE

We hypothesized that there would be correlations between female patients becoming pregnant at a young age and practices such as harmful alcohol misuse, cigarette smoking, and drug use, the use of toxic substances, low educational attainment, and an essential absence of health care seeking about the outcome of adolescent pregnancies.

METHODS

We performed a prospective cross-sectional study of patients who gave birth between August and November 2017 at St. Pantelimon Emergency Hospital in Bucharest, Romania. Seventy-four patients aged 14 to 20 years, with a mean maternal age of 18.07 years, were enrolled in the study and answered a 15-item questionnaire about their social, educational, and medical background.

RESULTS

Fifty-three patients (71.6%) gave birth by caesarean section and 21 (28.3%) by vaginal delivery. Notably, patients aged 14 to 16 years had a lower rate of caesarean delivery compared with those aged 17 to 20 years. Moreover, 83.0% of the caesarean sections and 76.1% of the vaginal deliveries were at term. With reference to age and type of delivery, women are more likely to give birth by caesarean section at any age group (the association is not statistically significant at P < .05), except for the age of 15 years (five out of six patients in our sample had a spontaneous birth). Smoking was the most common risk behavior in the sample (45.9%, n = 34), followed by alcohol consumption (17.5%, n = 13) and drug use (5.40%, n = 4).

CONCLUSIONS

A high percentage of caesarean delivery was reported, particularly in patients aged >17 years. The percentage of female participants who underwent a caesarean delivery for their second pregnancy was significantly higher than compared with primipara participants. Patients receiving consistent antenatal care visits compared with those who did not monitor their pregnancy did not differ in the likelihood of undergoing a caesarean section.

摘要

背景

青少年和年轻成年人(尤其是在中低收入国家)的妊娠比例不断增加,这引起了社会和经济方面的关注。

目的和目标

我们假设,年轻女性怀孕与以下行为之间存在相关性:有害的酒精滥用、吸烟和吸毒、使用有毒物质、受教育程度低以及对青少年怀孕结果缺乏基本的医疗保健寻求。

方法

我们对 2017 年 8 月至 11 月在罗马尼亚布加勒斯特圣潘泰莱蒙紧急医院分娩的患者进行了前瞻性横断面研究。该研究纳入了 74 名 14 至 20 岁的患者,平均产妇年龄为 18.07 岁,她们回答了一个包含 15 个问题的问卷,内容涉及她们的社会、教育和医疗背景。

结果

53 名(71.6%)患者行剖宫产分娩,21 名(28.3%)患者行阴道分娩。值得注意的是,14 至 16 岁患者的剖宫产率低于 17 至 20 岁患者。此外,83.0%的剖宫产和 76.1%的阴道分娩均为足月分娩。参照年龄和分娩方式,各年龄段女性行剖宫产分娩的可能性更高(除 15 岁组外,在该年龄组,5 名患者中有 6 名患者为自然分娩,关联无统计学意义,P<.05)。吸烟是该样本中最常见的风险行为(45.9%,n=34),其次是饮酒(17.5%,n=13)和吸毒(5.40%,n=4)。

结论

报告的剖宫产率较高,特别是在年龄>17 岁的患者中。与初产妇相比,行第二次剖宫产的患者中接受剖宫产分娩的比例明显更高。与未监测妊娠的患者相比,接受定期产前护理的患者行剖宫产分娩的可能性并无差异。

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