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探索菲律宾青少年和年轻女性多次怀孕的风险。

Exploring the Risks of Repeated Pregnancy Among Adolescents and Young Women in the Philippines.

作者信息

Maravilla Joemer C, Betts Kim S, Alati Rosa

机构信息

Institute for Social Science Research, The University of Queensland, 80 Meiers Road, Indooroopilly, QLD, 4068, Australia.

School of Public Health, The University of Queensland, Herston, QLD, Australia.

出版信息

Matern Child Health J. 2019 Jul;23(7):934-942. doi: 10.1007/s10995-018-02721-0.

Abstract

Objective Knowledge of the factors which influence repeat pregnancy can inform much needed evidence-based prevention programs. This study aims to identify correlates of repeat pregnancy in the Philippines. Methods We used data from five Philippine Demographic and Health Surveys (1993-2013). A total of 4757 women 15-24 years old who had experienced ≥ 1 pregnancy were included. Individual and partner-related factors were fitted into a series of logistic regression stepwise models with deformalized survey weights. Stratified analyses using two age groups (15-19, 20-24) were also conducted. Interaction terms were included to test for statistical differences between the groups. Results Lower wealth quintiles [odds ratio (OR) 1.71, 95% confidence interval (CI) 1.17-2.49] and partner characteristics such as age of ≥ 30 years (OR = 1.99, CI = 1.41-2.82), multiple partners (OR = 4.19, CI = 1.57-11.19) and live-in status (OR = 1.38, CI = 1.02-1.87) were found to be highly correlated with repeat pregnancy in fully adjusted analysis. Receiving prenatal care from traditional healers (OR = 1.93, CI = 1.02-3.63) during the first pregnancy and giving birth for the first time before 18 years of age (OR = 1.12, CI = 1.04-1.20) showed increased risks among 15-19 years old compared to 20-24 years old in stratified analysis. Conclusions for practice In general, partner characteristics were associated with repeat pregnancy among young women suggesting male involvement, especially older partners, in family planning. High risks for repeat pregnancy were observed among adolescent women who reported younger age at first birth and received prenatal care from a traditional healer which entail promotion of trained prenatal care. Further analysis is needed to validate these findings in other developing countries.

摘要

目的 了解影响再次怀孕的因素,可为急需的循证预防项目提供依据。本研究旨在确定菲律宾再次怀孕的相关因素。方法 我们使用了五项菲律宾人口与健康调查(1993 - 2013年)的数据。纳入了4757名15 - 24岁且经历过≥1次怀孕的女性。将个人和伴侣相关因素纳入一系列带有调整后调查权重的逻辑回归逐步模型。还使用两个年龄组(15 - 19岁、20 - 24岁)进行了分层分析。纳入交互项以检验组间的统计学差异。结果 在完全调整分析中,较低的财富五分位数(比值比[OR] 1.71,95%置信区间[CI] 1.17 - 2.49)以及伴侣特征,如年龄≥30岁(OR = 1.99,CI = 1.41 - 2.82)、多个伴侣(OR = 4.19,CI = 1.57 - 11.19)和同居状态(OR = 1.38,CI = 1.02 - 1.87)与再次怀孕高度相关。在分层分析中,15 - 19岁女性与20 - 24岁女性相比,首次怀孕时接受传统治疗师的产前护理(OR = 1.93,CI = 1.02 - 3.63)以及首次分娩年龄在18岁之前(OR = 1.12,CI = 1.04 - 1.20)显示出更高的风险。实践结论 总体而言,伴侣特征与年轻女性再次怀孕有关,这表明男性参与,尤其是年长伴侣参与计划生育。在首次生育年龄较小且接受传统治疗师产前护理的青少年女性中观察到再次怀孕的高风险,这需要推广经过培训的产前护理。需要进一步分析以在其他发展中国家验证这些发现。

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