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一项关于接受与拒绝堕胎对教育程度影响的前瞻性队列研究。

A Prospective Cohort Study of the Effect of Receiving versus Being Denied an Abortion on Educational Attainment.

机构信息

Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, Oakland, California.

Goldman School of Public Policy, University of California Berkeley, Berkeley, California.

出版信息

Womens Health Issues. 2019 Nov-Dec;29(6):455-464. doi: 10.1016/j.whi.2019.09.004. Epub 2019 Nov 8.

Abstract

BACKGROUND

Research on the effects of unintended childbearing has been limited in its ability to disentangle the direct effects of childbearing from common selection factors that predispose women to both unintended childbearing and lower educational attainment.

METHODS

Using data from a 5-year prospective cohort study of 876 individuals seeking abortion care, some of whom were denied care because they presented beyond a facility's gestational age limit, we used discrete time survival models to estimate the hazard of graduating and dropping out among those enrolled in high school, college, or other type of school (n = 280). We also examined cluster-adjusted bivariable differences in degrees completed by receipt versus denial of a wanted abortion.

RESULTS

Participants denied an abortion who parented were equally likely to be in school as compared with women who received a wanted abortion (33 vs. 28%; p = .19); however, they were more likely to be seeking a high school diploma (40 vs. 24%; p = .05) than a higher degree. In adjusted models, there were no differences in the hazard of graduating (adjusted hazard ratio, 0.76; 95% confidence interval, 0.36-1.61) or dropping out (adjusted hazard ratio, 1.12; 95% confidence interval, 0.67-1.88) between those who were denied versus received an abortion. Among graduates, participants denied a wanted abortion less often completed a postsecondary degree (27%) compared with those who received a wanted abortion (71%; p = .002).

CONCLUSIONS

Unintended childbirth was not associated with graduating or dropping out in this population, a finding that is at least partially explained by differences in degrees sought at the time of abortion seeking.

摘要

背景

研究意外怀孕的影响受到限制,因为它无法将生育的直接影响与那些导致女性意外怀孕和教育程度较低的共同选择因素区分开来。

方法

利用一项针对 876 名寻求堕胎护理的个体的 5 年前瞻性队列研究的数据,其中一些人因超出医疗机构的妊娠年龄限制而无法获得护理,我们使用离散时间生存模型来估计在高中、大学或其他类型学校注册的人的毕业和辍学风险(n=280)。我们还检查了因获得或拒绝期望的堕胎而完成的学位数量在集群调整的双变量差异。

结果

与接受期望堕胎的女性相比,意外怀孕并生育的参与者同样有可能在学校(33%对 28%;p=0.19);然而,他们更有可能寻求高中文凭(40%对 24%;p=0.05)而不是更高的学位。在调整模型中,那些被拒绝堕胎的人与那些接受堕胎的人相比,毕业的风险(调整后的危险比,0.76;95%置信区间,0.36-1.61)或辍学的风险(调整后的危险比,1.12;95%置信区间,0.67-1.88)没有差异。在毕业生中,与接受期望堕胎的参与者相比,那些被拒绝期望堕胎的参与者完成中学后学位的比例较低(27%对 71%;p=0.002)。

结论

在这个人群中,意外分娩与毕业或辍学无关,这一发现至少部分可以用在堕胎时寻求的学位差异来解释。

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