Khoramrooz Maryam, Rezapour Aziz, Shirinbakhsh Shamsollah, Khosravi Ardeshir
Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2019 Dec 12;33:134. doi: 10.34171/mjiri.33.134. eCollection 2019.
Unintended pregnancy is a global public health problem that has adverse health, economic, and social consequences for families and societies. This study aimed to measure levels of and analyze changes in unintended pregnancies before and after the changes in the family planning policies in Iran. Data were extracted from Iran's Demographic and Health Surveys in 2000, 2010, and 2015. The study population consisted of married pregnant women aged 15-49 years. In this study, the data of 112 400, 29 609, and 32 264 households and 4976, 1123, and 900 married pregnant women in 2000, 2010 and 2015, respectively, were used. Logistic regression model was applied to estimate effect of the study explanatory variables on unintended pregnancy in each year, and contribution of different factors to the changes in unintended pregnancies was investigated using multivariate decomposition method. All the study analyses were performed using the Stata software, with the statistical significance level of 0.05. The rate of unintended pregnancies decreased by 13% in 2000-2010 and by 1.3% in 2010-2015. Changes in women's likelihood of experiencing unintended pregnancy positively contributed to unintended pregnancy reduction in 2000-2010 and 2010- 2015; however, the change patterns were different. Changes in the distribution of women's characteristics had positive and negative contributions in 2000-10 and 2010-15, respectively. An increase in pregnant women's parity was the main factor with counteracting effect on unintended pregnancy reduction in 2010-2015. Unintended pregnancies decreased among Iranian married women over the study years, but its reduction was slowed down after the changes in the family planning policies. Policy actions in health and other socioeconomic sectors aiming to encourage nulliparous women to become pregnant and help nulliparous women, women with the parity of more than 2, and women in the middle and late reproductive ages to reduce their risk of unintended pregnancy, can accelerate the trend of unintended pregnancy reduction in the future.
意外怀孕是一个全球性的公共卫生问题，会给家庭和社会带来不良的健康、经济和社会后果。本研究旨在衡量伊朗计划生育政策变化前后意外怀孕的水平并分析其变化情况。数据取自2000年、2010年和2015年伊朗的人口与健康调查。研究人群包括年龄在15至49岁的已婚孕妇。在本研究中，分别使用了2000年、2010年和2015年112400户、29609户和32264户家庭以及4976名、1123名和900名已婚孕妇的数据。应用逻辑回归模型估计每年研究解释变量对意外怀孕的影响，并使用多变量分解方法研究不同因素对意外怀孕变化的贡献。所有研究分析均使用Stata软件进行，统计显著性水平为0.05。2000年至2010年意外怀孕率下降了13%，2010年至2015年下降了1.3%。2000年至2010年以及2010年至2015年，女性意外怀孕可能性的变化对意外怀孕减少有正向贡献；然而，变化模式不同。2000年至2010年以及2010年至2015年，女性特征分布的变化分别有正向和负向贡献。2010年至2015年，孕妇生育次数的增加是对意外怀孕减少起抵消作用的主要因素。在研究期间，伊朗已婚女性的意外怀孕情况有所减少，但在计划生育政策变化后，其减少速度放缓。卫生和其他社会经济部门旨在鼓励未育女性怀孕并帮助未育女性、生育次数超过2次的女性以及育龄中晚期女性降低意外怀孕风险的政策行动，可在未来加速意外怀孕减少的趋势。
