日本甲州地区女性意外妊娠的流行状况及相关因素：2011-2016 年甲州项目的横断面证据。
Prevalence of and factors associated with unplanned pregnancy among women in Koshu, Japan: cross-sectional evidence from Project Koshu, 2011-2016.
机构信息
Department of Health Sciences, School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan.
Centre for Birth Cohort Studies, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, Japan.
出版信息
BMC Pregnancy Childbirth. 2020 Jul 9;20(1):397. doi: 10.1186/s12884-020-03088-3.
BACKGROUND
Unplanned pregnancy is a public health issue with adverse consequences for maternal and neonatal health. In Japan, the prevalence of unplanned pregnancy was 46.2% in 2002. However, few studies have investigated this topic, and there is little recent data from Japan. We described and examined the prevalence and determinants of unplanned pregnancy among rural women in Japan from 2011 to 2016.
METHODS
We used cross-sectional data from a community-based cohort study (Project Koshu). Data were collected from 2011 to 2016 via a self-report questionnaire included in the Maternal and Child Health Handbook of Japan. Pregnancy intention was measured as a binary variable (planned or unplanned). Univariate and multivariate logistic regression analyses were performed to examine factors associated with unplanned pregnancy, with results reported as odds ratios (ORs) and 95% confidence intervals (CIs). We conducted sensitivity analyses with different definitions of pregnancy intention to assess the robustness of the results. The significance level was set at 5%.
RESULTS
Of the 932 participants (mean ± standard deviation age at baseline: 31.3 ± 5.2 years), 382 (41%) pregnancies were reported as unplanned. The multivariate analyses showed that maternal age (+ 1 year: OR = 0.94, 95% CI: 0.92-0.97, p < 0.001), 'other' family structure (OR = 2.76, 95% CI: 1.12-6.76, p = 0.03), three or more pregnancies (OR = 2.26, 95% CI: 1.66-3.08, p < 0.001), current smoking (OR = 2.60, 95% CI: 1.26-5.35, p = 0.01), balanced diet (OR = 0.62, 95% CI: 0.47-0.83, p < 0.001) and current depression (OR = 1.63, 95% CI: 1.24-2.16, p < 0.001) were strongly associated with unplanned pregnancy. These associations were consistent across definitions of pregnancy intention, supporting the robustness of our results.
CONCLUSIONS
The prevalence of unplanned pregnancy in the study population was high (41%). Risk factors for unplanned pregnancy were age, number of pregnancies, smoking, having a balanced diet and current depression. These results suggest greater efforts are needed to enhance sex education for young people, improve access to family planning services and provide comprehensive health care for high-risk women to help reduce unplanned pregnancies.
背景
意外怀孕是一个对母婴健康有不良后果的公共卫生问题。在日本，2002 年意外怀孕的发生率为 46.2%。然而，很少有研究调查这个问题，而且日本最近的数据也很少。我们描述并检查了 2011 年至 2016 年期间日本农村妇女意外怀孕的发生率和决定因素。
方法
我们使用了一项基于社区的队列研究（项目 Koshu）的横断面数据。数据是通过 2011 年至 2016 年期间日本母婴健康手册中的自我报告问卷收集的。妊娠意图被测量为一个二分变量（计划或意外）。我们进行了单变量和多变量逻辑回归分析，以检查与意外怀孕相关的因素，结果以比值比（OR）和 95%置信区间（CI）表示。我们用不同的妊娠意图定义进行了敏感性分析，以评估结果的稳健性。显著性水平设定为 5%。
结果
在 932 名参与者中（基线时的平均年龄 ± 标准差：31.3 ± 5.2 岁），382 名（41%）妊娠被报告为意外。多变量分析显示，母亲年龄（每增加 1 岁：OR=0.94，95%CI：0.92-0.97，p<0.001），“其他”家庭结构（OR=2.76，95%CI：1.12-6.76，p=0.03），三次或更多次妊娠（OR=2.26，95%CI：1.66-3.08，p<0.001），当前吸烟（OR=2.60，95%CI：1.26-5.35，p=0.01），均衡饮食（OR=0.62，95%CI：0.47-0.83，p<0.001）和当前抑郁（OR=1.63，95%CI：1.24-2.16，p<0.001）与意外怀孕有很强的关联。这些关联在不同的妊娠意图定义中都是一致的，支持了我们结果的稳健性。
结论
研究人群中意外怀孕的发生率很高（41%）。意外怀孕的危险因素是年龄、妊娠次数、吸烟、均衡饮食和当前抑郁。这些结果表明，需要加大力度加强对年轻人的性教育，改善计划生育服务的获取，并为高风险妇女提供全面的保健，以帮助减少意外怀孕。
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