Pan Africa University Institute of Life and Earth Sciences (Including Health and Agriculture), University of Ibadan, Ibadan, Nigeria.
Arba Minch University, Arba Minch, Ethiopia.
BMC Womens Health. 2020 Sep 3;20(1):188. doi: 10.1186/s12905-020-01023-4.
There has been a significant reduction of abortion rates in high-income countries, while the rates remain unchanged in low- and middle-income countries. In Ethiopia, for example, the number of women of reproductive age seeking an induced abortion is increasing. However, there is limited information concerning the reasons why the occurrence of this procedure is increasing. Thus, this study aimed to identify factors associated with having induced abortion in Addis Ababa, Ethiopia.
An unmatched case-control study was conducted using a semi-structured, interviewer-administered questionnaire from October to December 2017. The cases were 147 women of reproductive age who underwent abortion in a health facility or presented with complications due to induced abortion conducted outside the health facility. The controls were 295 women who came for antenatal care and who reported never having had an induced abortion. The cases were selected by consecutive sampling from nine health facilities, whereas the controls were selected by systematic sampling from the same health facilities. Bivariate and multivariate logistic regression models were employed using STATA version 14 to identify factors associated with induced abortion.
The mean age of cases was 26.5 ± 5.7 years, while for the controls it was 28.1 ± 4.8 years. Being unmarried (AOR = 9.6; 95% CI: 1.5-61.7), having primary (AOR = 5.3; 95% CI: 1.5-18.3) and tertiary (AOR = 5.7; 95% CI: 1.6-21.1) education, earning monthly income 100-300 USD (AOR = 0.2; 95% CI: 0.1-0.4) and > 300 USD (AOR = 0.1; 95% CI: 0.0-0.2), initiating first intercourse between ages of 15 and 19 (AOR = 4.7; 95% CI: 1.4-15.6), marrying before the age of 18 (AOR = 2.9; 95% CI: 1.3-6.7), and having two children (AOR = 4.7; 95% CI: 1.8-12.7) were independent predictors of induced abortion.
Family planning programs hoping to reduce the occurrence of induced abortion should specifically target unmarried women, low income, and those who have two children. The government should also work on preventing early marriage and providing sexual and reproductive health education to help adolescents delay age at first sexual experience.
高收入国家的堕胎率显著下降，而中低收入国家的堕胎率则保持不变。例如，在埃塞俄比亚，寻求人工流产的育龄妇女数量正在增加。然而，关于这种手术增加的原因的信息有限。因此，本研究旨在确定与在埃塞俄比亚亚的斯亚贝巴进行人工流产相关的因素。
2017 年 10 月至 12 月期间，我们进行了一项非匹配病例对照研究，使用半结构式、访谈员管理的问卷。病例组是 147 名在医疗机构进行人工流产的育龄妇女，或因在医疗机构外进行人工流产而出现并发症。对照组是 295 名来进行产前护理且从未进行过人工流产的妇女。病例组通过连续抽样从 9 家医疗机构中选择，对照组通过系统抽样从相同的医疗机构中选择。使用 STATA 版本 14 采用双变量和多变量逻辑回归模型来确定与人工流产相关的因素。
病例组的平均年龄为 26.5±5.7 岁，而对照组为 28.1±4.8 岁。未婚（AOR=9.6；95%CI：1.5-61.7）、小学（AOR=5.3；95%CI：1.5-18.3）和大专（AOR=5.7；95%CI：1.6-21.1）教育、月收入 100-300 美元（AOR=0.2；95%CI：0.1-0.4）和>300 美元（AOR=0.1；95%CI：0.0-0.2）、15-19 岁初次性交（AOR=4.7；95%CI：1.4-15.6）、18 岁前结婚（AOR=2.9；95%CI：1.3-6.7）和有两个孩子（AOR=4.7；95%CI：1.8-12.7）是人工流产的独立预测因素。
希望减少人工流产发生的计划生育项目应特别针对未婚妇女、低收入者和有两个孩子的妇女。政府还应努力防止早婚，并提供性和生殖健康教育，帮助青少年延迟首次性经历的年龄。
