School of Public Health, Hebei Medical University, Shijiazhuang 050017, China.
Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang 050017, China.
Int J Environ Res Public Health. 2021 Apr 22;18(9):4446. doi: 10.3390/ijerph18094446.
In China, there were about 9.76 million induced abortions in 2019, 50% of which were repeat abortions. Understanding the tendency of repeat induced abortion and identifying its related factors is needed to develop prevention strategies.
Two hospital-based cross-sectional surveys were conducted from 2005-2007 and 2013-2016 in 24 and 90 hospitals, respectively. The survey included women who sought an induced abortion within 12 weeks of pregnancy. The proportion of repeat induced abortions by adjusting the covariates through propensity score matching was compared between the two surveys, and the zero-inflated negative binomial regression model was established to identify independent factors of repeat induced abortion.
Adjusting the age, occupation, education, marital status and number of children, the proportion of repeat induced abortions in the second survey was found to be low (60.28% vs. 11.11%), however the unadjusted proportion was high in the second survey (44.97% vs. 51.54%). The risk of repeat induced abortion was higher among married women and women with children [OR and 95% CI: 0.31 (0.20, 0.49) and 0.08 (0.05, 0.13)]; the risk among service industry staff was higher when compared with unemployed women [OR and 95% CI: 0.19 (0.07, 0.54)]; women with a lower education level were at a higher risk of a repeat induced abortion (OR < 1). Compared with women under the age of 20, women in other higher age groups had a higher frequency of repeat induced abortions (IR: 1.78, 2.55, 3.27, 4.01, and 3.93, separately); the frequency of women with lower education levels was higher than those with a university or higher education level (IR > 1); the repeat induced abortion frequency of married women was 0.93 (0.90, 0.98) when compared to the frequency of unmarried women, while the frequency of women with children was 1.17 (1.10, 1.25) of childless women; the induced abortion frequency of working women was about 60-95% with that of unemployed women.
The repeat induced abortion proportion was lower than 10 years ago. Induced abortion seekers who were married, aged 20 to 30 years and with a lower education level were more likely to repeat induced abortions.
在中国，2019 年约有 976 万例人工流产，其中 50%为重复流产。了解重复人工流产的趋势并确定其相关因素，对于制定预防策略是必要的。
2005-2007 年和 2013-2016 年分别在 24 家和 90 家医院进行了两次基于医院的横断面调查。调查包括怀孕 12 周内寻求人工流产的妇女。通过倾向评分匹配调整协变量，比较两次调查中重复人工流产的比例，并建立零膨胀负二项回归模型，以确定重复人工流产的独立因素。
调整年龄、职业、教育程度、婚姻状况和子女数量后，第二次调查中重复人工流产的比例较低（60.28%比 11.11%），但第二次调查中未调整的比例较高（44.97%比 51.54%）。已婚妇女和有子女的妇女重复人工流产的风险更高[比值比（OR）和 95%置信区间：0.31（0.20，0.49）和 0.08（0.05，0.13）]；与失业妇女相比，服务业工作人员的风险更高[OR 和 95%CI：0.19（0.07，0.54）]；教育程度较低的妇女重复人工流产的风险更高（OR < 1）。与 20 岁以下的妇女相比，其他年龄组的妇女重复人工流产的频率更高（IR：1.78、2.55、3.27、4.01 和 3.93）；教育程度较低的妇女的重复人工流产频率高于具有大学或更高学历的妇女（IR > 1）；已婚妇女的重复人工流产频率为 0.93（0.90，0.98），与未婚妇女相比，有子女的妇女为 1.17（1.10，1.25）；有工作的妇女的人工流产频率约为失业妇女的 60%-95%。
重复人工流产的比例低于 10 年前。已婚、20-30 岁和教育程度较低的人工流产寻求者更有可能重复人工流产。
