Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2022 Sep 9;17(9):e0271372. doi: 10.1371/journal.pone.0271372. eCollection 2022.
Early resumption of post-partum sexual intercourse has an adverse outcome on the health of women and indirectly unintended pregnancy might happen and affects both the health of women and the delivered baby. There is limited evidence that shows predictors at the individual and community level from the Ethiopian demographic and health survey. Therefore, the aim of this study was to assess predictors of early resumption of post-partum sexual intercourse among post-partum period women in Ethiopia: a multilevel analysis based on Ethiopian demographic and health survey 2016.
This study used an in-depth secondary data analysis of the survey using the 2016 main EDHS. A total weighted sample of 6447 post-partum women who have children aged 0 to 36 months (about 3 years) was included for the analysis. Multilevel binary logistic regression analysis was conducted considering the hierarchical nature of the EDHS data. Intra-class Correlation Coefficient (ICC), and deviance [-2 Log-Likelihood Ratio (LRR)] were used for model comparison and for assessing model fitness. In a multivariable analysis adjusted OR with a 95% CI (Confidence Interval) was reported with a p-value <0.05 was used to declare a significant association between the explanatory and the outcome variables.
The proportion of early resumption of post-partum sexual intercourse was found to be 60.41% [95% CI 59.19-61.63]. Women with age group of 25-28 (AOR = 0.8; 95% CI 0.67-0.96), 29-32 (AOR = 0.79; 95% CI 0.63-0.98), and 33-49 (AOR = 0.67; 95% CI 0.53-0.85), women with sex of child female (AOR = 0.82; 95% CI 0.73-0.92), women whose child is alive (AOR = 0.52; 95% CI 0.38-0.69), women who delivered by cesarean section(AOR = 0.34; 95% CI 0.23-0.49), women with primary educational level (AOR = 1.27; 95% CI 1.09-1.48), women with secondary educational level (AOR = 1.61; 95% CI 1.19-2.17) and women with higher educational level (AOR = 1.6; 95% CI 1.05-2.45), Para 3-4 women (AOR = 1.45; 95% CI 1.21-1.73) and women with grand multi parity (AOR = 1.61; 95% CI 1.29-2), women with fertility desire wanted latter (AOR = 0.81; 95% CI 0.69-0.94), women with fertility desire wanted no more (AOR = 0.81; 95% CI 0.66-1.01), women who are on family planning use (AOR = 1.2; 95% CI 1.05-1.38) and participant with currently on working (AOR = 0.79; 95% CI 0.69-0.91) were significantly associated with early resumption of post-partum sexual intercourse.
The magnitude of early resumption of post-partum sexual intercourse was found to be high. Giving emphasis to the age groups of 25-28, 29-32, and 33-49 women, women with the sex of child female, women who delivered by cesarean section, currently working, the child is live, fertility desire wanted later and no more were suggested to reduce early resumption of post-partum sexual intercourse. On the other hand, improved educational attainments of women, women with parity 3-4, and >5, and family planning use were variables to increase early resumption of post-partum sexual intercourse. Therefore, the health care providers and program managers should act on early resumption of post-partum sexual intercourse through health education and promotion considering the significant factors.
产后早期恢复性生活对妇女健康有不利影响，意外怀孕可能会发生，这既影响妇女的健康，也影响所分娩婴儿的健康。埃塞俄比亚人口与健康调查显示，在个人和社区层面上，有一些有限的证据表明存在预测因素。因此，本研究旨在评估埃塞俄比亚产后妇女产后早期恢复性生活的预测因素：基于埃塞俄比亚人口与健康调查 2016 年的多水平分析。
本研究使用了对该调查的深入二次数据分析，使用了 2016 年主要 EDHS 的数据。总共包括了 6447 名产后 0 至 36 个月（约 3 岁）孩子的产后妇女进行分析。考虑到 EDHS 数据的分层性质，进行了多水平二项逻辑回归分析。使用类内相关系数（ICC）和偏差[-2 对数似然比（LRR）]进行模型比较和模型拟合评估。在多变量分析中，调整后的 OR（95%置信区间）与 p 值 <0.05 用于表示解释变量和结果变量之间存在显著关联。
发现产后早期恢复性生活的比例为 60.41%[95%CI 59.19-61.63]。年龄组为 25-28 岁（AOR=0.8；95%CI 0.67-0.96）、29-32 岁（AOR=0.79；95%CI 0.63-0.98）和 33-49 岁（AOR=0.67；95%CI 0.53-0.85）、孩子为女孩（AOR=0.82；95%CI 0.73-0.92）、孩子存活（AOR=0.52；95%CI 0.38-0.69）、剖宫产分娩（AOR=0.34；95%CI 0.23-0.49）、小学教育程度（AOR=1.27；95%CI 1.09-1.48）、中学教育程度（AOR=1.61；95%CI 1.19-2.17）和高等教育程度（AOR=1.6；95%CI 1.05-2.45）、产次 3-4 次（AOR=1.45；95%CI 1.21-1.73）和多胎产次（AOR=1.61；95%CI 1.29-2）、生育愿望为后者（AOR=0.81；95%CI 0.69-0.94）、生育愿望为不再生育（AOR=0.81；95%CI 0.66-1.01）、使用计划生育（AOR=1.2；95%CI 1.05-1.38）和目前工作（AOR=0.79；95%CI 0.69-0.91）的妇女与产后早期恢复性生活显著相关。
产后早期恢复性生活的比例很高。强调年龄组 25-28 岁、29-32 岁和 33-49 岁、孩子为女孩、剖宫产分娩、目前工作、孩子存活、生育愿望为后者和不再生育的妇女，以减少产后早期恢复性生活。另一方面，提高妇女的教育程度、产次 3-4 次和>5 次、以及计划生育的使用是增加产后早期恢复性生活的变量。因此，卫生保健提供者和方案管理者应通过健康教育和促进考虑到这些重要因素来应对产后早期恢复性生活的问题。
