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严重精神障碍女性人工流产的流行情况及相关因素。

Prevalence and associated factors of abortion among women with severe mental disorders.

机构信息

Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC), Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China.

Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; National Health Commission of China (NHC), Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan 250012, China.

出版信息

J Affect Disord. 2024 Jun 15;355:432-439. doi: 10.1016/j.jad.2024.03.116. Epub 2024 Mar 26.

Abstract

BACKGROUND

Abortion behaviors among individuals with mental disorders presented major obstacles to women's health. However, few studies reported the prevalence and associated factors of abortion among women with severe mental disorders in China. Consequently, this study aims to investigate the prevalence of abortion among female patients in rural communities and identify potential health risks.

METHOD

This was a cross-sectional study of 276 women aged 18 years and older with severe mental disorders in rural areas of Shandong Province, China. The pregnancy history, abortion history and socio-demographic characteristics of women were investigated by questionnaire. Logistic regression analysis was employed to examine the associated factors for different abortion behaviors.

RESULT

The study showed that 82.61 % (228/276) of patients had a pregnancy history. Among the patients with a pregnancy history, 43.42 % (99/228) reported having had at least one abortion, and 15.79 % (36/228) had more than one. In the other side, 31.58 % (72/228) of them experienced spontaneous abortion, while 12.72 % (29/228) experienced induced abortion. Age at first gestation (aOR 0.80, 95 % CI 0.70-0.90) and age at last gestation (aOR 1.17, 95 % CI 1.07-1.27) were both associated with abortion. Anxiety was related to spontaneous (aOR 1.08, 95 % CI 1.02-1.15) and repeat abortions (aOR 1.10, 95 % CI 1.01-1.19). In addition, religion (aOR 10.47, 95 % CI 2.81-39.01), number of children≥2 (aOR 0.18, 95 % CI 0.04-0.77), and family functioning (aOR 1.31, 95 % CI 1.06-1.63) were associated with induced abortion.

CONCLUSION

Women with severe mental disorders in rural regions have notably higher rates of abortion compared to the general female population, particularly for spontaneous abortions. Gestational age and anxiety of pregnant patients deserve attention and preventive measures to avoid the outcomes of abortion.

摘要

背景

精神障碍个体的堕胎行为对女性健康构成了重大障碍。然而,在中国,很少有研究报告精神障碍严重的女性堕胎的流行率和相关因素。因此,本研究旨在调查农村地区女性患者的堕胎流行率,并确定潜在的健康风险。

方法

这是一项在中国山东省农村地区的 276 名年龄在 18 岁及以上的严重精神障碍女性的横断面研究。通过问卷调查了女性的妊娠史、堕胎史和社会人口统计学特征。采用 logistic 回归分析探讨不同堕胎行为的相关因素。

结果

研究表明,82.61%(228/276)的患者有妊娠史。在有妊娠史的患者中,43.42%(99/228)报告至少有一次堕胎,15.79%(36/228)有多次堕胎。另一方面,31.58%(72/228)的患者经历了自然流产,而 12.72%(29/228)经历了人工流产。首次妊娠年龄(aOR 0.80,95%CI 0.70-0.90)和末次妊娠年龄(aOR 1.17,95%CI 1.07-1.27)均与堕胎有关。焦虑与自然流产(aOR 1.08,95%CI 1.02-1.15)和重复流产(aOR 1.10,95%CI 1.01-1.19)有关。此外,宗教信仰(aOR 10.47,95%CI 2.81-39.01)、子女数≥2(aOR 0.18,95%CI 0.04-0.77)和家庭功能(aOR 1.31,95%CI 1.06-1.63)与人工流产有关。

结论

与一般女性人群相比,农村地区严重精神障碍女性的堕胎率明显更高,尤其是自然流产率更高。妊娠患者的胎龄和焦虑值得关注,并采取预防措施避免堕胎结局。

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