Centre for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Centre for Obstetrical and Gynaecological Diseases, Beijing, China.
J Glob Health. 2024 Sep 20;14:04149. doi: 10.7189/jogh.14.04149.
Ensuring women's sexual and reproductive health (SRH) is a fundamental human right and key to 2030 agenda of the UN Sustainable Development Goals (SDGs), yet limited evidence exists on SRH in China, including national estimates and disparities of women's SRH experiences, gynaecological diseases, and sexually transmitted diseases (STDs).
A national cross-sectional survey based on a multistage stratified sampling from 15 provinces of China was performed from May 2019 to April 2021. A total of 12 815 reproductive-aged (20-49 years) women were involved. The SRH experiences (including age at menarche, age at first sexual activity, history of abortion, miscarriage, recurrent miscarriage, stillbirth, age at first delivery, types of delivery), the history of gynaecological diseases and STDs, as well as the environmental factors of participants were investigated. Human development index (HDI) was utilised to categorise and describe the socioeconomic status of the regions. The prevalence rates of diseases were compared among different HDI regions.
We observed a decrease in the mean age at menarche, an increase in the proportion of women who became sexually active before 20, and a modest rise in mean age at first childbirth across generations. Age-standardised prevalence estimates of miscarriage, recurrent miscarriage, artificial abortion, ectopic pregnancy, and stillbirth were 9.3, 1.4, 55.7, 3.3, and 2.1%, respectively. Approximately 50% of participants reported a history of gynaecological diseases, with vulvovaginitis, cervicitis, and pelvic infection diseases being the most prevalent. The overall prevalence of STDs was estimated at 22.2‰, with mycoplasma genitalium infection having the highest reported prevalence. Disease prevalence varies across HDI regions.
Women's SRH behaviours and experiences have evolved, along with shifts in the spectrums of gynaecological diseases and STDs in China. Urgent recalibration of health care policies and disease control strategies is necessary, aligning them with women's changing SRH needs, ultimately ensuring their reproductive health and rights.
确保妇女的性与生殖健康（SRH）是一项基本人权，也是联合国可持续发展目标（SDGs）2030 议程的关键，但中国在 SRH 方面的证据有限，包括全国范围内对妇女 SRH 体验、妇科疾病和性传播疾病（STDs）的估计和差异。
本研究于 2019 年 5 月至 2021 年 4 月在中国 15 个省份开展了一项基于多阶段分层抽样的全国性横断面调查。共纳入 12815 名育龄期（20-49 岁）女性。调查了她们的 SRH 体验（包括初潮年龄、初次性行为年龄、堕胎史、流产史、复发性流产史、死产史、初次分娩年龄、分娩类型）、妇科疾病和 STDs 史以及参与者的环境因素。利用人类发展指数（HDI）对区域的社会经济状况进行分类和描述。比较了不同 HDI 地区疾病的患病率。
我们观察到初潮年龄的平均值下降，20 岁前有性行为的女性比例增加，以及初育年龄的适度上升。流产、复发性流产、人工流产、异位妊娠和死产的年龄标准化患病率分别为 9.3%、1.4%、55.7%、3.3%和 2.1%。约 50%的参与者报告有妇科疾病史，其中阴道炎、宫颈炎和盆腔炎最为常见。STD 的总患病率估计为 22.2‰，其中解脲支原体感染的报告率最高。疾病的患病率在不同的人类发展指数地区之间存在差异。
中国妇女的 SRH 行为和体验发生了变化，妇科疾病和 STDs 的范围也发生了变化。迫切需要对卫生保健政策和疾病控制策略进行重新调整，使其与妇女不断变化的 SRH 需求保持一致，最终确保她们的生殖健康和权利。
