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2023 年,在埃塞俄比亚西北部南贡德尔地区选定医院,对生育年龄妇女进行人工流产护理服务的晚期就诊情况及其相关因素的多中心、横断面研究。

Magnitude of late presentation for induced abortion care services and the associated factors among reproductive-age women at selected hospitals in the South Gondar district of Northwest Ethiopia in 2023: a multicentred, cross-sectional study.

机构信息

Midwifery, Debre Tabor University, Debre Tabor, Ethiopia

Midwifery and Women's health, University of Gondar, Gondar, Ethiopia.

出版信息

BMJ Open. 2024 Nov 20;14(11):e081946. doi: 10.1136/bmjopen-2023-081946.

Abstract

OBJECTIVE

The objective of the study was to determine the magnitude of and the factors associated with late presentation for induced abortion care services at hospitals in the South Gondar district of Ethiopia.

DESIGN

This study employed an institution-based, cross-sectional design.

SETTING

The study was conducted at five hospitals in the South Gondar district of Ethiopia.

PARTICIPANTS

A total of 381 women recruited through systematic random sampling techniques from October 2022 to February 2023 participated in the study. All women presenting for safe abortion care services at selected hospitals during the data collection period were included, whereas induced abortion care service due to the pregnancy being a high risk to maternal health or at high risk for fetal anomaly were excluded from the study. Data were collected at the abortion clinic at the time of presentation through face-to-face interviews using a pretested and structured questionnaire.

OUTCOME MEASURES

The magnitude of and the factors associated with late presentation for induced abortion care service were assessed in the study.

STATISTICAL ANALYSIS

The collected data were entered and coded using EpiData V.4.6, and SPSS V.25 was used for analysis. Binary logistic regression analyses were undertaken to identify the factors associated with the outcome variable. The level of significance was declared at a p value of <0.05.

RESULTS

The magnitude of late presentation for induced abortion care service was 21.5% (95% CI 17.7, 25.7). Being a rural resident (adjusted OR (AOR) = 1.934; 95% CI 1.010, 3.703), history of use of contraceptives (AOR=0.462; 95% CI 0.227, 0.938), having irregular menstrual cycles (AOR=5.132; 95% CI 2.648, 9.944), delayed decision for termination (AOR=8.196; 95% CI 3.996, 16.808) and pregnancy resulting from incest (AOR=2.549; 95% CI 1.286, 5.052) were factors significantly associated with late presentation for induced abortion care.

CONCLUSION

Increased awareness and education in rural communities related to late presentations for induced abortion and the associated complications may facilitate timely decision-making in the context of induced abortion, resulting in reduced morbidity and mortality.

摘要

目的

本研究旨在确定埃塞俄比亚南贡德尔地区医院人工流产服务延迟就诊的程度和相关因素。

设计

本研究采用基于机构的横断面设计。

地点

研究在埃塞俄比亚南贡德尔区的五家医院进行。

参与者

2022 年 10 月至 2023 年 2 月期间,通过系统随机抽样技术从 381 名在选定医院就诊的妇女中招募了全部参与者。所有在数据收集期间因安全堕胎护理服务而就诊的妇女均包括在内,而因妊娠对产妇健康有高风险或胎儿异常高风险而进行人工流产护理服务的妇女则排除在研究之外。数据是在流产诊所就诊时通过面对面访谈使用预测试和结构化问卷收集的。

结果测量

本研究评估了人工流产护理服务延迟就诊的程度和相关因素。

统计分析

使用 EpiData V.4.6 输入和编码收集的数据,并使用 SPSS V.25 进行分析。采用二项逻辑回归分析确定与结果变量相关的因素。显著性水平定义为 p 值<0.05。

结果

人工流产护理服务延迟就诊的程度为 21.5%(95%CI 17.7, 25.7)。农村居民(调整后的比值比(AOR)=1.934;95%CI 1.010, 3.703)、使用过避孕药具的历史(AOR=0.462;95%CI 0.227, 0.938)、月经不规律(AOR=5.132;95%CI 2.648, 9.944)、终止妊娠的决定延迟(AOR=8.196;95%CI 3.996, 16.808)和因乱伦导致的妊娠(AOR=2.549;95%CI 1.286, 5.052)是与人工流产护理服务延迟就诊相关的显著因素。

结论

提高农村社区对人工流产延迟就诊和相关并发症的认识和教育,可能有助于在人工流产背景下及时做出决策,从而降低发病率和死亡率。

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Modern methods to induce abortion: Safety, efficacy and choice.现代流产方法:安全性、有效性和选择。
Best Pract Res Clin Obstet Gynaecol. 2020 Feb;63:37-44. doi: 10.1016/j.bpobgyn.2019.11.008. Epub 2020 Jan 9.

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