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不孕症患病率及协变量对妊娠存活时间的影响:一项基于全国代表性人群的横断面研究。

Prevalence of infertility and the effect of covariates on survival time to pregnancy: A nationally representative population based cross sectional study.

作者信息

Teklemicheal Ashebir Getachew, Gebreyohannes Rahel Demissew

机构信息

Gandhi Memorial Hospital, Addis Ababa, Ethiopia.

Population Services International, Addis Ababa, Ethiopia.

出版信息

Int J Gynaecol Obstet. 2025 Jun;169(3):937-944. doi: 10.1002/ijgo.16124. Epub 2025 Jan 3.

Abstract

OBJECTIVE

This study sought to estimate population level prevalence of infertility and explored whether time to pregnancy is related to selected factors.

METHODS

This study's analysis was based on data collected from 2081 women who were sampled from participants of the 2016 Ethiopia Demographic and Health Survey based on risk of pregnancy criteria: age between 15 and 49 years, currently married or cohabitating, sexually active, not used contraception method during the 5 years before interview, not menopausal, and not pregnant. We used a current duration (CD) approach in which for each woman we calculated the length of time-at-risk of pregnancy (CD value) in months. A parametric survival model was fitted to CD values from which the median time to pregnancy (TTP) and prevalence of infertility were estimated. To explore variables associated with a longer TTP accelerated failure time, regression models were built to estimate time ratios.

RESULTS

The median TTP was 4 months (95% confidence interval [CI] 3.9-4.1). The 12-month prevalence of overall, primary, and secondary infertility were 29.5% (95% CI 27.50-31.47), 31.1% (95% CI 27.85-34.48), and 27.7% (95% CI 25.30-30.23), respectively. A longer TTP was observed for women aged 35 to 49 (P = 0.001), nulliparous (P = 0.00), when the usual residence of the husband is outside the home (P = 0.001), for women who want to give birth soon (P = 0.00), for cigarette smokers (P = 0.027), for rich women (P = 0.002), and for tertiary (P = 0.00) and primary educated women (P = 0.00).

CONCLUSION

This study suggests 30% of reproductive-age women experience infertility, which indicates that large numbers of Ethiopian women need fertility services.

摘要

目的

本研究旨在估计不孕症在人群中的患病率,并探讨受孕时间是否与某些因素相关。

方法

本研究的分析基于从2081名女性收集的数据,这些女性是根据怀孕风险标准从2016年埃塞俄比亚人口与健康调查的参与者中抽样选取的:年龄在15至49岁之间,目前已婚或同居,有性行为,在访谈前5年内未使用避孕方法,未绝经,且未怀孕。我们采用当前持续时间(CD)方法,即对于每位女性,我们计算其怀孕风险时间的长度(CD值),以月为单位。对CD值拟合参数生存模型,从中估计受孕中位时间(TTP)和不孕症患病率。为了探索与较长TTP相关的变量,建立加速失效时间回归模型来估计时间比。

结果

受孕中位时间为4个月(95%置信区间[CI] 3.9 - 4.1)。总体、原发性和继发性不孕症的12个月患病率分别为29.5%(95% CI 27.50 - 31.47)、31.1%(95% CI 27.85 - 34.48)和27.7%(95% CI 25.30 - 30.23)。35至49岁的女性(P = 0.001)未生育的女性(P = 0.00)、丈夫常住地不在家的女性(P = 0.001)、希望尽快生育的女性(P = 0.00)、吸烟女性(P = 0.027)、富裕女性(P = 0.002)以及受过高等教育(P = 0.00)和小学教育的女性(P = 0.00)的TTP较长。

结论

本研究表明30%的育龄妇女患有不孕症,这表明大量埃塞俄比亚妇女需要生育服务。

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