Misago C, Fonseca W, Correia L, Fernandes L M, Campbell O
Maternal and Child Epidemiology Unit, London School of Hygiene and Tropical Medicine, UK.
Int J Epidemiol. 1998 Oct;27(5):833-9. doi: 10.1093/ije/27.5.833.
Maternal mortality from complications of unsafe abortion constitutes a serious problem in several developing countries. There is, however, a paucity of well-designed and implemented studies in this area, especially in Latin America. The aim of this paper is to present the findings on the determinants and medical characteristics of abortions among women admitted to hospitals.
A descriptive cross-sectional hospital-based study was carried out between October 1992 and September 1993 in Fortaleza, Brazil. A Cox's proportional hazard model was used to estimate prevalence rate ratios after adjustment for confounding.
Among 2074 (48%) women who admitted to terminating the pregnancy, 66% reported using misoprostol to induce abortion. Women with an induced abortion as compared with those with an unlikely induced abortion are younger, more often not married, have fewer children alive and experienced one or more previous induced abortions. We have not found any important differences with regard to complication or duration of stay in hospital.
This finding, at odds with most previous studies, could reflect the special situation in Brazil where misoprostol is used for illegally-induced abortion. The use of misoprostol by this population may have contributed to the reduction of severe complications related to induced abortion which were most prevalent with more invasive methods. Recommendations are made as to the need for confirmatory studies as well as on information regarding cultural perceptions and concepts of abortion, and reasons why poor women fail to adopt available family planning methods.
在一些发展中国家，不安全堕胎并发症导致的孕产妇死亡是一个严重问题。然而，该领域精心设计和实施的研究匮乏，尤其是在拉丁美洲。本文旨在呈现入院女性堕胎的决定因素和医学特征的研究结果。
1992年10月至1993年9月在巴西福塔莱萨开展了一项基于医院的描述性横断面研究。采用Cox比例风险模型在调整混杂因素后估计患病率比值。
在承认终止妊娠的2074名（48%）女性中，66%报告使用米索前列醇引产。与不太可能引产的女性相比，引产女性更年轻，更常未婚，存活子女更少，且有过一次或多次引产经历。我们未发现并发症或住院时间方面的任何重要差异。
这一发现与大多数先前研究不同，可能反映了巴西的特殊情况，即米索前列醇被用于非法引产。该人群使用米索前列醇可能有助于减少与引产相关的严重并发症，而这些并发症在侵入性更强的方法中最为普遍。针对确认性研究的必要性以及关于堕胎的文化认知和观念信息，以及贫困女性未能采用现有计划生育方法的原因提出了建议。
