19个发展中国家避孕失败的生育结果调查

作     者：Cleland J. Ali M.M. 宁亮 

作者机构：Centre for Population Studies London S ch. of Hyg. and Trop. Med. 49-51 Bedford Square London WC1B 3DP United Kingdom Prof. 

出 版 物：《世界核心医学期刊文摘（妇产科学分册）》 (Core Journal in Obstetrics/Gynecology)

年 卷 期：2005年第1卷第9期

页      面：39-40页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100404[医学-儿少卫生与妇幼保健学] 10[医学] 

主　　题：胎儿流产 避孕措施 已婚女性 非意愿妊娠 足月分娩 活产 量表分 妊娠情况 调查数据 析评 

摘      要：OBJECTIVE: To ascertain the contribution of contraceptive failure to uninten de d births and fetal loss in developing countries. METHODS: Nationally representat ive survey data from married women in 19 developing countries were analyzed. All surveys contained retrospective monthly calendars of contraceptive use and preg nancies for a 5-year period preceding each survey. Information on the intendedn ess of live births, ascertained earlier in the interview, were linked to the cal endar data. Single-decrement life table analysis was applied to episodes of use to estimate failure probabilities. The reproductive consequences of failure wer e established by simple tabulation. Logistic regression was used to explore the determinants of fetal loss. RESULTS: Reported contraceptive failure rates were s imilar to those derived from studies conducted mainly in the United States. Abou t three fourths of pregnancies resulting from contraceptive failure were carried to term, and all but 16%of those were classified by the mother as unwanted or mistimed. Just over one tenth ended in fetal loss, either induced or spontaneous . Analysis of determinants of fetal loss suggested that a large proportion were induced. The median contribution of failure to all unintended births for all 19 surveys was about 15%, and the contribution to fetal loss was 12%. CONCLUSION: The contribution of contraceptive failure in developing countries is much lower than the estimate of 50%in the United States. Despite the substantial increase s in contraceptive practice that have occurred in Asia, Latin America, the Middl e East, and to a lesser extent, Africa, the level of use is still below the 75% mark achieved in most industrialized countries. Nonuse of contraception remains the dominant direct cause of unintended births, and family planning promotion sh ould remain a public health priority.