目的 了解河南省育龄妇女产后2年内非意愿妊娠发生率分布及其影响因素。方法 选取河南省7个省辖市的13家医院为项目点,随机抽取2015年7月至2016年12月在项目点住院分娩的5 900名产妇为调查对象,于2017年9月至2018年3月通过电话调查其分娩后至随访日期间再次妊娠、月经恢复、哺乳方式等情况。应用SPSS 21.0统计学软件进行生存分析,采用寿命表法分析产后累积非意愿妊娠的发生率,采用Cox比例风险回归模型进行非意愿妊娠影响因素的多因素分析。结果 产后第3、6、9、12、15、18、21和24个月内累积非意愿妊娠率分别为0.0%、0.5%、1.9%、3.6%、6.4%、8.1%、10.2%和11.3%;Cox回归分析结果显示,年龄越大、怀孕次数越多,产后发生非意愿妊娠的风险越小;人工流产次数越多,产后发生非意愿妊娠的风险越高;剖宫产者相对于自然分娩者,母乳喂养>12个月相对于≤6个月者、产后>6个月相对于产后≤3个月恢复性生活者产后发生非意愿妊娠的风险分别降低20.9%、55.2%、74.8%;产后>6个月相对于产后≤3个月开始避孕者,产后发生非意愿妊娠的风险增加273.7%。结论 有人工流产史、开始避孕时间晚是产后非意愿妊娠发生的危险因素,年龄大、剖宫产、孕次多、母乳喂养时间长、月经和性生活恢复晚是产后非意愿妊娠发生的保护因素。

Objective To investigate the incidence and influencing factors of unplanned pregnancy within 2 years after delivery among childbearing age women in Henan province. Methods At 13 hospitals from 7 cities of Henan province, 5 900 women were randomly selected from July 2015 to June 2016, and were surveyed information on the situation on re-pregnancy, menstrual recovery, breast-feeding modes, etc. by telephone from 1 September 2017 to 31 March 2018. Survival analysis was performed by SPSS 21.0 statistical software. Life table method was used to analyze the cumulative incidence of unwanted pregnancy postpartum, and Cox proportional risk regression model was used for multi-factor analysis of the influencing factors of unwanted pregnancy. Results The cumulative incidences of unwanted pregnancies within 3, 6, 9, 12, 15, 18, 21 and 24 months postpartum were 0.0%, 0.5%, 1.9%, 3.6%, 6.4%, 8.1%, 10.2% and 11.3%, respectively. The results of the Cox proportional risk regression model showed that:the older age and more gravidities were associated with lower risk of unwanted pregnancy postpartum, and more abortions was associated with higher risk of unwanted pregnancy postpartum. As comparing with women underwent virginal delivery, the risk of unwanted pregnancy those underwent cesarean delivery were reduced by 20.9%, by 55.2% for women breast-feeding for more than 12 months versus those for 6 months or less, and by 74.8% for women restored sexual life at 6 months or more postpartum versus those within 3 months postpartum. In addition, the risk of unwanted pregnancy increased by 273.7% for women who took birth control at 6 months or more postpartum versus those within 3 months postpartum. Conclusion Abortion history and later birth control are the risk factors for unwanted pregnancy, and older age, cesarean delivery, more gravidities, and longer breast-feeding duration. and the later recovery of sexual life and menstruation are the protective factors.