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摘要:
目的 探讨人工流产对农村女性健康预期寿命(healthy life expectancy, HLE)和预期寿命(life expectancy, LE)的影响。 方法 基于河南农村队列基线(2015―2017年)和随访(2018―2022年)调查，通过问卷调查获得农村女性人工流产情况，采用婚姻状况、受教育程度、家庭人均月收入评价研究对象社会经济地位(socioeconomic status, SES)，根据是否患慢性病评定机体健康状况；采用多状态寿命表法计算各年龄不同人工流产次数女性的HLE和LE。 结果 本研究共纳入18 291名农村女性，其中人工流产次数为0次、1次和≥2次的女性分别有11 540人(63.09%)、3 889人(21.26%)和2 862人(15.65%)。人工流产0次女性40岁时的HLE和LE分别为22.65年和43.69年，与人工流产0次的女性相比，人工流产1次女性损失的HLE和LE分别为0.66年和0.73年，人工流产≥2次女性损失的HLE和LE分别为1.42年和1.66年；较高和较低SES人工流产0次女性40岁时的HLE分别为23.21年和22.39年，与人工流产0次的女性相比，较高和较低SES人工流产1次女性损失的HLE分别为0.69年和0.64年，人工流产≥2次女性损失的HLE分别为1.48年和1.38年。 结论 农村女性HLE和LE与人工流产相关，随着人工流产次数的增加，HLE和LE呈下降趋势，提示应加强生殖健康知识教育，以延长女性HLE和LE。 Abstract:Objective To investigate the effect of induced abortion on healthy life expectancy (HLE) and life expectancy (LE) of rural women. Methods Based on the baseline (2015-2017) and follow-up survey (2018-2022) of Henan Rural Cohort, the information of women induced abortion was obtained through questionnaire survey. The socioeconomic status (SES) of the subjects was evaluated based on their marital status, educational level and average monthly income, and health status was assessed according to whether they had chronic diseases. The multi-state life table method was used to calculate the HLE and LE of women in different age groups and different number of induced abortions. Results A total of 18 291 rural women were included in this study. There were 11 540 (63.09%), 3 889 (21.26%) and 2 862 (15.65%) women with 0, 1 and 2 or more induced abortions, respectively. The HLE and LE of women with 0 induced abortion at aged 40 were 22.65 and 43.69 years, respectively. Compared with 0 induced abortion, women with 1 induced abortion lost HLE and LE by 0.66 and 0.73 years, respectively, and women with 2 or more induced abortions lost HLE and LE by 1.42 and 1.66 years, respectively. The HLE of women with 0 induced abortion at aged 40 was 23.21 and 22.39 years in higher and lower SES, respectively. Compared with 0 induced abortion, the loss of HLE for women with 1 induced abortion was 0.69 and 0.64 years in higher and lower SES, respectively, and the loss of HLE for women with 2 or more induced abortions was 1.48 and 1.38 years, respectively. Conclusions HLE and LE were associated with induced abortion in rural women. As the number of induced abortions increased, HLE and LE showed a downward trend, suggesting that reproductive health education should be strengthened to prolong women′s HLE and LE. -
Key words:
- Induced abortion /
- Healthy life expectancy /
- Life expectancy /
- Reproductive health /
- Rural women
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图 2 不同SES、人工流产次数女性HLE和LE
SES: 社会经济地位；HLE: 健康预期寿命；LE: 预期寿命。
Figure 2. HLE and LE of women in different SES and number of induced abortions
SES: socioeconomic status; HLE: healthy life expectancy; LE: life expectancy.
表 1 研究对象的基本情况
Table 1. Basic information of the participants
基本特征Basic characteristics 人工流产次数Number of induced abortions① Z/χ2值
valueP值
value0 (n=11 540) 1 (n=3 889) ≥2 (n=2 862) 年龄/岁Age /years 60.17(51.92, 66.40) 53.67(48.50, 62.00) 52.00(47.50, 59.50) 1 211.855 ＜0.001 婚姻状况Marital status 100.307 ＜0.001 未婚/离婚/分居/丧偶Unmarried/divorced/separated/windowed 1 369(11.86) 312(8.02) 183(6.39) 已婚/同居Married/cohabitation 10 171(88.14) 3 577(91.98) 2 679(93.61) 受教育程度Education level 237.440 ＜0.001 小学及以下Elementary school or below 7 004(60.69) 1 979(50.89) 1 338(46.75) 初中Junior high school 3 647(31.60) 1 518(39.03) 1 212(42.35) 高中及以上High school or above 889(7.71) 392(10.08) 312(10.90) 家庭人均月收入/元Average monthly income/yuan 109.211 ＜0.001 ＜500 4 605(39.90) 1 271(32.68) 898(31.38) 500~ < 1 000 3 732(32.34) 1 374(35.33) 998(34.87) ≥1 000 3 203(27.76) 1 244(31.99) 966(33.75) 吸烟Smoking 1.906 0.386 否No 11 502(99.67) 3 877(99.69) 2 848(99.51) 戒烟Former 6(0.05) 2(0.05) 9(0.31) 是Yes 32(0.28) 10(0.26) 5(0.18) 饮酒Drinking 43.312 ＜0.001 否No 11 292(97.85) 3 771(96.97) 2 739(95.70) 戒酒Former 25(0.22) 11(0.28) 7(0.25) 是Yes 223(1.93) 107(2.75) 116(4.05) 饮茶Drinking tea 5.053 0.080 否No 10 759(93.23) 3 595(92.44) 2 640(92.24) 是Yes 781(6.77) 294(7.56) 222(7.76) 蔬菜水果摄入量Intake of fruit and vegetable/(g·d-1) 0.532 0.767 ＜500 6 775(58.71) 2 276(58.52) 1 699(59.36) ≥500 4 765(41.29) 1 613(41.48) 1 163(40.64) 体力活动Physical activity 13.999 0.001 轻度Low 3 515(30.46) 1 060(27.26) 745(26.03) 中度Moderate 4 963(43.01) 1 769(45.48) 1 353(47.28) 重度High 3 062(26.53) 1 060(27.26) 764(26.69) BMI/(kg·m-2) 16.669 ＜0.001 低体重Underweight 251(2.18) 53(1.36) 43(1.50) 正常Standard 4 293(37.20) 1 349(34.69) 1 009(35.26) 超重Overweight 4 780(41.42) 1 689(43.43) 1 241(43.36) 肥胖Obesity 2 216(19.20) 798(20.52) 569(19.88) 注：①以人数(占比/%)或M(P25, P75)表示。
Note: ①Number of people (proportion/%) or M(P25, P75).
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表 2 不同人工流产次数女性40岁时HLE和LE
Table 2. HLE and LE of women at aged 40 in different number of induced abortions
人工流产次数Number of induced abortions HLE①/年year LE②/年year 差值Difference③ HLE/年year LE/年year 0 22.65 (21.79~23.51) 43.69 (41.44~45.94) 参考组Reference 参考组Reference 1 21.99 (21.15~22.83) 42.96 (39.85~46.08) -0.66(-2.36~1.04) -0.73(-6.09~4.63) ≥2 21.23 (20.33~22.12) 42.03 (37.04~47.02) -1.42(-3.18~0.34) -1.66(-8.89~5.57) 注：1. HLE，健康预期寿命；LE，预期寿命。
2. 模型调整婚姻状况、受教育程度、家庭人均月收入、吸烟、饮酒、饮茶、蔬菜水果摄入量、体力活动及BMI。
①以HLE(95% CI)表示；②以LE(95% CI)表示；③以寿命差值(95% CI)表示。
Note: 1. HLE, healthy life expectancy；LE, life expectancy.
2. Adjusted for marital status, education level, average monthly income, smoking, drinking, drinking tea, intake of fruit and vegetable, physical activity, and BMI.
①HLE (95% CI); ②LE (95% CI); ③Difference of life (95% CI).
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表 3 不同SES、人工流产次数女性40岁时HLE和LE
Table 3. HLE and LE of women at aged 40 in different SES and number of induced abortions
变量Variable 人工流产0次0 induced abortion 人工流产1次1 induced abortion 人工流产≥2次2 or more induced abortions 较高SES Higher SES HLE/年year① 23.21(21.14~25.29) 22.52 (19.97~25.07) 21.73(18.49~24.96) LE/年year② 44.87(39.62~50.12) 44.09(38.97~49.20) 43.11(37.76~48.45) 不同人工流产次数差值Difference of different number of induced abortions③ HLE/年year 参考组Reference -0.69(-5.32~3.94) -1.48(-6.79~3.83) LE/年year -0.78(-11.14~9.58) -1.76(-12.35~8.83) 不同SES差值Difference of different SES③ HLE/年year 0.82(-3.08~4.72) 0.77(-4.29~5.83) 0.72(-5.78~7.22) LE/年year 1.68(-8.13~11.49) 1.60(-8.20~11.40) 1.53(-8.66~11.72) 较低SES Lower SES HLE/年year① 22.39(20.56~24.21) 21.75(19.24~24.26) 21.01(17.75~24.28) LE/年year② 43.19(38.62~47.75) 42.49(37.80~47.18) 41.58(36.73~46.43) 不同人工流产次数差值Difference of different number of induced abortions③ HLE/年year 参考组Reference -0.64(-4.97~3.69) -1.38(-6.47~3.71) LE/年year -0.70(-9.95~8.55) -1.61(-11.02~7.80) 不同SES差值Difference of different SES③ HLE/年year 参考组Reference 参考组Reference 参考组Reference LE/年year 注：1. SES，社会经济地位；HLE，健康预期寿命；LE，预期寿命。
2. 模型调整婚姻状况、受教育程度、家庭人均月收入、吸烟、饮酒、饮茶、蔬菜水果摄入量、体力活动及BMI。
①以HLE(95% CI)表示；②以LE(95% CI)表示；③以寿命差值(95% CI)表示。
Note: 1. SES, socioeconomic status; HLE, healthy life expectancy; LE, life expectancy.
2. Adjusted for marital status, education level, average monthly income, smoking, drinking, drinking tea, intake of fruit and vegetable, physical activity, and BMI.
①HLE (95% CI); ②LE (95% CI); ③Difference of life (95% CI).
下载: 导出CSV
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