Spontaneous and Induced Abortions and Its Determinants in Women Aged 15-49

Year 2021, Volume: 15 Issue: 3, 490 - 500, 10.09.2021

Meral Cetinkaya , Yeliz Mercan

https://doi.org/10.21763/tjfmpc.895883

Cited By: 3

Abstract

Aim: Abortions, which are among the causes of maternal mortality in the world, continue to be important not only for women's health, but also because they have devastating physiological, psychological, and economic effects on the family and society. The present study aimed to determine the prevalence of total, induced, and spontaneous abortion in women aged 15-49 in a Family Health Center (FHC) region, and the factors affecting the abortion prevalence. Methods: This cross-sectional study was conducted with 311 women aged 15-49 registered between February and December 2017 at the FHC region in Northwest Thrace in Turkey. Results: The unintended pregnancy prevalence of the participants was 14.8%, and abortion prevalence was 22.2%. Spontaneous and induced abortions prevalence was 12.2% and 10.9%, respectively. According to the multivariate logistic regression analysis, the likelihood of abortion was significantly higher than the reference category in those who perceived their income at a bad level, current smokers, and those who considered abortion as a family planning method used to avoid unwanted pregnancies (p <0.05). The likelihood of induced abortion was significantly higher in women who perceived their income at a bad level, those with spouses aged 35 and older, and those whose spouses had primary school and lower levels of education (p<0.05). The likelihood of spontaneous abortion in women was higher in each one-unit increase in the total number of pregnancies, compared to those with high-school education, and those who perceived their income at a bad level (p<0.05). Conclusion: Nearly one out of every five women had undesired pregnancy experience, and one out of every four women had abortion experience. Spontaneous abortion prevalence was higher than that of induced abortion. Some sociodemographic and/ or obstetric characteristics are determinants of total abortion, induced abortion, and spontaneous abortion.

Keywords

Abortion, Spontaneous abortion, Induced abortion, Unintended pregnancies

Supporting Institution

Yok

Project Number

Yok

Thanks

This article was based on the master thesis prepared at the Institute of Health Sciences of Kirklareli University. The article was presented as an oral presentation at the 1st International Midwifery Education and Research Development Congress held in Izmir in Turkey in November 2018, and its full text was published in the proceedings book.

15-49 Yaş Kadınlarda Kendiliğinden ve İsteyerek Düşükler ve Belirleyicileri

Abstract

Giriş: Dünyada anne ölüm nedenleri arasında yer alan düşükler sadece kadın sağlığı değil aynı zamanda aile ve toplum için yıkıcı fizyolojik, psikolojik ve ekonomik etkilere sahip olması nedeniyle önemini sürdürmektedir. Bu araştırmada bir Aile Sağlığı Merkezi (ASM) bölgesinde yaşayan 15-49 yaş kadınlarda toplam, isteyerek ve kendiliğinden düşük prevalansını belirlemek ve düşük prevalansını etkileyen faktörleri saptamak amaçlandı. Yöntem: Bu kesitsel çalışma, Şubat ve Aralık 2017 tarihleri arasında Türkiye'de Kuzeybatı Trakya'daki bir ASM bölgesinde kayıtlı 15-49 yaş arası 311 kadın ile yürütüldü. Bulgular: Katılımcıların istenmeyen gebelik prevalansı %14,8, düşük prevalansı %22,2 idi. Kendiliğinden ve isteyerek düşük prevalansları sırasıyla %12,2 ve %10,9 idi. Katılımcıların %79,3’ü kürtajın, %52,1’i ertesi gün hapının bir aile planlaması yöntemi olmadığını ve %46,2’si Türkiye’de kürtajın yasal olduğunu bilmekteydi. Çok değişkenli lojistik regresyon analizine göre, kadınlarda düşük görülme olasılığı gelirini kötü düzeyde algılayanlarda, sigara içenlerde ve düşüğü istenmeyen gebeliklerden kaçınmak için kullanılan bir aile planlaması yöntemi olarak görenlerde referans kategoriye göre yüksekti (p<0,05). Kadınlarda isteyerek düşük görülme olasılığı gelirini kötü düzeyde algılayanlarda, eşinin yaşı 35 ve daha büyük olanlarda ve eşinin eğitim düzeyi ilkokul ve daha düşük düzeyde olanlarda anlamlı düzeyde yüksekti (p<0,05). Kadınlarda kendiliğinden düşük görülme olasılığı toplam gebelik sayısındaki her bir artışta, lise düzeyinde eğitimi olanlarda, gelirini kötü düzeyde algılayanlarda yüksek bulundu (p<0,05). Sonuç: Yaklaşık her beş kadından birine yakını istenmeyen gebelik deneyimi, her dört kadından birine yakını kürtaj deneyimi yaşamıştır. Kendiliğinden düşük sıklığı, isteyerek düşük sıklığından yüksek düzeydedir. Bazı sosyodemografik ve / veya obstetrik özellikler toplam düşük, isteyerek düşük ve spontan düşüklerin belirleyicileridir..

Keywords

Düşük, kendiliğinden düşük, İsteyerek düşük, İstenmeyen gebelik

Project Number

Yok

References

• 1. World Health Organization. Reproductive health. [cited 2020 July 15]. Available from:https://www.who.int/westernpacific/health-topics/reproductive-health
• 2. World Health Organization. Abortion, Health Impact. [cited 2020 July 15]. Available from: https://www.who.int/health-topics/abortion#tab=tab_2
• 3. World Health Organization (2020) Abortion, Overview. [cited 2020 July 15]. Available from: https://www.who.int/health-topics/abortion#tab=tab_1
• 4. Ford HB, Schust DJ. Recurrent Pregnancy Loss: Etiology, Diagnosis, and Therapy. Rev Obstet Gynecol. 2009;2(2):76–83.
• 5. Dereli Yilmaz S, Ege E, Akin B, Celik C. The reasons of induced abortion and contraceptive preference in 15-49 years women. FNJN. 2010; 18(3):156-163.
• 6. Hacettepe University Institute of Population Studies. 2013 Turkey Demographic and Health Survey Advanced Analysis Study. Ankara, Turkey, 2015. p.139-223.
• 7. Santos APV, Cardoso Coelho EA, Neves Gusmao ME, Silva DO, Marques PF, Almeida MS. Factors Associated with Abortion in Women of Reproductive. RBGO. 2016;38(6):273-279.
• 8. United Nations, Department of Economic and Social Affairs, Population Division. World Family Planning 2017 - Highlights New York, USA, 2017. (ST/ESA/SER.A/414).
• 9. Hacettepe University Institute of Population Studies. 2018 Turkey Demographic and Health Survey. Ankara, Turkey,2019. p.159-170.
• 10. Singh S, Shekhar C, Acharya R, Moore AM, Stillman M, Pradhan MR, et al. The incidence of abortion and unintended pregnancy in India, 2015. Lancet Glob Health. 2018;6(1):111-120. 11. Hagos G, Tura G, Kahsay G, Haile K, Grum T, Araya T. Family Planning Utilization and Factors Associated among Women Receiving Abortion Services in Health Facilites of Central Zone Towns of Tigray, Northern Ethiopia: A Cross Sectional Study. BMC Women’s Health. 2018;18:83-91.
• 12. World Health Organization. Preventing unsafe abortion. [cited 2020 July 15]. Available from: https://www.who.int/news-room/fact-sheets/detail/preventing-unsafe-abortion
• 13. Cavlin A, Tezcan S, Ergocmen B. Women’s perspective 14. on induced abortion. The Turkish Journal of Population Studies. 2012;34:51-67.
• 15. Gokgol T. A global perspective on abortion: Laws and experiences. Turk J Public Health. 2012;10(1): 1-9.
• 16. Wokoma TT, Jampala M, Bexhell H, Guthrie KA, Lindow SW. Reasons Provided for Requesting a Termination of Pregnancy in the UK. J Fam Plann Reprod Health Care. 2015;41:186-192.
• 17. Doganer G, Bilgic D, Doganer A, Umut UF, Kurk H, Celik E. Attitudes and Knowledge Related to the Emergency Contraception of the Women Aged 15-49. DEU E-Journal of Nursing Faculty. 2011;4(4):159-164.
• 18. Finer LB, Zolna MR. Declines in Unintended Pregnancy in the United States, 2008-2011. N Engl J Med. 2016;374(9):843-52.
• 19. Omani-Samani R, Rarani MA, Sepidarkish M, Morasae EK, Maroufizadeh S, Almasi-Hashiani A. Socioeconomic inequality of unintended pregnancy in the Iranian population: a decomposition approach. BMC Public Health. 2018;18(1):607.
• 20. Wado YD, Afework MF, Hindin MJ. Unintended pregnancies and the use of maternal health services in Southwestern Ethiopia. BMC Int Health Hum Rights. 2013;13:36.
• 21. Kant S, Srivastava R, Rai SK, Misra P, Charlette L, Pandav SC. Induced abortion in villages of Ballabgarh HDSS: rates, trends, causes and determinants. 2015;Reprod Health. 12:51.
• 22. Budak MŞ, Togrul C, Balsak D, Sakar MN, Tahaoğlu AE, Akgöl S, et al. The Evaluation of Failed Contraception Methods and Causes In Elective Pregnancy Termination. The Journal of Gynecology - Obstetrics and Neonatology. 2015;12(3):106-109.
• 23. Maina BW, Mutua MM, Sidze EM. Factors Associated with Repeat Induced Abortion in Kenya. BMC Public Health. 2015;15:1048.
• 24. Fusco LBC, Silva RS, Andreoni S. Unsafe abortion: social determinants and health inequities in a vulnerable population in São Paulo, Brazil. Cad Saude Publica. 2012;28(4):709-19.
• 25. Wolf MF, Bar-Zeev Y, Solt I. Interventions for Supporting Women to Stop Smoking In Pregnancy. Harefuah. 2018 Dec;157(12):783-786.
• 26. Pineles BL, Park E, Samet JM. Systematic review and meta-analysis of miscarriage and maternal exposure to tobacco smoke during pregnancy. Am J Epidemiol. 2014 Apr 1;179(7):807-23. doi: 10.1093/aje/kwt334.
• 27. González-Rábago Y, Rodriguez-Alvarez E, Borrell LN, Martín U. The Role of Birthplace and Educational Attainment on Induced Abortion Inequalities. BMC Public Health. 2017;17(69):1-7.
• 28. Gunyeli I, Abike F, Bingol B, Ornek T. Contraceptive counseling in Turkey after induced abortion. Int J Gynaecol Obstet. 2012;119(2):174-7.
• 29. Pereira J, Pires R, Pedrosa AA, Vicente L, Bombas T, Canavarro MC. Sociodemographic, sexual, reproductive and relationship characteristics of adolescents having an abortion in Portugal: a homogeneous or a heterogeneous group?. Eur J Contracept Reprod Health Care. 2017;22(1):53-61.
• 30. Ilboudo PGC, Somda SMA, Sundby J. Key determinants of induced abortion in women seeking postabortion care in hospital facilities in Ouagadougou, Burkina Faso. Int J Womens Health. 2014;6:565-72.
• 31. Ruiz-Ramos M, Gimeno-Ivanez L, Garcia Leon FJ. Sociodemographic characteristics of induced abortions in Andalusia (Spain): differences between native and foreign populations. Gac Sanit. 2012;26(6):504-11.
• 32. Souza Goulart M, Fusco LBC, Andreoni SA, Silva RS. Prevalence and sociodemographic characteristics of women with induced abortion in a population sample of São Paulo, Brazil. Rev Bras Epidemiol. 2014;17(2):297-312.
• 33. Ilboudo PGC, Greco G, Sundby J, Torsvik G. Estimating the costs for the treatment of abortion complications in two public referral hospitals: a cross-sectional study in Ouagadougou, Burkina Faso. BMC Health Serv Res. 2016;16(1):559.
• 34. Kara F, Bati S, Demir S. Evaluation of Women Applying to a Hospital for Legal Evacuation. 17. National Public Health Congress Book, Edirne, 2014. p. 413-414.
• 35. Cakmak B, Metin FZ, Ozsoy AZ, Yilmaz Dogru H. Opinion of Women about Deliberate Abortion. Smyrna Med J. 2015;7(1):31-35.