15-49 Yaş Kadınlarda Kendiliğinden ve İsteyerek Düşükler ve Belirleyicileri

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..

Anahtar Kelimeler:

Düşük, kendiliğinden düşük, İsteyerek düşük, İstenmeyen gebelik

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

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,

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