Zhonghua Fu Chan Ke Za Zhi. 2026 Apr 25;61(4):305-315. doi: 10.3760/cma.j.cn112141-20250930-00466.
ABSTRACT
Objective: To explore the baseline demographic characteristics of women seeking induced abortion, the proportion of repeat induced abortion, the trend from 2019 through 2021 and risk factors of repeat induced abortions within the framework of the Prospective Cohort of Induced Abortion and Future Pregnancy Outcomes. Methods: Based on the Prospective Cohort of Induced Abortion and Future Pregnancy Outcomes, women seeking abortion due to unwanted pregnancy were recruited from 10 clinical research centers across the country, and a structured questionnaire was used to collect information on age, marital status, pregnancy and childbirth status, and induced abortion and so on. Baseline data of subjects recruited from the beginning of the cohort in 2019 to the end of 2021 were extracted for this study, and were statistically analyzed using the SPSS 22.0 software. χ2 test was used to compare the differences between years and characteristics associated with repeat induced abortion, linear by linear association test was used for the trend test, and logistic regression analysis was performed to identify risk factors of repeat induced abortion. Results: A total of 8 990 women with complete key baseline information from the beginning of the cohort in 2019 to the end of 2021 were included in this study. (1) The average age at the time of induced abortion was (28.9±5.1) years (range: 16-49 years); among all these women, 64.2% (5 776/8 990) were aged 25-34 years, 27.8% (2 496/8 990) were unmarried, 70.9% (6 378/8 990) had junior college or above educational background, and 48.8% (4 391/8 990) were clerks (including teachers, doctors, civil servants, etc.). (2) The proportion of repeat induced abortion was 43.3% (3 897/8 990), with no statistical significance between different years (P>0.05). (3) Age, marital status, education, occupation, smoking, alcohol consumption, number of children and reason for current unintended pregnancy were independent risk factors for repeat induced abortion (all P<0.05). The strongest factors associated significantly with repeat induced abortion were: age≥40 years (OR=17.249, 95%CI: 9.535-31.203), remarried, divorced or widowed (OR=2.209, 95%CI: 1.595-3.059), frequency of alcohol consumption>1 drink/week (OR=2.098, 95%CI: 1.239-3.550), frequency of smoking≥5 cigarettes/day (OR=1.938, 95%CI: 1.267-2.966), number of children≥2 (OR=1.643, 95%CI: 1.356-1.992), master’s degree or higher education level (OR=0.351, 95%CI: 0.267-0.460). Conclusions: The 2019 to 2021 baseline information of the cohort reveals the characteristics of women seeking abortions, with the situation of repeated induced abortion still serious. Women who are with advanced maternal age, low educational level, unstable marital status, unemployed, smoking, drinking, with high frequency of sexual exposure, having more children, and using contraception but contraceptive failure in current unintended pregnancy carry an increased risk of repeat induced abortions. There is an urgent need for effective tertiary prevention interventions for unintended pregnancy and subsequent induced abortion, including early and universal access to sexual and reproductive health education, contraceptive delivery services, postpartum contraceptive services and emergency contraceptive services, and sustaining and strengthening post abortion care services. Promoting consistent and correct use of highly effective contraception is critical.
PMID:42045781 | DOI:10.3760/cma.j.cn112141-20250930-00466
