2017-2020年早期堕胎条款是如何导致堕胎率增加的

IF 2.3 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2025-10-13 DOI:10.1016/j.contraception.2025.111108

AJ Stevenson, L Root

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引用次数: 0

摘要

目的2017-2020年全国人工流产率呈上升趋势。我们描述了向早期堕胎的转变是如何促成这一增长的。方法根据已公布的国家妊娠退出统计数据（分娩、流产、报告的妊娠丢失、流产率表和妊娠期间死亡），构建2017-2020年国家妊娠生命表。使用删除原因生命表，其中堕胎作为退出的原因被删除，我们估计在每个妊娠周流产的比例，如果不终止，将在随后的每个妊娠周流产。由此我们估计，如果2017-2020年妊娠期堕胎保持不变，在孕妇进行堕胎之前，2020年流产的数量将以流产告终。通过改变我们的假设，我们测试了结果的敏感性，并产生了一系列的估计。结果如果2017年至2020年妊娠期未发生流产，那么在2020年流产的约1万~ 2万例妊娠在孕妇成功流产之前就已流产。因此，在2017年至2020年期间，流产率增加了1-2个百分点，仅仅是因为流产时妊娠期提前。因此，2017-2020年堕胎总增长的15-30%可能是由于妊娠期较早发生的堕胎。结论妊娠期越早发生流产，流产发生率越高，其原因是在流产前流产的孕妇较少。在妊娠早期堕胎越来越多的时期内，稳定的堕胎发生率可能反映了获得所需堕胎的成功率下降。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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HOW EARLIER ABORTION PROVISION CONTRIBUTED TO INCREASED ABORTION INCIDENCE 2017-2020

Objectives

National abortion incidence increased 2017-2020. We describe how the shift to earlier abortion contributed to this increase.

Methods

We build national pregnancy life tables for 2017-2020 based on published national statistics on pregnancy exits (deliveries, abortions, reported pregnancy loss, miscarriage rate schedules, and deaths during pregnancy). Using cause-deleted life tables in which abortion is removed as a cause of exit, we estimate the fraction of abortions at each week gestation that, if not terminated, would end in miscarriage by each subsequent week of pregnancy. From this we estimate the number of 2020 abortions that would have ended in miscarriage before the pregnant person accessed abortion, had gestational duration of abortions remained constant 2017-2020. By varying our assumptions, we test the sensitivity of our results and generate a range of estimates.

Results

If abortions had not occurred at earlier gestational durations between 2017 and 2020, some 10,000-20,000 pregnancies that ended in abortion in 2020 would have ended in miscarriage before the pregnant person could successfully access abortion. Therefore, abortion incidence increased by 1-2 percentage points between 2017 and 2020 just due to the shift to earlier gestational durations at abortion. Thus, 15-30% of the overall increase in abortion 2017-2020 could be due to abortions occurring at earlier gestational durations.

Conclusions

As abortions occur at earlier gestational durations, abortion incidence increases simply because fewer pregnancies end in miscarriage before abortion is accessed. Stable abortion incidence over a period when abortion is increasingly accessed earlier in pregnancy may reflect declining success securing wanted abortions.

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来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.