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台灣地區婦女之生育年齡、懷孕次序、生育間隔與胎兒死流產危險性之關係研究

A Study on the Risk of Pregnancy Outcomes by Pregnancy Order, Maternal Age and Birth Interval in Taiwan Area

摘要


根據文獻報告,生育型態對婦幼健康有顯著影響力。尤其是亞、非、拉丁美洲等國家,此影響關係是:懷孕次數太多(四胎以上)、母親生育年齡太小或太大(小於18歲、大於35歲,不包括8歲和35歲)、生育間隔太密(低於兩年),則發生早產、死產、流產、嬰幼兒夭折及傷害母體使康的危險性愈大。本研究擷取上述部份關係,探討台灣地區婦女的生育型態(指母說生育年齡、懷孕次序、生育間隔)與胎兒死流產的關係。研究資料取自台灣省家庭計畫研究所所做:台灣地區第四次家庭與生育力調查和第五次家庭與生育力調查資料,以台灣地區20-39歲有偶婦女爲母群體。 結果只有生育間隔對自然流產的發生有些微影響力,以間隔兩年以上時的危險性最低,第一次懷孕和間隔13-24個月時是間隔25個月以上的1.4-1.6倍,間隔在12個月以內的危險性最大,是間隔25個月以上的4.7倍。由於研究對象是民國二十至四十九年之間出生的婦女,其生育年齡是在民國四十年以後,這意謂著早在民國四十年代時,社會性因素如營養、環境、醫療照護的影響,已超越母親生育年齡、懷孕次序和生育間隔對發生死產、自然流產的影響,其水準可能已具有保護懷孕結果的能力。但也有可能是懷孕的自然結果受到生育型態的影響本來就比較小,而是養育嬰幼兒和母體產後健康與生育型態比較有關,故若以嬰幼、孕產婦死亡率爲評估指標,結果是否會跟亞、非、拉丁美洲等其他國家有一玫的結果,值得進一步探討。

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並列摘要


Childbearing patterns have an impact on maternal and child health. According to surveys in Asia, Africa and Latin America, pregnancies may be considered high risk if they are too young (maternal age under 18), too old (maternal age over 35), too many (pregnancy after four births), too close (less than two years apart). To evaluate the impact, pregnancy outcomes, infant, child and maternal mortality are usually used as evaluation indices. This paper studied on the relationship between childbearing patterns and pregnancy outcomes (whether miscarried or stillbirthed). Data were drawn from KAP-4 (1973) and KAP-5 (1980) surveys that were conducted by Taiwan Provincial Institute of Family planning. The relationship in Taiwan Area did not show the similarity and consistency as those in other countries of Asia, Africa and Latin America. Only birth interval had a little influence on the happening of miscarriage. The ratios of miscarriage rates stratified by birth interval were: firth pregnancy: less than 1 year 1-2 years: over 2 years=1.6:4.7:1.4:1. It was concluded that social economic factors so dominantly confounded the relationship that pregnancy outcomes had been protected beyond the influences of childbearing patterns; otherwise the fact was that childbearing patterns had more association with infant, child and maternal mortality than with pregnancy outcomes. The latter needs to be studied further.

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