国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2019, Vol. 38 ›› Issue (6): 463-466.

• 论著 • 上一篇    下一篇

停用宫内节育器后育龄妇女妊娠率的双向性队列研究

周健，杨月华，王冠融，施雯慧，巴磊，张敏，许豪勤   

  1. 210036 南京，江苏省计划生育科学技术研究所，国家卫生计生委计划生育药具不良反应监测中心
  • 收稿日期:2019-09-06 修回日期:2019-10-14 出版日期:2019-11-15 发布日期:2019-11-15
  • 通讯作者: 杨月华，E-mail：156808960@qq.com；许豪勤，E-mail：jsw@adrs.org.cn E-mail:156808960@qq.com
  • 基金资助:
    江苏省卫生计生委妇幼项目（F201675）；江苏省卫生计生委科研课题（Q201603）；江苏省青年医学重点人才项目（QNRC2016556）；江苏省卫生健康委科研课题（H2018095）；江苏省妇幼健康重点学科项目（FXK201755）

Recovery of Fertility after Removal of IUD: A Cohort Study

ZHOU Jian，YANG Yue-hua，WANG Guan-rong，SHI Wen-hui，BA Lei，ZHANG Min，XU Hao-qin   

  1. NHFPC Contraceptives Adverse Reaction Surveillance Center，Jiangsu Institute of Planned Parenthood Research，Nanjing 210036，China
  • Received:2019-09-06 Revised:2019-10-14 Published:2019-11-15 Online:2019-11-15
  • Contact: YANG Yue-hua，E-mail：156808960@qq.com；XU Hao-qin，E-mail：jsw@adrs.org.cn E-mail:156808960@qq.com
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摘要： 目的：探讨使用宫内节育器（IUD）对女性生育能力的影响。方法：采用双向性队列研究方法，以生育一孩的妇女采用IUD避孕对象作为观察队列（1 361例），同期使用避孕套妇女作为对照队列（1 307例），于2016年7月1日—2017年9月30日随访观察停用避孕措施后1年内的妊娠情况，计算1年累积妊娠率，采用Cox比例风险模型进行多因素分析。结果：IUD组和对照组停用措施后妊娠者平均受孕时间分别为（144.1±96.86）d和（122.5±91.33）d，差异有统计学意义（P＜0.05）。IUD组累积妊娠率低于对照组，差异有统计学意义（P＜0.05）。使用IUD时间小于5年者停用后1年累积妊娠率是停用避孕套者的0.866倍（95%CI：0.788～0.952）。多因素Cox回归分析显示，与使用避孕套妇女相比，使用高铜IUD妇女停用后对妊娠有影响（HR=0.826，95%CI：0.720～0.947）。结论：使用高铜IUD者1年累积妊娠率较使用避孕套者低，受孕时间延长，对于使用高铜IUD者如近期有再生育计划，建议及早取出IUD以做好生育准备。

关键词: 宫内避孕器, 妊娠率, 生育力, 队列研究

Abstract: Objective：To investigate the effect of intrauterine device (IUD) on female fertility. Methods：From July 1, 2016 to September 30, 2017, two-way cohort study was used to observe the pregnancy within one year after using IUD as the observation cohort (1 361 cases) and condom women as the control cohort (1 307 cases) after giving birth to one child. The cumulative pregnancy rate of one year was calculated and the Cox proportional hazard model was used for multivariate analysis. Results：The average days of pregnancy in IUD group and control group were (144.1±96.86) days and (122.5±91.33) days, respectively. There was statistically significant difference between the two groups (P＜0.05). The cumulative pregnancy rate in IUD group was lower than that in control group. The difference was statistically significant (P＜0.05). The cumulative pregnancy rate of one year after removal of IUD for less than 5 years was 0.866 times higher than that of condom group (95%CI: 0.788～0.952). Multivariate Cox regression analysis showed that using of high copper IUD had a slighter effect on pregnancy (HR=0.826, 95%CI: 0.720～0.947) than using condoms. Conclusions：The cumulative pregnancy rate of one year after removal of high copper IUD was lower than that in condom group, and the pregnancy time was longer. It is suggested that if the subjects with using high copper IUD have plans for reproduction in the near future, IUD should be removed as early as possible to prepare for fertility.

Key words: Intrauterine devices, Pregnancy rate, Fertility, Cohort studies

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