Risk factors associated with repeated voluntary termination of pregnancy in Tuscany, Italy. (13th November 2019)

• Record Type: Journal Article
• Authors: Napolitani, M; Kundisova, L; Serafini, A; Lenzi, D; Messina, G; Nante, N
• Is Part Of: European journal of public health. Volume 29(2019)Supplement 4
• Publication Date: 2019-11-13
• Subjects: Epidemiology -- Europe -- Periodicals; Public health -- Europe -- Periodicals; 362.109405
• DOI: 10.1093/eurpub/ckz185.570
• Languages: English
• ISSNs: 1101-1262

Abstract

Abstract: Introduction: In Italy, voluntary termination of pregnancy (VTP) was introduced in 1978 with law n°194, it guarantees autonomy of choice and avoids the practice of unsafe abortions, health complications and death. The aim of this work was to analyse variables associated with repeated VTP. Methods: A cross-sectional study was realized, with data relative to VTP acquired in the period 2016-2018 in Tuscany South-East area (Italy). Data on age, nationality, civil state, education level and n° of living children were extracted from the information system in April 2019. A descriptive analysis was conducted using Stata. Results: The sample consisted of 3451 females (65% Italian). The average age was 31.1±7.3 years. The majority of females (53%) had medium-high education level (non-Italian females had more frequently low education level: 48% vs. 28%, chi-2; p<0.001). The 57% were unmarried, mostly Italian (64% vs. 43%). The majority (62%) already had child (26% one, 36% two or more). Females with repeated VTP represented 25% and were significantly older (32.1 ±6.4 vs. 30.7±7.6; p<0.001). The non-Italian females (OR = 2.15; 95%CI 1.8-2.6; p<0.001) and females that already have children (OR = 2.4; 95%CI 2.02-2.9; p<0.001) had higher probability of having a VTP in the past. The multivariate analysis showed lower probability of repeated VTP for married women (OR = 0.49; 95%CI 0.42-0.64) and women with higher education level in confrontation to those with an elementary education (OR = 0.3; 95%CI 0.18-0.62). The variables associated with higher probability of VTP were age (OR = 1.02; 95%CI 1.01-1.04), nationality (OR = 2.0; 95%CI 1.7-2.4) and children (OR = 2.4; 95%CI 1.9-3). Conclusions: Females with repeated VTP were older, have already children and were more frequently of non-Italian nationality. The reduction of VTP should be one of major objectives of public health as in has negative consequences on women's health. The targeted public health intervention could be a solution of this situation. Key messages: Females with multiple VTP were older, already had children and were more frequently of non-Italian nationality. Targeted public health interventions could be effective in reducing the number of VTP.