Profiles of hospital-based patients with abortion and factors associated with mental health in China: a nationwide cross-sectional study
1
School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
2
Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
3
Department of Obstetrics and Gynaecology, National Clinical Research Centre for Obstetric and Gynaecological Diseases, State Key Laboratory of Common Mechanism Research for Major Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
4
School of Clinical Medicine, Tsinghua University, Beijing, China
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
China has entered a phase of sustained low fertility, yet abortion remains prevalent in gynecological care. Characterizing patients with abortion is essential for informing reproductive health protection strategies. Beyond reproductive outcomes, abortion may also be associated with mental health problems; however, nationwide evidence from routine clinical settings remains limited. This study aimed to describe the distribution of abortion among gynecological patients in China and examine factors associated with their mental health.
METHODS:
This study drew on data from the 2024 China Gynecological Healthcare Quality Survey and adopted a multicenter, hospital-based cross-sectional design covering 31 provincial-level administrative regions in China. Female outpatients and inpatients aged 15 years or older were included. Mental health was assessed using the five-item Mental Health Inventory. Data on healthcare institutional and demographic characteristics of abortion patients were analyzed using chi-square tests and multivariable logistic regression.
RESULTS:
Among 15,782 gynecological patients, 2,022 (12.8%) were diagnosed with abortion, ranking as the second most common gynecological diagnosis. Most abortion patients were aged 25–34 years; 69.5% were married and had children, of whom 48.4% had one child, and 38.8% were of low socioeconomic status. Approximately two-thirds reported possible psychological distress. Inpatient care, older age, being married, higher education, urban residence, higher household income, self-employment, and higher overall patient experience were associated with a lower likelihood of possible psychological distress(P<0.05). Treatment in primary/secondary hospital, ethnic minority status, having children, and having commercial health insurance were associated with a higher likelihood of possible psychological distress (P<0.05).
CONCLUSIONS:
Abortion is common among gynecological patients in China and is accompanied by a substantial burden of possible psychological distress. Disparities in mental health among abortion patients reflect both social and healthcare system factors. Strengthening mental health assessment and supportive care within abortion-related services may contribute to improved reproductive health under sustained low fertility.
China has entered a phase of sustained low fertility, yet abortion remains prevalent in gynecological care. Characterizing patients with abortion is essential for informing reproductive health protection strategies. Beyond reproductive outcomes, abortion may also be associated with mental health problems; however, nationwide evidence from routine clinical settings remains limited. This study aimed to describe the distribution of abortion among gynecological patients in China and examine factors associated with their mental health.
METHODS:
This study drew on data from the 2024 China Gynecological Healthcare Quality Survey and adopted a multicenter, hospital-based cross-sectional design covering 31 provincial-level administrative regions in China. Female outpatients and inpatients aged 15 years or older were included. Mental health was assessed using the five-item Mental Health Inventory. Data on healthcare institutional and demographic characteristics of abortion patients were analyzed using chi-square tests and multivariable logistic regression.
RESULTS:
Among 15,782 gynecological patients, 2,022 (12.8%) were diagnosed with abortion, ranking as the second most common gynecological diagnosis. Most abortion patients were aged 25–34 years; 69.5% were married and had children, of whom 48.4% had one child, and 38.8% were of low socioeconomic status. Approximately two-thirds reported possible psychological distress. Inpatient care, older age, being married, higher education, urban residence, higher household income, self-employment, and higher overall patient experience were associated with a lower likelihood of possible psychological distress(P<0.05). Treatment in primary/secondary hospital, ethnic minority status, having children, and having commercial health insurance were associated with a higher likelihood of possible psychological distress (P<0.05).
CONCLUSIONS:
Abortion is common among gynecological patients in China and is accompanied by a substantial burden of possible psychological distress. Disparities in mental health among abortion patients reflect both social and healthcare system factors. Strengthening mental health assessment and supportive care within abortion-related services may contribute to improved reproductive health under sustained low fertility.
| eISSN: | 2654-1459 |
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