Descriptive epidemiology of induced abortion in Italy 1979-1990

Trends of induced abortions in Italy from 1979 to 1990 have been analysed in terms of overall age-standardised rates and ratios, and according to various characteristics of the women. Temporal trends were characterised by an increase of rates from 11.3/1,000 women aged 15-49 in 1979 to 16.5 in 1982 and then followed by a steady decrease to 11.1/1,000 in 1990. Ratios increased from 228/1,000 livebirths in 1979 to 389 in 1984 and then declined to 286 in 1990. Thus, the overall declines from the early 1980's to 1990 were 33% in rates and 26% in ratios. The same pattern was followed by rates and ratios in various age groups. The highest rates were observed in women aged 25-29 years (27.0/1,000 in 1982 and 17.9/1,000 in 1988) and 30-34 years (25.5/1,000 in 1982 and 19.0/1,000 in 1988), and the lowest ones were in women aged 45-49 (1.0/1,000 in 1982 and 0.8/1,000 in 1988). Ratios reached the highest values in 1984 in most age groups, particularly in women between 40 and 49 years and under 20 years. Ratios increased constantly with number of previous deliveries. At all levels of education, a decline in rates has been observed since 1982, but in the highest educational level, the decline started earlier and was more substantial. The decline in rates among more educated women from 1982 to 1987 was 36%, but it was only 9% among less educated ones. Scope for further preventive action is indicated by the differences according to education and by the slowing down of the decline in the more recent years. This preventive intervention should be focused particularly to women of lower educational level and to those with two or more births.