Objectives Decreasing fertility implies considerable public health, societal, political, and international consequences. Induced abortion (IA) and the recent COVID-19 pandemic can be contributing factors to it but these have not been adequately studied so far. The purpose of this paper is to explore the relation of IA incidence and the COVID-19 pandemic to declining rates of delivery, as per our Sardinian experience. Methods We analyzed the registered data from the official Italian statistics surveys of deliveries and IA in the last 10 years from 2011 to 2020 in Sardinia. Results A total of 106,557 deliveries occurred and a progressive decrease in the birth rate has been observed. A total of 18,250 IA occurred and a progressive decline has been observed here as well. The ratio between IA and deliveries remained constant over the decade. Between 2011 and 2019 a variation of −4.32% was observed for IA while in the last year, during the COVID-19 pandemic the decrease of the procedures was equal to −12.30%. For the deliveries, a mean variation of the −4.8% was observed between the 2011 and the 2019 while in the last year, during the COVID-19 pandemic the decrease was about −9%. Considering the about 30% reduction of live births between 2011 and 2020, there is an almost proportional reduction in IA. Conclusions Public policy responses to decreasing fertility, especially pronatalist ones, would be provided with evidence base about trends in delivery and IA and women’s decision making.

中文翻译：

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人工流产和 COVID-19 是撒丁岛生育率下降的促成因素

目标 降低生育率意味着相当大的公共卫生、社会、政治和国际后果。人工流产 (IA) 和最近的 COVID-19 大流行可能是促成它的因素，但迄今为止尚未对这些因素进行充分研究。根据我们在撒丁岛的经验，本文的目的是探讨 IA 发病率和 COVID-19 大流行与分娩率下降之间的关系。方法 我们分析了撒丁岛 2011 年至 2020 年过去 10 年意大利官方统计调查的交付和 IA 的登记数据。结果 共有 106,557 次分娩发生，并且观察到出生率逐渐下降。总共发生了 18,250 次 IA，并且这里也观察到了逐渐下降的情况。IA 和交付之间的比率在十年间保持不变。在 2011 年至 2019 年期间，IA 的变化为 -4.32%，而在去年，在 COVID-19 大流行期间，程序减少了 -12.30%。对于交付，观察到 2011 年和 2019 年之间的平均变化为 -4.8%，而在去年，在 COVID-19 大流行期间，下降幅度约为 -9%。考虑到 2011 年至 2020 年间活产儿减少约 30%，IA 几乎成比例地减少。结论 对生育率下降的公共政策反应，尤其是对生育的政策反应，将提供有关分娩趋势和 IA 和妇女决策的证据基础。在 2011 年和 2019 年之间观察到平均变化为 -4.8%，而在去年 COVID-19 大流行期间，下降幅度约为 -9%。考虑到 2011 年至 2020 年间活产儿减少约 30%，IA 几乎成比例地减少。结论 对生育率下降的公共政策反应，尤其是对生育的政策反应，将提供有关分娩趋势和 IA 和妇女决策的证据基础。在 2011 年和 2019 年之间观察到平均变化为 -4.8%，而在去年 COVID-19 大流行期间，下降幅度约为 -9%。考虑到 2011 年至 2020 年间活产儿减少约 30%，IA 几乎成比例地减少。结论 对生育率下降的公共政策反应，尤其是对生育的政策反应，将提供有关分娩趋势和 IA 和妇女决策的证据基础。