Medical and social characteristics of youth from the perspective of assessing reproductive potential: a multicentral study in the Far Eastern Federal District. A cross-sectional one-step study

Introduction. In the context of the demographic crisis in modern Russia, the focus of the state’s demographic policy is aimed at young people. The reproductive health (RH) and positive reproductive attitudes (RA) of young people, whose number is progressively declining, are especially important for ensuring population reproduction.

Aim. To assess the RH and RA of the student-age population from the standpoint of demographic potential.

Materials and methods. A cross-sectional study was conducted based on an anonymous online interview of young people using a specially created questionnaire. The statistical database was developed based on 2005 questionnaires completed by I–VI-year students and residents of medical universities of four subjects of the Far Eastern Federal District: Amur State Medical Academy (Amur Region), Chita State Medical Academy (Trans-Baikal Territory), Banzarov Buryat State University (Republic of Buryatia), Ammosov North-Eastern Federal University (Republic of Sakha, Yakutia). Mathematical analysis of the results was performed using the IBM SPSS Statistics version 25.0 software. Differences were considered significant at p < 0.05.

Results. 11.4% of female and 1.1% of male respondents had chronic diseases of the reproductive system. Reproductive diseases accounted for 82.8% of gynecological pathology: 54.2% of polycystic ovary syndrome, 11.3% of pelvic inflammatory disease, 8.9% of external endometriosis, 5.4% of menstrual disorders, 3% of female infertility [pχ² < 0.001, odds ratio 22.97 (95% confidence interval 13.05–40.46)]. In 32.7% of respondents, sexual debut occurred before the age of 18. The majority of respondents (67.8%) do not consider early onset of sexual activity to be a risk factor for RH (pχ² < 0.001), and 68.2% received information about the contraception method for the first time in their lives from unreliable sources of information (friends/relatives, Internet resources), and only 31.8% from healthcare professionals. Contraceptive methods currently used include condoms (88.2%), oral contraceptives (20.5%), withdrawal (18.8%), rhythm method (8.6%), and intrauterine contraceptives (1.2%). 5.8% of respondents have children, 94.2% are childless, of which 6% are childfree. In the future, 94% of respondents plan to have children at 20–24 years (11.8%), 25–29 years (62.7%), 30–34 years (15.7%), 35 years and older (3.8%). Causes of delayed childbearing and voluntary childlessness include getting an education (77.7%; pχ² = 0.019), fear of financial difficulties (56.8%; pχ² = 0.619), career priority (47.7%; pχ² = 0.680), common law marriage (46.8%; pχ² = 0.103), not sure about the future (33.0%; pχ² = 0.620), relationship problems within a couple (27.0%; pχ² < 0.001), do not want to be responsible (22.4%; pχ² < 0.001). In general, 70.5% of respondents consider the state policy aimed at supporting motherhood to be effective; 29.5% do not or rather do not consider it effective (pχ² < 0.001). The majority of respondents considered the improvement of housing conditions to be the most effective measure for deciding on the birth of a child in a young family [66.2%; pχ² < 0.001, odds ratio 1.29 (95% confidence interval 1.13–1.48)]. The desired number of children was 2.05 ± 0.9 [0; 4], and in case of adequate living, material, and financial conditions available, it was 2.37 ± 1.0 [0; 4] (p > 0.05).

Conclusion. The state of RH and RA in modern youth can have a negative impact on the quality of the demographic potential of the population. Active cross-departmental work with young people on education in the field of RH and the fostering of commitment to its protection, education of family-oriented values, and positive RA is necessary.