In China, more and more female college students engage in premarital sex. Few seek reproductive health services, increasing their risk for unintended pregnancy and reproductive tract infections (RTIs). The present study aims to explore the prevalence and sex-related risk factors of premarital pregnancy and RTIs among female undergraduates in China. A total of 4769 females were recruited using randomized cluster sampling and anonymously completed questionnaires. Of the 4,769 females, 863 (18.1%) reported ever having sexual intercourse, 17.5% of which had become pregnant, and 22.7% had contracted RTIs. Younger age or not using a condom at first sex and having multiple sex partners contributed to premarital pregnancy. Majoring in arts, being from less-developed regions of China, having multiple partners, and self-reported pregnancy contributed to RTIs. Findings suggest importance of sexual health education among undergraduates, especially women from less-developed regions of China and/or majoring in arts.
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