免费孕前优生健康检查对象潜在危险因素接触和妊娠结局分析

车焱()1、周公望2、王彩琴2、张焕玲1、张建娥1、闫立新3、陆珍1、陆梅1、沈洁1、朱昊平1

中国工程科学 ›› 2014, Vol. 16 ›› Issue (5) : 56-59.

PDF(975 KB)
PDF(975 KB)
中国工程科学 ›› 2014, Vol. 16 ›› Issue (5) : 56-59.

免费孕前优生健康检查对象潜在危险因素接触和妊娠结局分析

  • 车焱()1、周公望2、王彩琴2、张焕玲1、张建娥1、闫立新3、陆珍1、陆梅1、沈洁1、朱昊平1

作者信息 +

Potential risk factors exposure and pregnant outcomes among women receiving free pre-pregnancy health examination

  • Che Yan1、Zhou Gongwang2、Wang Caiqin2、Zhang Huanling1、Zhang Jiane1、Yan Lixin3、Lu Zhen1、Lu Mei1、Shen Jie1、Zhu Haoping1

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摘要

分析并报告上海市静安区免费孕前优生健康检查后待孕夫妇不良妊娠结局潜在影响因素接触情况以及妊娠率和妊娠结局,为免费孕前健康检查政府实施项目效果的评估提供基础数据。对2011 年8 月—2012 年11 月在静安区参加免费孕前优生健康检查的所有对象在其检查结束后的3 个月、6 个月、12 个月进行随访,重点关注不良妊娠结局潜在危险因素接触情况以及妊娠时间和妊娠结局。统计方法为χ2检验、寿命表、Logistic 回归分析。在目标时段内共有1 480 对夫妇参加了免费孕前优生健康检查,其中1 249 对服务对象接受了随访,随访率为84.4 %。截至2013 年4 月,48.7 %的随访对象已经受孕,孕前检查后3 个月调查累积妊娠率为23.9 %,6 个月调查累积妊娠率为45.0 %。365 人完成妊娠结局的随访,结果显示,早产率为3.0 %,低出生体重率为4.3 %,巨大儿发生率为3.3 %。自然流产率为6.3 %。另外,发现出生缺陷1 人,占妊娠妇女数的0.16 %,占有妊娠结局妇女数的0.27 %。烟酒等不良生活习惯丈夫的比例(18 %~20 %)高于妻子(1 %~3 %),77 %的丈夫和妻子接受潜在电磁辐射的时间超过8 h。9 %的夫妇自述生活和工作中接触重金属以及农药、化肥等潜在致畸物。超过10 %的妻子在怀孕以后接触了潜在致畸物。初步分析未发现上述因素与不良妊娠结局的关系。静安区孕前健康检查后半年内妇女妊娠率不到50 %,有必要在上海乃至全国开展免费孕前健康检查的成本效益评估。

Abstract

To provide evidence for effectiveness evaluation of the government project free pre- pregnancy health examination through reporting exposure of potential risk factors of adverse pregnancy outcome and pregnancy rate and the pregnancy outcome of the couples to be pregnant after free pre- pregnancy physical examination in Jingan District,Shanghai. Followups were completed to women who had a free pre-prenancy health examination in Jingan District from August 2011 to November 2012,which foucused on exposure of potential risk factors of adverse pregnancy outcome,time of pregnancy and pregnancy outcome of the women. Chisq test,life table and Logistic regression model were used for data analysis. 1 480 couples had free pre- pregnancy health examinations in the target period. Of which,84.4 % were followed up. By April 2013,48.7 % of the women who were followed up were pregnant. The cumulative pregnancy rate at 3 months and 6 months after free pre-pregnancy health examination was 23.9 % and 45.0 %,respectively. 365 women completed the follow up about pregnancy outcomes.The incidence rate of premature delivery,low birth weight,giant baby and spontaneous abortion was 3.0 %,4.3 %,3.3 % and 6.3 %,respectively. One birth defect was reported during the follow up period,accounting for 0.16% of the number of pregnant women and 0.27 % of the number of women who had pregnancy outcomes. The proportion of husbands who had unhealthy habits such as smoking or drinking ranged from 18 % to 20 %,which was much higher than that of their wives (1 %~3 %). 77 % husbands and 77 % wifives exposed to potential electromagnetic radiation over 8 hours a day. 9 % couples reported exposing to potential teratogenicity such as heavy mental,pesticide and chemical fertilizer in their daily life and work. Over 10 % wivies had exposed to potential teratogenicity after they were pregnant. Primary analysis showed no association between the above factors and adverse pregnancy outcomes. Since the 6-month cumulative pregnancy rate of women who had free pre- pregnancy health examination was lower than 50 %,it is necessary to evaluate the cost benefit of free pre-pregnancy health examination in Shanghai and throughout the country.

关键词

孕前优生健康检查 / 妊娠率 / 累积妊娠率 / 不良妊娠结局 / 危险因素

Keywords

free pre- pregnany health examination / pregnancy rate / cumulative pregnancy rate / adverse pregnancy outcome / risk factors

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车焱,周公望,王彩琴,张焕玲,张建娥,闫立新,陆珍,陆梅,沈洁,朱昊平. 免费孕前优生健康检查对象潜在危险因素接触和妊娠结局分析. 中国工程科学. 2014, 16(5): 56-59

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