产前保健方式对出生结局的影响

Antenatal care and outcomes in newborns.

【目的】了解产前保健方式对婴儿出生结局的影响,以明确如何加强孕期适宜保健和妊娠期营养,减少低出生体重儿的发生及危害程度。【方法】整群收集孕妇1 451例。采用病例回顾方法,根据产前保健次数与适宜营养、分娩方式及地点等将病例界定为全程、部分和无系统保健三组。并根据胎儿出生状况分析出生结局。【结果】1 451例样本中,早产发生率在全程、部分和无系统保健三组分别为1.8%、7.1%和21.1%(P<0.05);新生儿的平均出生体重在三组差异有显著性(3.4、3.3和3.1 kg,P<0.05);低体重儿的发生率三组差异有显著性(1.6%、2.9%和14.7%,P<0.05)。无系统保健组孕产妇其新生儿窒息发生率明显增高,达到3.8%(P<0.05)。孕期的营养测试和指导可降低低体重儿和巨大儿的发生率(P<0.05)。【结论】出生前保健次数的增加及保健内涵的提高可明显降低早产、低出生体重及窒息的发生。加强产前保健可能对降低低出生体重儿对儿童体格和智能发育的消极影响具有重要意义。

[Objective] To explore the effect of prenatal pregnant woman management could prevent and reduce the damage of low birth weight （LBW）. [Methods] 1451 pregnant women were collected as samples. Subjects were defined as entire journey, partial journey and nonsystem health care group （440/486/525 subjects） according the start time and frequency of pre-natal health care as well as place of birth.[Results] Of the 1451 enrolled subjects, 3.8% non-system group subject was newborn asphyxia （P〈0.05）, which was significant higher than other two groups. The premature delivery rate was significant difference among entire, partial and non--system health care group （1.8 %, 7.1% and 21.1%. P〈0.05） ;newborn＇ s average birth weight differed among entire journey, partial journey and non-system health care group （3.4,3.3 and 3. lkg;P〈0.05）; the incidence of LBW was significant difference among entire, partial and non-system health care group（1.6%.2.9% and 14. 7%,P〈0.05）. Pregnant nutrition test and consultation may reduce the rate of LBW and the huge baby （P〈0.05）. [Conclusion] Prenatal health care can significant reduce premature, LBW and newborn asphyxia and it is very important strategy for preventing and reducing the damage of low birth weight on physical growth and cognitive development to their childhood and adolescence.