婚前医学检查与出生缺陷预防的现状调查

The effects of premarital medical examination on primary prevention of birth defects

目的探讨婚前医学检查(premarital medical examination,PME)的影响因素及其对出生缺陷预防的意义。方法随机选择2006年9月29日至11月1日,在复旦大学附属妇产科医院门诊进行产前登记的300例孕妇,按PME与否分为PME组和无PME组,采用问卷问答的方法调查孕妇的PME率、人群特点、相关因素,对出生缺陷预防的认知程度,以及相关知识,比较二组之间的差异。结果在300例孕妇中,PME率为42.7%。本调查结果显示,丈夫的籍贯与PME率有关,丈夫为上海籍贯的夫妇PME率(35.1%)明显低于外省、市来沪人员(50.7%)和国外来沪人员(43.7%)(P<0.05);PME率与个体受教育程度和个人收入均呈两头大中间小趋势;医疗行业从业人员的PME率低于平均水平;有效叶酸补充,在PME组和无PME组之间比较,差异无显著意义(分别为27.3%和22.1%)(P>0.05);PME组通过医务人员孕前咨询的比例(14.8%)明显高于无PME组(4.7%)(P<0.05)。结论PME的依从性较差,对预防出生缺陷的效果有限。PME的内容有待改进。

Objective To explore the associated factors of premarital medical examination （PME） and investigate its effects on primary prevention of birth defects. Methods 300 pregnant women enrolled in the out-patient department of Obstetrics and Gynecology Hospital Affiliated to Fudan University from September 29, 2006 to November 1,2006 were divided into 2 groups according to performing PME or not. A questionnaire was used to survey PME, basic characteristics of pregnant women, cognition of prevention of birth defects, and its influences on preconceptional counseling. Results The total rate of PME was 42.7%, the difference of the rate of PME was significantly lower in Shanghai native men（35. 1 % ） than that in foreigners from other provinces（50. 7%） and foreigners from other countries（43.7%）. Women with middle level of education and income had lowest rate of PME, compared with high and low level of education and income. The rate of PME in medical staff was lower than the average rate. The rates of preconceptive supplement of folic acid in 2 groups were similar. However, preconceptional counseling in the right way in women with PME was higher than those women without PME（14.8% and 4.7%） （P〈 0.05）. Conclusion The role of PME in prevention of birth defects is restricted and it should be innovated in China.