上海市社区孕情监测工作的实施与成效

Implementation and effect of community-based monitoring of pregnancy in Shanghai

目的:加强社区孕情监测力度,提高孕期保健管理质量。方法:在上海市各区(县)试点社区建立孕情监测网络,通过比较孕情监测工作实施前后(2008年4～9月与2009年4～9月)的社区孕期管理指标评估该工作的成效。结果:孕情监测工作试点实施后,孕妇建册数增加了26.2%,早孕建册率从39.4%提高到43.9%(P<0.01),建册时间提早(P<0.01);中心城区孕妇早孕建册率(57.2%)高于周边城区(34.9%)(P<0.01),建册时间早于周边城区(P<0.01);孕情监测人力资源分布在中心城区和周边城区之间存在较大差异;受监测孕妇早孕建册率(47.1%)高于未受监测孕妇(31.3%)(P<0.01),建册时间早于未受监测孕妇(P<0.01),且孕妇越早受到监测其建册时间也越早。结论:孕情监测工作促进了社区孕情管理由被动等待向主动发现的转变,提高了孕期保健服务的可及性与公平性。

Objective：To enhance community-based monitoring of pregnancy,and improve the quality of healthcare and management during pregnancy.Methods：A community-based monitoring network of pregnancy was built in some pilot study areas in every administrative district in Shanghai.The effect of pregnancy monitoring was evaluated by pre-post data comparison （from April to September in 2008 vs from April to September in 2009）.Results：After the implementation of pregnancy monitoring in pilot study areas,the pregnant women registered increased by 26.2%,the rate of early registration during pregnancy increased from 39.4% to 43.9% （P 0.01）,and the registration time was shortened （P 0.01） ;the rate of early registration during pregnancy in central areas （57.2%） was significantly higher than that in surrounding areas （34.9%） （P 0.01） ;the registration time of central areas was significantly longer than that of surrounding areas （P 0.01） ;there was significant difference in distribution of human resources in pregnancy monitoring between central areas and surrounding areas;the rate of early registration during pregnancy among monitored pregnant women （47.1%） was significantly higher than that among non-monitored pregnant women （31.3%） （P 0.01）,the registration time of monitored pregnant women was significantly longer than that of non-monitored pregnant women （P 0.01）,and the earlier pregnant women were monitored,the sooner they registered.Conclusion：Monitoring of pregnancy promotes the transformation of community-based monitoring of pregnancy from passive waiting to active finding,increases the accessibility and fairness of maternal health services.