上海市奉贤区出生缺陷一级预防现状、问题和对策

The current situation,problem,and strategy for primary prevention of birth de- fects in Fengxian district in Shanghai city

目的：描述奉贤区出生缺陷一级预防开展的现状，探讨可能的影响因素，提出改善或提高一级预防干预策略。方法：对2012年1～6月到上海奉贤区各社区卫生服务中心产科初诊的孕妇共760名（本市和非本市各380名）进行问卷调查，并对部分对象开展深入访谈。结果：奉贤区出生缺陷一级预防开展项目较全面，但服务利用率不高，婚检率为31．4％，怀孕前、后3个月叶酸服用率35．3％，孕前检查率28．6％，孕前咨询率12．0％，优生培训率22．1％，孕12周前建卡率为55．3％。结论：建议建立区级协调机制，提高科学管理水平，努力打造婚前-孕前-围孕期保健模式，改善服务利用，改进出生缺陷一级预防工作。

Objective： To describe the current situation of primary prevention of birth defects in Fengxian district in Shanghai city, explore the probable influencing factors, put forward interventional strategies to improve primary prevention. Methods： A total of 760 preg- nant women （380 local pregnant women and 380 migrant women） who went to obstetric departments of community health care service centers in Fengxian district of Shanghai city for the first time from January to June in 2012 were selected, and then a questionnaire investigation was performed, partial pregnant women were interviewed deeply. Results： The primary prevention projects of birth defects in Fengxian district were relatively comprehensive, but the utilization rate of maternal and child health care service was not high, the rate of premarital check - up was 31.4%, the intake rate of folic acid at three months before pregnancy and the first 3 months after pregnancy was 35.3%, the rate of pre - pregnancy physical examination was 28. 6% , the rate of preconception counseling was 12. 0% , the rate of eugenic training was 22. 1%, the rate of establishing card before 12 gestational weeks was 55.3%. Conclusion： It is recommended to establish district -level coordination mechanism, improve scientific management level, implement a premarital - progestational - periconceptional health care mode, and improve the utilization of maternal and child health care service to improve primary prevention of birth defects.