孕前保健对出生缺陷及其他不良妊娠结局的影响

Effect of Preconception Care on Birth Defects and Other Adverse Pregnancy Outcomes

目的研究孕前保健对出生缺陷及其他不良妊娠结局的影响。方法选取2012年5月至2015年4月重庆市万州区生殖健康中心进行产前检查的已婚待孕妇女268例作为研究对象,抽签法随机分为两组,观察组134例进行过孕前保健,对照组134例未进行孕前保健。产前筛查时根据调查问卷比较两组研究对象叶酸服用情况、优生知识知晓率、治疗情况指标,并追踪观察出生缺陷及不良妊娠结局的发生情况。结果观察组的主要预防措施覆盖率、优生知识知晓率、服用叶酸率显著高于对照组[77.61%(104/134)比64.18%(86/134),83.58%(112/134)比73.13%(98/134)、94.78%(127/134)比78.36%(105/134)],差异有统计学意义(P<0.05)。观察组的产前出生缺陷筛查覆盖率显著高于对照组[70.15%(94/134)比53.73%(72/134)],差异有统计学意义(P<0.05)。观察组的出生缺陷率、产后出血量、早产及过期妊娠率、新生儿窒息发病率显著低于对照组[0.00%(0/134)比3.73%(5/134),(325±9)m L比(401±12)m L,3.73%(5/134)比10.45%(14/134),0.75%(1/134)比5.22%(7/134)],差异有统计学意义(P<0.05)。结论孕前保健能减少出生缺陷,有利于其他不良妊娠结局的改善。

Objective To study the effect of preconception care on birth defects and other adverse pregnancy outcomes. Methods Total of 268 married for pregnant women in Reproductive Health Center of Wanzhou District of Chongqing from May 2012 to Apr. 2015 were included in the study. They were randomly divided into 2 groups by lottery method,observation group of 134 received preconception care,control group of 134 cases was not given preconception care. According to the survey questionnaire at prenatal examination,the usage of folic acid,awarenes of knowledge about eugenics,treatment of the two groups were compared,and the incidence of birth defects and adverse pregnancy outcomes were tracked. Results Main preventive measures coverage,awareness of knowledge about eugenics,taking folic acid rate of the observation group were significantly higher than the control group[77. 61%（ 104 /134） vs 64. 18%（ 86 /134）,83. 58%（ 112 /134） vs73. 13%（ 98 /134）,94. 78%（ 127 /134） vs 78. 36%（ 105 /134） ],the differences were statistically significant（ P〈0. 05）. Prenatal screening coverage of the birth defects was significantly higher than the control group[70. 15%（ 94 /134） vs 53. 73%（ 72 /134） ]（ P〈0. 05）. Incidence of birth defects,postpartum blood loss,premature birth and prolonged pregnancy rate,newborn asphyxia incidence of the observation group were obviously lower than the control group[0. 00%（ 0 /134） vs 3. 73%（ 5 /134）,（ 325 ± 9） m L vs（ 401 ±12） m L,3. 73%（ 5 /134） vs 10. 45%（ 14 /134）,0. 75%（ 1 /134） vs 5. 22%（ 7 /134） ],the differences were statistically significant（ P〈0. 05）. Conclusion Preconception care can reduce birth defects,and is helpful for the improvement of other adverse pregnancy outcomes.