2008—2015年广州市荔湾区华林街孕产妇高危因素分析

Analysis on the High Risks of Maternal in Hualin Street of Liwan District in Guangzhou from 2008 to 2015

目的通过掌握本社区孕产妇高危因素,以采取有针对性的干预措施。方法按广州市围产保健管理规定,进行建卡、产前追踪和产后随访,严格按照《广州市高危妊娠管理办法(修订)》进行管理,包括高危妊娠筛查、登记、监护、转诊和结案等。结果 (1)2008—2012年度,高危妊娠发生率呈现下降趋势,从36.71%下降到19.77%,2013—2015年度重回30%以上水平;(2)高危因素中,年龄≥35岁、地中海贫血、疤痕子宫和双胎呈现逐步上升的趋势,胎膜早破呈下降趋势,各年份间差异有统计学意义(χ~2=57.43,P<0.05);(3)2013—2015年孕产妇1 281例,生育二胎202例,其中高危妊娠119例,年龄≥35岁39例,疤痕子宫53例,发生率分别为58.91%、19.31%和26.24%,明显高于生育一胎孕产妇,差异均有统计学意义(P<0.05)。结论 2013年起多种高危因素呈上升趋势,高龄产妇、疤痕子宫与二胎有关,应加强对孕产妇尤其是二胎孕产妇的高危妊娠管理、密切监护,降低产科风险因素。

OBJECTIVE Through the grasp of the community maternal risk factors, co-related measures were applied. METHODS Ac cording to the Guangzhou perinatal health care management regulations for the cards, prenatal tracking, postpartum follow-up, in strict accordance with the Guangzhou City High Risk Pregnancy Management Approach （Revised） to management, including hing risk pregnancy registration, screening, monitoring, referral, etc. RESULTS （1） From 2008 to 2012, incidence of high-risk pregnancy decreased from 36.71% to 19.77%, but it returned to 30% levels from 2013 to 2015; （2）In all the risk factors, 35 years of age or older, poor in the mediterranean blood, uterine scar, twins, showing a gradual upward trend, decreased premature rupture of membranes, thex2 value was 57.43, the difference was statistically significant by each year（P〈0.05）; （3）During 2013-2015, in 1281 cases of pregnant women, there were 202 cases of the second child and the later included 119 cases of high-risk pregnancy, 39 cases of aged above 35 years, 53 cases of uterine scar, the incidence rates were 58.91%, 19.31% and 26.24%, significantly higher than the maternal birth of a child, the differences were statistically significant（P〈0.05）. CONCLUSION Since 2013, many risk factors increased; the maternal age and uterine scar were related with the second child. It should strengthen the high-risk pregnancy management especially second child, pay attention to monitoring and reduce obstetric risk factors.