2015年青岛市高龄产妇二胎生育孕前保健调查研究

Pre-pregnancy preparation for the second child in puerperae with advanced maternal age in Qingdao City,2015

目的调查青岛市高龄产妇生二胎的孕前保健情况及其重要性。方法随机选取青岛市2015年1月-2016年1月各大医院妇产科分娩二胎的1 016名高龄产妇为研究对象,采用问卷的方式,调查产妇孕前保健的情况,将进行了孕前保健的产妇作为观察组,未进行孕前保健的作为对照组,对比分析两组产妇妊娠期及分娩期的并发症发生率、妊娠结局以及新生儿并发症的发生率。结果本次发放问卷1 016份,收回有效问卷1 000份,有效回收率98.43%。其中孕前有准备627例,占62.7%,孕前无准备373例,占37.3%,观察组新生儿Apgar评分高于对照组(P<0.05),产妇并发症发生率、阴道分娩率、剖宫产率、难产率及死胎率均低于对照组(P<0.05),观察组新生儿并发症发生率低于对照组(P<0.05),差异有统计学意义。结论 2015年青岛市生二胎的高龄产妇进行孕前保健的仅占62.7%,孕前是否进行准备对产妇及胎儿影响较大,应加强健康教育宣传工作,增强高龄妇女孕前保健的意识,降低分娩风险,确保母婴健康和安全。

Objective To investigate the situation and importance of pre-pregnancy preparation for the second child among pu- erperae with advanced maternal age in Qingdao City. Methods A total of 1,016 puerperae with advanced maternal age and de- livered the second child in departments of obstetrics and gynecology of hospitals in Qingdao City from January, 2015 to January, 2016 were randomly selected to serve as the research objects, and the status of pre-pregnaney preparation was surveyed. The puer- perae with pre-pregnancy preparation were considered as the observation group, while the puerperae without pre-pregnaney served as the control group. We compared and analyzed the incidence rates of maternal complications during pregnancy and parturition, the pregnancy outcomes and the incidence rates of neonatal complications. Results A total of 1,016 questionnaires were issued and 1,000 valid ones retrieved~ with the effective recovery rate being 98.43%. There were 627 cases with pre-pregnancy prepara- tion and 373 ones without pre-pregnancy preparation, accounting for 62.7% and 37.3% respectively. Neonatal Apgar score was higher in the observation group than in the control group {P〈0.05） , while the incidence rates of maternal complications, the vagi- nal delivery rate and the incidence rates of cesarean section, dystocia, stillbirth and neonatal complications were all lower in the observation group than in the control group, showing statistically significant differences （ all P〈 0.05 ）. Conclusions Only 62. 7% of the puerperae with advanced maternal age in Qingdao City in 2015 have the pre-pregnancy preparation for the second child. Pre-pregnancy preparation significantly influences puerperae and neonates; and hence, it is necessary to strengthen health education and propaganda and enhance the awareness of pre-pregnancy preparation of women with advanced maternal age so as to decline the delivery risk and ensure maternal and child health and safety.