计划二胎妊娠妇女优生健康检查高风险人群筛查结果分析

Health examination of high-risk women for second childbirth

目的:通过分析计划二胎妊娠妇女体格、内外科疾病(如甲状腺亢进、糖尿病、高血压等)筛查结果,为二胎备孕提供重要依据。方法:以本院2014年6月至2016年1月门诊咨询、孕前检查的5000名计划二胎妇女为研究对象,均接受体格(如身高、体重、病史、血常规)、甲状腺功能、血糖、血压等检查,统计甲状腺亢进、糖尿病及高血压发生率,并分析上述疾病与妇女年龄、体重、流产史、首胎不良妊娠结局等关系。结果:5000名妇女中BMI值25kg/m2以上者1050名(21.00%),甲状腺疾病家族史占10.00%,首胎妊娠期高血压、妊娠期糖尿病分别413名、750名,流产史18.68%,吸烟史12.16%。筛查出甲亢648名,占12.96%,糖尿病1006名,占20.12%,高血压783名,占15.66%。年龄≥30岁、BMI>25kg/m2、多次流产史妇女甲亢、糖尿病、高血压发生比例显著高于对应因素(P<0.05);甲状腺疾病家族史妇女检出甲亢100名,首胎妊娠期高血压、妊娠期糖尿病妇女分别检出糖尿病102名、187名,高血压89名、140名,吸烟妇女中检出高血压137名。结论:计划二胎妊娠妇女年龄以30岁及以上为主,甲亢、糖尿病、高血压筛查率较高,这与计划二胎妊娠妇女年龄(≥30岁)、多次流产史、肥胖等有关。

Objectives：To provide important basis for the second childbirth by analyzing the screening re-sults of physical health,internal and surgical diseases（such as thyroid disease,diabetes,high blood pressure,etc.）.Methods：5000 women planning for second childbirth in this hospital from June 2014 to January 2016 were selected and all received physical health examination（such as height,weight,medical history,routine blood examination） and screening of thyroid function,blood glucose and blood pressure,such as inspection,to summarize the incidence of thyroid disease,diabetes and high blood pressure,and analyze the correlation of the above diseases and women’s age,weight,history of abortion and the first adverse pregnancy outcomes.Results：Of the 5000 women,there were 1050（21.00%） women with BMI over 25 kg/m2,10.00% with family history of thyroid disease,413 and 750 women with hypertension and gestational diabetes respectively in the first pregnancy,18.68% and 12.16%with abortion history and smoking history.According to the screening results,there were 648 cases（12.96%） of hyperthyroidism,1006 cases（20.12%） of diabetes,783 cases（15.66%） of hypertension.The incidence of those with age of over 30 years old,BMI 〉 25 kg/m2,multiple miscarriages history,hyperthyroidism,diabetes and high blood pressure were significantly higher than the corresponding factors（P 〈 0.05）.100 women with family history of thyroid disease had hyperthyroidism.Of women with first gestational hypertension and gestational diabetes,102 and 187 women were detected having diabetes,and 89 and 140 women having hypertension respectively.137 women with the habit of smoking were detected with hypertension.Conclusion：The majority of women planning for second childbirth are over 30 years old,with high risk of hyperthyroidism,diabetes and hypertension,which is related to their age（30-year old or higher）,histories of multiple miscarriages,obesity and so on.