西藏高海拔地区孕产期保健现状及母婴预后

Analysis of maternal health status during pregnancy and after dilivery and the maternal and neonatalprognosis in high-altitude areas of Tibet

目的探讨西藏自治区孕产妇特点、孕产期保健现状及母儿预后。方法对2012年1月至2015年12月在拉萨市人民医院住院分娩的孕产妇进行回顾性分析,共纳入6915例孕妇和7004例新生儿。分析孕产妇一般情况、孕产史、孕产保健情况、分娩情况及新生儿情况。结果孕产妇中55.0%居住在农牧区,25.7%生活在海拔4000米以上,文盲比例24.7%,经产妇占43.8%。2012—2015年,孕产保健各项指标呈逐年升高趋势,但存在地区差异、城乡差异、人群差异。拉萨的孕产保健各项指标最好,相对偏远地区较差。农牧区孕产妇各项孕产保健指标全面低于城镇孕产妇,尤其口服叶酸比例仅有8.7%。低龄(<20岁)及外省孕产妇孕产保健意识较差。妊娠期贫血和妊娠期高血压疾病(HDCP)是孕产妇最常见的并发症。新生儿低体重发生率较高。结论关注农牧区、文盲、低龄、外来人口孕产妇等重点人群,加强孕产期保健,减少妊娠合并症和并发症的发生,以改善母儿预后。

Objective To summarize the characteristics of pregnant women in Tibet,the status of their healthcare during pregnancy and the prognosis of mothers and infants.Methods A retrospective analysis was perfomed pregnant women delivered in Lhasa People＇s Hospital from January 2012 to December 2015,including 6915 mothers and 7004 neonates.The general situation of pregnant women,their pregnant history,maternal healthcare,delivery and neonatal status were recoeded.Results About 55% of the pregnant women lived in agricultural and pastoral areas,25.7% lived more than4000 meters above sea level,the illiteracy rate was 24.7%,and 43.8% were multipara.Though from 2012 to 2015 maternal healthcare has been better off year by year,there were still regional differences,urban and rural differences and population differences.As the capital city of Tibet Autonomous Region,Lhasa had the best indicators of maternal healthcare,while in remote areas they were relatively poor.The maternal healthcare indicators in agricultural and pastoral areas were lower than those in urban areas,especially the oral folic acid rate,which was only 8.7%.Healthcare utilization in young women（under 20 years old）and mothers from other provinces was also poor.The most common complications of pregnancy were anemia during pregnancy and hypertensive disorder complicating pregnancy.The incidence of low birth weight infant was high.Conclusion The prognosis of mothers and infants can be improved by paying more attention to the key groups of people from agricultural and pastoral areas and the illiterate,young and migrant pregnant women,strengthening their healthcare during pregnancy and childbirth,and reducing the occurrence of complications of pregnancy.