成都市13479名女性孕前健康检查情况分析

Analysis on the health examination of 13479 women before pregnancy

目的分析育龄女性孕前健康风险暴露状况,探讨减少导致出生缺陷等不良妊娠结局发生的风险因素的方法。方法按照全国妇幼健康研究会《孕前优生健康检查风险评估指导手册(2014版)》中制定的孕前保健检查原则和内容对2014~2016年成都市龙泉驿区、双流区、郫县(现为郫都区)参加孕前优生检查的20~49岁13479名育龄妇女进行孕前遗传风险、生殖风险、慢性病风险、感染风险、营养风险、行为风险、环境风险、社会心理风险8类风险暴露评估。结果参加孕前优生检查的13479名育龄妇女中,年龄以25~34岁最多(57.62%);职业以农民最多(31.21%)。健康风险总检出率54.51%,检查出各种风险中遗传风险最低(1.28%),营养风险最高(33.21%)。年龄>44岁组营养风险、慢性病风险、社会心理风险均在各年龄段为最高。且随年龄的增加,生殖风险、慢病风险、感染风险、营养风险、行为风险、社会风险整体呈现升高趋势。随着文化程度升高,健康风险整体呈下降趋势。感染风险中HBsAg阳性率2014~2016年平均为6.05%。梅毒筛查阳性率2014~2016年平均为0.26%。结论为进一步降低出生缺陷,应提高孕前女性人群参检率,加强专业人员培训及高风险人群的管理。

Objective To analyze the health risk exposure of women of childbearing age before pregnancy and explore the methods to reduce the risk factors of adverse pregnancy outcomes such as birth defects.Methods According to the pre-pregnancy health check-up principles and contents formulated in the"Pre-pregnancy Prenatal Health Check-up Risk Assessment Guide(2014 Edition)"by the National Maternal and Child Health Research Association,13479 women of childbearing age who participated in prepregnancy eugenics examinations in Longquanyi District,Shuangliu District,and Pixian County(now Pidu District)of Chengdu from 2014 to December 2016 were tested for 8 types of risk exposure assessment including pre-pregnancy genetic risk,reproductive risk,chronic disease risk,and infection risk,nutrition risk,behavioral risk,environmental risk,and psychosocial risk.Results Among the 13479 women of childbearing age who participated in the pre-pregnancy eugenic examination,most were 25~34 years old(57.62%)and the most occupation was farmers(31.21%).The total detection rate of health risk was 54.51%,among which the genetic risk was the lowest(1.28%)and the nutritional risk was the highest(33.21%).The nutritional risk,chronic disease risk and social psychological risk of the>44 year-old group were higher than any other age groups.With the increase of age,the reproductive risk,chronic disease risk,infection risk,nutrition risk,behavior risk and social risk were increasing.As education level increased,the overall health risk was on a downward trend.In infection risks,the average positive rate of HBsAg was 6.05%during the three years,and the positive rate of syphilis screening was 0.26%.Conclusion In order to further reduce birth defects,it is necessary to increase the examination participation rate of female population before pregnancy,strengthen professional training and management of high-risk groups.