上海市杨浦区国家定点医院孕前检查人群特征分析

Analysis of the population characteristics of the national fixed-point pre-pregnancy examination in Yangpu District of Shanghai

目的孕前保健是降低出生缺陷和减少不良妊娠结局的一级预防措施。上海市杨浦区自2010年启动国家城市地区免费孕前优生健康检查试点。为更有针对性开展免费孕前检查(孕检),本研究调查上海市杨浦区参加国家免费孕前优生健康检查的人群特征,评估免费孕前优生健康检查对高危因素的检出情况。方法选择2015-01-01-2017-12-31在上海市杨浦区国家免费定点孕前检查医院参加免费孕前检查的夫妇作为调查对象。以孕检单位使用的《国家免费孕前优生健康检查项目技术服务家庭档案》为数据来源,分析免费孕检人群民族、年龄、受教育程度、既往孕产次和避孕实施情况。结果共2 033对夫妇(4 066例)纳入研究。其中>98%为汉族。女性年龄22~54岁,平均年龄(31.41±4.30)岁;男性年龄24~62岁,平均年龄(33.93±5.23)岁;其中25~<35岁的女性和男性分别占79.64%和64.58%,≥35岁女性占19.18%。免费孕前保健参加者以大学及以上学历居多,占85.26%。高中及以下学历占14.74%。619对(30.44%)夫妇孕检前已有妊娠史,584对(28.73%)夫妇孕检前未避孕,仅有1.03%夫妇使用口服避孕药。结论应加强高龄女性、二胎妊娠及低学历人群的孕前管理,避免"延时妊娠"。加强生育规划引导,普及正确的避孕方法,减少非计划妊娠人工流产。同时将婚姻登记与孕前保健联动,确保新婚夫妇及时获得孕前保健的资讯并落实防止遗漏。

OBJECTIVE Pre-pregnancy care is a primary preventive measure to reduce birth defects and reduce adverse pregnancy outcomes.The Yangpu District of Shanghai has launched a pilot program of free pre-pregnancy eugenic health checkups in urban areas in the country since 2010,and it has been 9 years since then.In order to carry out free prepregnancy check-ups in a more targeted manner,this study investigated the characteristics of the population who participated in the national free pre-pregnancy health check-up in Yangpu District,Shanghai,and assessed the detection of high-risk factors by the free pre-pregnancy health check-up.METHODS The couples who participated in the free pre-pregnancy check-up at the National Free Pre-pregnancy Check-up Hospital in Yangpu District,Shanghai from January 1,2015 to December 31,2017 were selected as the survey subjects.The " National Free Pre-pregnancy Pregnancy Health Examination Project Technical Service Family File" was used as a data source,the nationality,age,education level,previous pregnancy and birth times and contraception implementation of the free pregnancy examination population were analyzed.RESULTS Totally 2 033 couples(4 066 cases)from 2015 to 2017 were collected.More than 98% of women and men were from Han nationality.The age of females was 22 to 54 years old,and the average age was(31.41±4.30)years old,and the age of males was24 to 62 years old,and the average age was(33.93±5.23)years old.Women and men aged 25 to 35 accounted for 79.64%and 64.58%respectively,and 19.18% women were over 35 years old.The majority of participants in free pre pregnancy health care were university degree or above,accounting for 85.26%.The proportion of senior high school and below accounted for 14.74%.619 couples(30.44%)had a pregnancy history.584 couples(28.73%)had no contraception before pregnancy test.Only 1.03% of couples used oral contraceptives.CONCLUSIONS It is necessary to strengthen the prepregnancy management of elderly women,second-child pregnancy and low-educated people to avoid "delayed pregnancy".Strengthen the guidance of birth planning,popularize correct contraceptive methods,and reduce unplanned pregnancy induced abortions.At the same time,marriage registration and pre-pregnancy health care are linked to ensure that newlyweds receive timely pre-pregnancy health care information and prevent omissions.