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首页> 中文期刊> 《中国工程科学》 >免费孕前优生健康检查对象潜在危险因素接触和妊娠结局分析

免费孕前优生健康检查对象潜在危险因素接触和妊娠结局分析

         
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分析并报告上海市静安区免费孕前优生健康检查后待孕夫妇不良妊娠结局潜在影响因素接触情况以及妊娠率和妊娠结局，为免费孕前健康检查政府实施项目效果的评估提供基础数据。对2011年8月-2012年11月在静安区参加免费孕前优生健康检查的所有对象在其检查结束后的3个月、6个月、12个月进行随访，重点关注不良妊娠结局潜在危险因素接触情况以及妊娠时间和妊娠结局。统计方法为χ2检验、寿命表、Logistic回归分析。在目标时段内共有1480对夫妇参加了免费孕前优生健康检查，其中1249对服务对象接受了随访，随访率为84.4%。截至2013年4月，48.7%的随访对象已经受孕，孕前检查后3个月调查累积妊娠率为23.9%，6个月调查累积妊娠率为45.0%。365人完成妊娠结局的随访，结果显示，早产率为3.0%，低出生体重率为4.3%，巨大儿发生率为3.3%。自然流产率为6.3%。另外，发现出生缺陷1人，占妊娠妇女数的0.16%，占有妊娠结局妇女数的0.27%。烟酒等不良生活习惯丈夫的比例（18%～20%）高于妻子（1%～3%），77%的丈夫和妻子接受潜在电磁辐射的时间超过8 h。9%的夫妇自述生活和工作中接触重金属以及农药、化肥等潜在致畸物。超过10%的妻子在怀孕以后接触了潜在致畸物。初步分析未发现上述因素与不良妊娠结局的关系。静安区孕前健康检查后半年内妇女妊娠率不到50%，有必要在上海乃至全国开展免费孕前健康检查的成本效益评估。%To provide evidence for effectiveness evaluation of the government project free pre-pregnancy health examination through reporting exposure of potential risk factors of ad-verse pregnancy outcome and pregnancy rate and the pregnancy outcome of the couples to be pregnant after free pre-pregnancy physical examination in Jingan District,Shanghai. Follow-ups were completed to women who had a free pre-prenancy health examination in Jingan Dis-trict from August 2011 to November 2012,which foucused on exposure of potential risk factors of adverse pregnancy outcome,time of pregnancy and pregnancy outcome of the women. Chisq test,life table and Logistic regression model were used for data analysis. 1 480 couples had free pre-pregnancy health examinations in the target period. Of which,84.4 % were fol-lowed up. By April 2013,48.7%of the women who were followed up were pregnant. The cu-mulative pregnancy rate at 3 months and 6 months after free pre-pregnancy health examination was 23.9%and 45.0%,respectively. 365 women completed the follow up about pregnancy out-comes. The incidence rate of premature delivery,low birth weight,giant baby and spontaneous abortion was 3.0%,4.3%,3.3%and 6.3%,respectively. One birth defect was reported dur-ing the follow up period,accounting for 0.16%of the number of pregnant women and 0.27%of the number of women who had pregnancy outcomes. The proportion of husbands who had un-healthy habits such as smoking or drinking ranged from 18%to 20%,which was much higher than that of their wives (1%~3%). 77%husbands and 77%wifives exposed to potential elec-tromagnetic radiation over 8 hours a day. 9%couples reported exposing to potential teratogenic-ity such as heavy mental,pesticide and chemical fertilizer in their daily life and work. Over 10%wivies had exposed to potential teratogenicity after they were pregnant. Primary analysis showed no association between the above factors and adverse pregnancy outcomes. Since the 6-month cumulative pregnancy rate of women who had free pre-pregnancy health examination was lower than 50%,it is necessary to evaluate the cost benefit of free pre-pregnancy health ex-amination in Shanghai and throughout the country.

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