强制婚检取消前后不良妊娠结局及其危险因素暴露比较  

Impacts on averse pregnancy outcomes and relevant risk factors before and after abolish of the coercion premarital medical examination

作　　者：陈英[1] 任爱国[2] 叶荣伟[2] 郑俊池[2] 李松[2] 刘建蒙[2] 郝玲[2] 李竹[2] 

机构地区：[1]青海大学医学院公共卫生系,810001 [2]北京大学生育健康研究所

出　　处：《中国妇幼保健》2008年第22期3147-3150,共4页Maternal and Child Health Care of China

摘　　要：目的：评价婚检政策变化对妇女孕早期危险因素暴露及母婴健康的可能影响。方法：回顾调查浙江、江苏22个县市2001年1月～2005年12月间分娩的孕产妇，共484783例。采用单变量统计分析方法，比较2003年前后某些危险因素的暴露频率、新生儿早产、新生儿低体重及肉眼可见畸形的发生率。结果：新生儿早产发生率出现波动，趋势尚不明显；新生儿低体重及肉眼可见畸形的发生率2003年后较2003年前有不同程度的上升。2003年后孕前6月内服用避孕药物、孕早期服用可疑致畸药物、接触放射线及饮酒的比例较2003年前明显增加；孕早期风疹病毒、巨细胞病毒、单纯疱疹病毒等病原体感染的检出率2003年后也有所上升。低龄及高龄孕产妇的比例也不断上升。结论：强制婚检的取消增加了妇女危险因素暴露的机会，对妊娠结局有不利影响。Objective： To evaluate the impact of policy change in premarital health assessment on women＇s exposure of risk factors and the health of mothers and infants in aborted first - trimester placenta. Methods： We chose 484 783 women who delivered during the period of 2001 - 2005 in twenty - two cities or counties in Zhejiang and Jiangsu provinces, China. Exposure rates of risk factors , incidences of preterm birth , low birth weight and the visible malformation were computed and compared before and after 2003, the year of implementation of the new Marriage Ordinance that changed premarital health assessment from mandatory to voluntary. Results： Incidences of preterm birth occurred fluctuation, the trend had no remarkable change. Incidences of low birth weight and the visible malformation had increased in 2005 compared with that in 2003. The proportion of taking oral contraceptives within 6 months preconception, taking suspected teratogenic drug within first -trimester placenta, radiation exposure and alcohol drinking also increased in 2005 compared with that in 2003. The detection rate of rubella virus, human Cytomegalovirus, herpes Simplex Virus and protozoon infection also increased in first - trimester placenta after 2003. The proportions of younger - aged and elder maternal women had been showing upward trends. Conclusion： The abolishment of mandatory premarital health assessment not only increases women＇s exposure of risk factors, but also has adverse impact on pregnancy outcome.

关 键 词：强制婚检 新生儿早产 新生儿低体重 畸形 危险因素 

分 类 号：R173[医药卫生—妇幼卫生保健]