妊娠前干预的方法及效果评价  

Evaluation of Preconceptional Intervention

作　　者：梁嬛[1] 李笑天[1] 

机构地区：[1]复旦大学附属妇产科医院,上海200011

出　　处：《国际生殖健康／计划生育杂志》2009年第4期224-226,236,共4页Journal of International Reproductive Health/Family Planning

基　　金：卫生部临床学科重点项目(2007-353);上海市重点学科建设项目(B117);国家科技支撑计划:重大遗传病产前筛查;诊断综合技术体系研究(2006BAI05A05);上海市卫生局科研项目(2008ZD004)

摘　　要：妊娠前干预是孕前期保健的重要组成部分。对妊娠前风险的准确评估和有效干预可显著改善妊娠结局。目前证明有效的干预方式包括,生活方式改变、环境改善、叶酸补充、遗传咨询以及慢性和感染性疾病控制等。对于生活方式和环境中的危险因素,开展大量的干预研究,效果显著。为保证围妊娠期妇女的叶酸摄入量,普遍采用补充叶酸制剂和食物叶酸强化两种方法。孕前遗传咨询是妊娠前干预的重要手段之一,其涉及生物医学、伦理道德、社会经济等多方面问题,目前还存在一些不足,但发展迅速。对患有慢性或传染性疾病的妇女采取一系列规范化的干预措施,可明显改善妊娠结局。Preconceptional intervention is an important part of progestatlon health care. Pregnancy outcomes can be improved by active preconceptional interventions based on correct risk assessments. The effective means of intervention include lifestyle changes, environmental improvement, folio acid supplementation, genetic counseling, chronic diseases management and infectious diseases control. A large number of intervention studies are performed on the risk factors in lifestyle and environment, and significant effectiveness are obtained. The supplementation of folic acid preparation and food fortification with folic acid is widely adopted to guarantee the folic acid intake in reproductive aged women. Genetic counseling is an important means of preconceptional intervention, which involved in biomedicine, ethics and soeio-economic issues. At present, genetic counseling is developing rapidly although there are still some deficiencies. And the pregnancy outcomes can be obviously improved by taking a series of standardized interventions in women with chronic or infectious diseases.

关 键 词：妊娠前干预 孕前期保健 饮酒 遗传咨询 叶酸 

分 类 号：R173[医药卫生—妇幼卫生保健]