上海市助产医疗机构妊娠风险评估管理效果  

Management effect of risk assessment for pregnancy in obstetric medical institutions in Shanghai

作　　者：花静[1] 朱丽萍 秦敏 许厚琴 张蕾[1] 俞铮[1] 李芬[1] 施红[1] 

机构地区：[1]同济大学附属第一妇婴保健院,上海200032 [2]上海市妇幼保健中心,上海200032

出　　处：《中国妇幼健康研究》2014年第4期574-576,共3页Chinese Journal of Woman and Child Health Research

基　　金：上海市市级医院适宜技术资助项目(SHDC12012231);上海市公共卫生三年行动计划资助项目(2011-2013);上海市卫生与计划生育委员会科技重点资助项目(20114010)

摘　　要：目的对上海市医疗机构妊娠风险预警评估管理的效果进行评价，为改进优化措施提供可靠的依据。方法在上海市17个区（县）各抽查1家助产医疗机构，获取其中预产期在4～6月并已随访管理结案的重点孕妇共3420名，分析妊娠风险评估管理模式对妊娠结局的影响。结果妊娠风险预警评估率达97．5％，黄色、橙色、紫色预警标示的孕产妇规范随访比例分别为62．8％、79．7％和44．4％，在控制了孕妇年龄、户籍、妊娠风险预警分类、分娩方式等混杂因素后，助产医疗机构对重点孕妇的随访次数增加（OR=0．594，P〈0．05）和进行规范随访（OR=0．268，P〈0．05），可降低早产的发生风险。结论上海市妊娠风险预警评估管理工作对于提高母婴安全具有一定效果，但助产医疗机构对于重点孕妇的随访管理仍有不足。Objective To evaluate the effect of risk assessment and management for pregnancy in obstetric medical institutions in Shanghai so as to provide evidences for improvement. Methods 17 obstetric medical institutions were selected from 17 districts in Shanghai. A total of 3 420 pregnant women who had established health care follow-up for pregnancy and who expected delivery date at the period of April to June were included in the study. The influence of the risk assessment and management for pregnancy on pregnancy outcomes was analyzed. Results The rate of risk assessment for pregnancy was 97.5%. The regular follow-up proportion of pregnant women with yellow, orange and purple sign was 62.8%, 79.7% and 44.4%, respectively. After controlling the factors of age, residence, pregnant risk category and delivery mode, the increase of follow-up frequency for high-risk pregnant women （ OR = 0. 594, P 〈 0.05 ） and regular follow-up （ OR = 0. 268, P 〈 0. 05 ） could reduce the risks of preterm. Conclusion The risk assessment and management for pregnant women is effective in promoting maternal and infant safety. However, the management on follow-up for key pregnant women with risk of complications is insufficient in medical institutions.

关 键 词：妊娠风险 预警评估管理 应用效果 助产医疗机构 

分 类 号：R173[医药卫生—妇幼卫生保健]