“全面二孩”政策前后温州市高危妊娠分布及影响因素分析  

Distribution characteristics and influencing factors of high-risk pregnancy in Wenzhou before and after the universal two-child policy

作　　者：吴晓雪 何静 张秀军[2] WU Xiao-xue;HE Jing;ZHANG Xiu-jun(Wenzhou Maternal and Child Health Care Center,Wenzhou,Zhejiang 325000,China;School of Public Health,Anhui Medical University,Hefei,Anhui 230032,China)

机构地区：[1]浙江省温州市妇幼保健所,浙江温州325000 [2]安徽医科大学公共卫生学院,安徽合肥230032

出　　处：《上海预防医学》2019年第5期395-399,共5页Shanghai Journal of Preventive Medicine

基　　金：安徽省高校学科(专业)拔尖人才学术资助项目(gxbjZD07)

摘　　要：【目的】分析“全面二孩”政策前后温州市高危妊娠分布特征及影响因素,为降低孕产妇、围产儿死亡率提供参考依据。【方法】采用回顾性调查分析法,对源于温州市妇幼保健信息管理系统2014年1月1日—2017年12月31日接受孕产期保健服务的所有高危孕产妇资料进行分析。【结果】2014—2017年温州市高危妊娠平均发生率为40.30%,呈逐年上升趋势,其中户籍孕产妇高于流动孕产妇(χ^2=1852.86,P<0.001)。孕产妇高危妊娠等级构成中轻度者达56.38%,高危因素居首者是孕早期体重(指数)异常(占14.71%),存在两个以上高危因素者达48.31%。重度高危妊娠平均发生率为1.25%,总体呈上升趋势,其中流动孕产妇高于户籍孕产妇(χ^2=4.56,P<0.05)。重度高危因素中居前6位的依次是子痫(前期)、中央型前置胎盘、胎盘早剥、合并内科严重疾病、妊娠合并病毒性肝炎且合并肝损(ALT≥100U/L)、妊娠合并血小板减少(PLT<70×10^9/L)。【结论】重视高危妊娠因素检出,并加强规范管理和服务,降低孕产妇、围产儿死亡率,保障母婴安全。[Objective]To analyze the distribution characteristics and influencing factors of high-risk pregnancies in Wenzhou before and after the universal two-child policy,and to provide reference for reducing maternal and perinatal mortality.[Methods]By the method of retrospective investigation and analysis,the data from the information management system of maternal and child health care in Wenzhou City from January 1,2014 to Dec 31,2017 was analyzed.[Results]The average incidence of high-risk pregnancies in Wenzhou City from 2014 to 2017 was 40.30%,showing an upward trend year by year.The incidence of high-risk pregnancy of registered mothers was higher than that of migrant mothers(χ^2=1 852.86,P<0.001).And 56.38%of the high-risk pregnancies were moderate to mild.The abnormal body weight(index)in the early pregnancy was the leading risk factor(14.71%),and 48.31%of the pregnant women had more than two high-risk factors.The average incidence of severe high-risk pregnancy was 1.25%,which showed an upward trend.However,the incidence of severe high-risk pregnancy in migrant mothers was higher than that in household registered mothers,and the difference was statistically significant.The top six risk factors were eclampsia(pre-eclampsia),central placenta previa,placental abruption,combined with serious medical diseases,pregnancy complicated with viral hepatitis and liver damage,and pregnancy complicated with thrombocytopenia.[Conclusion]Attention should be paid to the detection of high-risk pregnancy factors,and standardized management and services should be strengthened to reduce maternal and perinatal mortality thus ensuring maternal and infant safety.

关 键 词：高危孕产妇 高危妊娠 高危因素 高危管理 

分 类 号：R17[医药卫生—妇幼卫生保健]