浙江省出生缺陷人群监测地区不同生育政策时期生育情况分析  被引量:11

Analysis on the birth situation different fertility policy periods in monitoring area of birth defect population in Zhejiang Province

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作  者:张晓辉[1] 陈艳敏[1] 孙瑜[1] 邱丽倩[1] Zhang Xiaohui;Chen Yanmin;Sun Yu;Qiu Liqian(Department of Women's Health,Obstetrics and Gynecology,Women's Hospital School Of Medicine,Zhejiang University,Hangzhou 310006,China)

机构地区:[1]浙江大学医学院附属妇产科医院妇女保健部,杭州310006

出  处:《中华预防医学杂志》2020年第5期519-522,共4页Chinese Journal of Preventive Medicine

摘  要:目的了解生育政策调整对浙江省出生缺陷人群监测地区生育情况的影响。方法资料来源于浙江省出生缺陷人群监测系统,其监测对象为浙江省嘉兴市南湖区、宁波市奉化市居住≥1年的产妇。将资料分为"独生子女"(2012年1月至2013年9月)"单独二孩"(2015年1月至2016年9月)和"全面二孩"(2017年1月至2018年9月)3个时期,比较不同生育政策时期产妇年龄分布的差异,分析不同生育政策时期经产妇占比的变化趋势,采用非条件logistic回归模型分析生育政策与不良围产结局的关联。结果"独生子女""单独二孩"和"全面二孩"时期产妇数分别为12557、14097和15509名,后一时期分别较前一时期增长12.3%和10.0%;各时期产妇年龄M(P25,P75)分别为27(25,30)、28(26,31)和28(26,32)岁;各时期经产妇占比分别为19.5%、35.7%和45.8%,呈上升趋势(P<0.001)。"独生子女""单独二孩"和"全面二孩"时期分娩量分别为12721、14307和15772名。"独生子女"时期不良围产结局发生率最低(8.7%),"全面二孩"时期最高(11.1%)。非条件logistic回归模型分析显示,调整年龄因素后,与"独生子女"时期相比,"单独二孩"和"全面二孩"时期早产[OR(95%CI)分别为1.20(1.08~1.33)和1.08(1.02~1.13)]和出生缺陷[OR(95%CI)分别为1.33(1.13~1.55)和1.29(1.20~1.39)]风险增加;巨大儿风险降低[OR(95%CI)分别为0.87(0.80~0.96)和0.91(0.87~0.95)],围产儿死亡风险变化无统计学意义[OR(95%CI)分别为0.78(0.53~1.15)和0.84(0.69~1.02)]。结论随生育政策调整,浙江省出生缺陷人群监测地区高龄、经产妇比例增加,不良围产结局风险增加。Objective To explore the impacts on birth situation associated with birth policy adaption in monitoring area of birth defect population in Zhejiang province.Methods Data were obtained from hospital-based birth defect surveillance system in Zhejiang Province.The surveillance population was childbearing women living in Nanhu of Jiaxing and Fenghua of Ningbo no less than 1 year.We divided data into three groups as"only child"(Jan,2012-Sep,2013),"privileged second child"(Jan,2015-Sep,2016)and"universal second child"(Jan,2017-Sep,2018)according to birth policy adaption.The differences of maternal age distribution in different birth policy periods were compared by using Kruskal-Wallis test.The changing trend of the proportion of parturient in different birth policy periods was analyzed by using Trendχ2 test.Unconditional logistic regression model was used to analyze the relationship between birth policy and adverse perinatal outcomes.Results During"only child","privileged second child"and"universal second child"period,the number of childbearing women was 12557,14097 and 15509,respectively,with an increase of 12.3%and 10.0%over previous periods.Maternal ages[M(P25,P75)]were[27(25,30)],[28(26,31)]and[28(26,32)]years old.The proportion of multipara in each period was 19.5%,35.7%and 45.8%,showing an increased trend(P<0.001).The incidence of adverse perinatal outcomes was lowest in the"only child"period(8.7%)and highest in the"universal second child"period(11.1%).Unconditional logistic regression model showed that after adjusting for age,compared with the"only child"period,the risk of premature birth[OR values(95%CI)were 1.20(1.08-1.33)and 1.08(1.02-1.13),respectively]and birth defects[OR values(95%CI)were 1.33(1.13-1.55)and 1.29(1.20-1.39),respectively]increased in"privileged second child"and"universal second child"period.The risk of macro infants decreased significantly[OR values(95%CI)were 0.87(0.80-0.96)and 0.91(0.87-0.95),respectively],and the risk of perinatal death changed insignificantly[OR values(95%CI)were 0.78(0

关 键 词:计划生育政策 妊娠结局 监测 

分 类 号:C[社会学]

 

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