孕中期母血清学产前筛查高风险率评价筛查质量方法探索  

Exploration on Using the High Risk Rate of Maternal Serological Prenatal Screening in the Second Trimester to Evaluate the Screening Quality

作　　者：段争芳 黄金艺 张艳红 张永红 戴铮 段含 江磊 DUAN Zhengfang;HUANG Jinyi;ZHANG Yanhong;ZHANG Yonghong;DAI Zheng;DUAN Han;JIANG Lei(Laboratory of Birth Defect Prevention and Control Center,Yiyang Maternal and Child Health Hospital,Hu'nan Province,Yiyang Hu'nan 413000,China;College of Medical Technology,Hebei Medical University,Shijiazhuang Hebei 050000,China;Technical Support Center,Zhejiang Biosan Biotechnology Co.,LTD.,Hangzhou Zhejiang 310012,China)

机构地区：[1]湖南省益阳市妇幼保健院出生缺陷防控中心实验室,湖南益阳413000 [2]河北医科大学医学技术学院,河北石家庄050000 [3]浙江博圣生物技术股份有限公司技术保障中心,浙江杭州310012

出　　处：《中国卫生标准管理》2023年第2期26-31,共6页China Health Standard Management

摘　　要：目的探讨孕中期母血清学产前筛查高风险率作为母血清学产前筛查质量评价指标的方法。方法选取2017年1月—2022年9月在益阳市妇幼保健院进行孕中期母血清学产前筛查的102285例孕妇,统计分析高风险率、孕妇年龄分布,同时进行双因素方差分析。结果在2017—2022年,除2018年外,高风险率表现出逐年上升趋势;孕妇的年龄分布曲线在2017—2019年呈在最大分布频率年龄左右对称的单峰分布,在2020—2022年呈在25~27岁有肩峰,在30~33岁有最大分布频率年龄的不对称分布;不同年份的孕妇年龄高风险曲线趋势一致,在20~40岁年龄段曲线密集重叠。通过孕妇年龄及年份对高风险率的双因素方差分析发现:孕妇年龄是高风险率的显著影响因素(P<0.001),而年份间孕妇年龄分组下高风险率变化差异无统计学意义(P>0.05)。结论不同年份间孕妇年龄分布存在较大差异,孕妇年龄是高风险率的显著影响因素。通过年龄分组的方法,考察高风险率的变化情况,发现孕妇年龄以外的影响因素,采取措施优化产前筛查,从而提高项目运行质量。Objective To explore a method to evaluate the quality of maternal serological prenatal screening by analyzing the high risk rate of maternal serological prenatal screening in the second trimester.Methods A total of 102285 pregnant women who underwent serological prenatal screening during the second trimester were selected from Yiyang Maternal and Child Health Hospital from January 2017 to September 2022.The high risk rate and age distribution of pregnant women were analyzed statistically,and two-factor analysis of variance was performed.Results From 2017 to 2022,except for 2018,the high risk rate showed an increasing trend year by year.The age distribution curve of pregnant women showed a unimodal symmetrical distribution at the age of maximum distribution frequency from 2017 to 2019,a acromial peak at the age of 25 to 27 and an asymmetric distribution at the age of maximum distribution frequency at the age of 30 to 33 from 2020 to 2022.The trend of age risk curves of pregnant women in different years was consistent,and the curves overlap closely in the age group of 20 to 40 years.Through the two-factor analysis of variance between the age and year of pregnant women,it was found that the age of pregnant women was a significant influence factor on the high risk rate(P<0.001),but the change of the high risk rate under the age group of pregnant women between years was not significant(P>0.05).Conclusion The age distribution of pregnant women in different years has great differences,and the age of pregnant women is a significant factor influencing the risk.Through age grouping,we can investigate the changes in the high risk rate,discover subjective factors other than the age of pregnant women,and take measures to optimize prenatal screening,so as to improve the quality of program operation.

关 键 词：母血清学产前筛查 21-三体综合征 18-三体综合征 开放性神经管缺陷 高风险率 孕妇年龄 双因素方差分析 

分 类 号：R715[医药卫生—妇产科学]