上海市嘉定区再生育妇女孕前保健服务利用及影响因素分析  

Analysis of utilization and influencing factors of preconception healthcare services among women expecting additional childbirth in Jiading District,Shanghai

作　　者：程丽[1] 张丽峰 沈恋迪 王海琪[1] 国献丽[1] 刘冰[1] 范生荣 蒋泓[2] CHENG Li;ZHANG Lifeng;SHEN Liandi;WANG Haiqi;GUO Xianli;LIU Bing;FAN Shengrong;JIANG Hong(Shanghai Jiading District Maternal and Child Health Hospital,Shanghai 201821,China;School of Public Health,Fudan University,Key Laboratory of Health Technology Evaluation,National Health Commission(Fudan University),Shanghai 200032,China)

机构地区：[1]上海市嘉定区妇幼保健院,上海201821 [2]复旦大学公共卫生学院,国家卫生健康委员会卫生技术评估重点实验室(复旦大学),上海200032

出　　处：《上海预防医学》2024年第8期783-788,822,共7页Shanghai Journal of Preventive Medicine

基　　金：复旦大学公共卫生学院-嘉定区卫生健康委员会公共卫生高质量发展重点学科、重点专项(GWGZLXK-2023-04);上海市嘉定区2022—2024年公共卫生优秀人才培养项目。

摘　　要：【目的】了解上海市嘉定区再生育妇女孕前保健服务的利用情况及影响因素,为促进新人口政策形势下孕前保健服务利用提供参考。【方法】对上海市嘉定区6个街镇的682名再生育孕妇开展孕期保健服务利用和影响因素的问卷调查,并对结果进行统计学分析。【结果】再生育妇女平均年龄为(31.7±4.5)岁,30.2%的再生育妇女年龄≥35岁;生育三孩及以上占比较低,为16.4%;92.4%的再生育妇女伴有各种妊娠初筛风险因素。再生育妇女对孕前保健服务利用率较低,为26.7%;对嘉定区免费孕前检查项目的知晓率也低,为28.6%;对嘉定区免费孕前保健服务利用率更低,为7.69%。意外妊娠仍然是再生育妇女未能及时接受孕前保健服务的主要原因,占63.6%。多因素二元logistic回归分析显示,相对于年龄≤29岁的再生育妇女,年龄在35~39岁的再生育妇女本次妊娠前孕前保健服务利用率更高(OR=1.789,95%CI:1.033~3.099);本次妊娠为计划妊娠的再生育妇女妊娠前孕前保健服务利用率更高(OR=4.164,95%CI:2.627~6.602);首次生育前接受过孕前保健服务的再生育妇女本次妊娠前孕期保健服务利用率更高(OR=7.534,95%CI:4.954~11.456);无慢性病家族史的再生育妇女本次妊娠前孕前保健服务利用率更高(OR=1.903,95%CI:1.083~3.345)。【结论】三孩政策下,嘉定区再生育妇女中,三孩及以上生育率占比较低;大多数再生育妇女合并有妊娠初筛风险因素。再生育妇女对孕前保健服务利用率及对嘉定区免费孕前检查项目的知晓率均较低。意外妊娠仍然是再生育妇女未能及时接受孕前保健服务的主要原因。年龄、是否计划妊娠、首次生育前是否接受过孕前保健以及是否有慢性病家族史是影响再生育妇女利用孕前保健服务的主要因素。相关部门应进一步加强对孕前保健服务项目的宣传,尤其是针对尚未生育的育龄妇女,以提高孕前保健服�[Objective]To understand the utilization of preconception healthcare services and the influencing factors among the women expecting additional childbirth in Jiading District,Shanghai,and to provide references for promoting the utilization of preconception healthcare services under the new population policy.[Methods]A questionnaire survey on the utilization of preconception healthcare services and related influencing factors was carried out among 682 women expecting additional childbirth across six subdistricts in Jiading District,Shanghai.The results were statistically analyzed.[Results]The average age of the women was(31.7±4.5)years,30.2%of whom were≥35 years old.The proportion of women having their third or subsequent children was low,at 16.4%.A significant majority,92.4%,were found to have various risk factors during initial pregnancy screening.The utilization rate of preconception healthcare services among women seeking additional childbirth was relatively low at 26.7%.Awareness of the free preconception check-up program in Jiading District was also low at 28.6%,and the utilization rate for these services was even lower at 7.69%.Unplanned pregnancies were the primary reason for not utilizing preconception healthcare services,accounting for 63.6%.The results of multifactorial binary logistic regression analysis showed that the utilization rate of preconception healthcare services before the current pregnancy was higher for women aged between 35 and 39 compared to women aged≤29 years old(OR=1.789,95%CI:1.033‒3.099).Women with planned pregnancies had a higher utilization of preconception healthcare services prior to this pregnancy(OR=4.164,95%CI:2.627‒6.602).Women who had received preconception care prior to their first birth had a higher utilization rate of preconception care prior to the current pregnancy(OR=7.534,95%CI:4.954‒11.456).Women without a family history of chronic diseases had a higher utilization rate of preconception healthcare services(OR=1.903,95%CI:1.083‒3.345).[Conclusion]Under th

关 键 词：再生育妇女 孕前保健 服务利用 影响因素 三孩生育率 

分 类 号：R17[医药卫生—妇幼卫生保健]