CAJ | 학술논문

分析并报告上海市静安区免费孕前优生健康检查后待孕夫妇不良妊娠结局潜在影响因素接触情况以及妊娠率和妊娠结局，为免费孕前健康检查政府实施项目效果的评估提供基础数据。对2011年8月-2012年11月在静安区参加免费孕前优生健康检查的所有对象在其检查结束后的3个月、6个月、12个月进行随访，重点关注不良妊娠结局潜在危险因素接触情况以及妊娠时间和妊娠结局。统计方法为χ2检验、寿命表、Logistic回归分析。在目标时段内共有1480对夫妇参加了免费孕前优生健康检查，其中1249对服务对象接受了随访，随访率为84.4%。截至2013年4月，48.7%的随访对象已经受孕，孕前检查后3个月调查累积妊娠率为23.9%，6个月调查累积妊娠率为45.0%。365人完成妊娠结局的随访，结果显示，早产率为3.0%，低出生体重率为4.3%，巨大儿发生率为3.3%。自然流产率为6.3%。另外，发现出生缺陷1人，占妊娠妇女数的0.16%，占有妊娠结局妇女数的0.27%。烟酒等不良生活习惯丈夫的比例（18%～20%）高于妻子（1%～3%），77%的丈夫和妻子接受潜在电磁辐射的时间超过8 h。9%的夫妇自述生活和工作中接触重金属以及农药、化肥等潜在致畸物。超过10%的妻子在怀孕以后接触了潜在致畸物。初步分析未发现上述因素与不良妊娠结局的关系。静安区孕前健康检查后半年内妇女妊娠率不到50%，有必要在上海乃至全国开展免费孕前健康检查的成本效益评估。
분석병보고상해시정안구면비잉전우생건강검사후대잉부부불량임신결국잠재영향인소접촉정황이급임신솔화임신결국，위면비잉전건강검사정부실시항목효과적평고제공기출수거。대2011년8월-2012년11월재정안구삼가면비잉전우생건강검사적소유대상재기검사결속후적3개월、6개월、12개월진행수방，중점관주불량임신결국잠재위험인소접촉정황이급임신시간화임신결국。통계방법위χ2검험、수명표、Logistic회귀분석。재목표시단내공유1480대부부삼가료면비잉전우생건강검사，기중1249대복무대상접수료수방，수방솔위84.4%。절지2013년4월，48.7%적수방대상이경수잉，잉전검사후3개월조사루적임신솔위23.9%，6개월조사루적임신솔위45.0%。365인완성임신결국적수방，결과현시，조산솔위3.0%，저출생체중솔위4.3%，거대인발생솔위3.3%。자연유산솔위6.3%。령외，발현출생결함1인，점임신부녀수적0.16%，점유임신결국부녀수적0.27%。연주등불량생활습관장부적비례（18%～20%）고우처자（1%～3%），77%적장부화처자접수잠재전자복사적시간초과8 h。9%적부부자술생활화공작중접촉중금속이급농약、화비등잠재치기물。초과10%적처자재부잉이후접촉료잠재치기물。초보분석미발현상술인소여불량임신결국적관계。정안구잉전건강검사후반년내부녀임신솔불도50%，유필요재상해내지전국개전면비잉전건강검사적성본효익평고。
To provide evidence for effectiveness evaluation of the government project free pre-pregnancy health examination through reporting exposure of potential risk factors of ad-verse pregnancy outcome and pregnancy rate and the pregnancy outcome of the couples to be pregnant after free pre-pregnancy physical examination in Jingan District,Shanghai. Follow-ups were completed to women who had a free pre-prenancy health examination in Jingan Dis-trict from August 2011 to November 2012,which foucused on exposure of potential risk factors of adverse pregnancy outcome,time of pregnancy and pregnancy outcome of the women. Chisq test,life table and Logistic regression model were used for data analysis. 1 480 couples had free pre-pregnancy health examinations in the target period. Of which,84.4 % were fol-lowed up. By April 2013,48.7%of the women who were followed up were pregnant. The cu-mulative pregnancy rate at 3 months and 6 months after free pre-pregnancy health examination was 23.9%and 45.0%,respectively. 365 women completed the follow up about pregnancy out-comes. The incidence rate of premature delivery,low birth weight,giant baby and spontaneous abortion was 3.0%,4.3%,3.3%and 6.3%,respectively. One birth defect was reported dur-ing the follow up period,accounting for 0.16%of the number of pregnant women and 0.27%of the number of women who had pregnancy outcomes. The proportion of husbands who had un-healthy habits such as smoking or drinking ranged from 18%to 20%,which was much higher than that of their wives (1%~3%). 77%husbands and 77%wifives exposed to potential elec-tromagnetic radiation over 8 hours a day. 9%couples reported exposing to potential teratogenic-ity such as heavy mental,pesticide and chemical fertilizer in their daily life and work. Over 10%wivies had exposed to potential teratogenicity after they were pregnant. Primary analysis showed no association between the above factors and adverse pregnancy outcomes. Since the 6-month cumulative pregnancy rate of women who had free pre-pregnancy health examination was lower than 50%,it is necessary to evaluate the cost benefit of free pre-pregnancy health ex-amination in Shanghai and throughout the country.