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目的 全面了解近30年来我国孕产期保健服务变化情况。方法 采用分层、三阶段的容量比例抽样方法获得调查对象;由调查员入户对其进行面对面的问卷调查。结果 随着时间推移,调查对象产前检查覆盖率和服务质量以及住院分娩比例等都在不断增加,孕妇产前检查比例已由 20世纪70年代的38.7%上升到 2001 年以来的95.9%,住院分娩率则相应的由20.1%上升到87.4%。但是当前我国孕产期保健服务中仍然存在产前检查开始时间较晚,产前检查次数较少,产前检查项目不完整等问题。近3年来孕早期检查比例只有71.7%,5次及以上产前检查的比例也只达到64.1%,仅仅29.1%能够在产前完成7项基本的检查项目。另外,住院分娩比例也还需进一步提高,非住院分娩妇女中79.5%还是由接生员/村医和家人/朋友接生。不同地区比较,同时期西部地区几乎各项指标都明显落后于东部发达地区,存在明显的地区差异。结论 经过 30 年来的努力,全国各地区产前检查覆盖率和住院分娩率明显提高,产前保健服务质量得到加强,但存在地区差异,应加强对西部地区的重视和投入力度。
Objective To fully understand the changes of maternal health care services in China in the past 30 years. Methods A stratified and three-stage capacity proportion sampling method was used to obtain the surveyed persons. The investigators conducted a face-to-face questionnaire survey. Results With the passage of time, the survey coverage and quality of service of prenatal care and the proportion of hospital delivery were constantly increasing. The proportion of prenatal examination in pregnant women rose from 38.7% in 1970s to 95.9% since 2001, and hospitalization The corresponding rate of delivery increased from 20.1% to 87.4%. However, at present, there are still some problems in China’s maternal health care service, such as the late start of antenatal examination, the small number of prenatal examination and the incomplete prenatal examination. In the first 3 years of pregnancy, only 71.7% of the patients were checked in the early pregnancy, only 64.1% of the women took 5 or more prenatal tests, and only 29.1% of them were able to complete 7 basic check-ups during prenatal period. In addition, the rate of hospital delivery also needs to be further improved. 79.5% of non-hospital delivery women are still born by midwives / village doctors and family / friends. Compared with other regions, almost all the indicators in the western region lagged behind those in the developed eastern regions with obvious regional differences. Conclusion After 30 years of hard work, the prenatal examination coverage and hospital delivery rate in all regions of the country have been significantly improved. The quality of prenatal health care services has been strengthened. However, there are regional differences, and more attention and investment should be made in the western region.