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目的:描述奉贤区出生缺陷一级预防开展的现状,探讨可能的影响因素,提出改善或提高一级预防干预策略。方法:对2012年1~6月到上海奉贤区各社区卫生服务中心产科初诊的孕妇共760名(本市和非本市各380名)进行问卷调查,并对部分对象开展深入访谈。结果:奉贤区出生缺陷一级预防开展项目较全面,但服务利用率不高,婚检率为31.4%,怀孕前、后3个月叶酸服用率35.3%,孕前检查率28.6%,孕前咨询率12.0%,优生培训率22.1%,孕12周前建卡率为55.3%。结论:建议建立区级协调机制,提高科学管理水平,努力打造婚前-孕前-围孕期保健模式,改善服务利用,改进出生缺陷一级预防工作。
OBJECTIVE: To describe the status of primary prevention and treatment of birth defects in Fengxian District, to explore the possible influencing factors and to propose strategies to improve or improve primary prevention and intervention. METHODS: A total of 760 pregnant women (380 in each of the city and non-city) who came to the obstetrics department of various community health service centers in Fengxian District of Shanghai from January to June 2012 conducted a questionnaire survey and carried out in-depth interviews with some subjects. Results: The primary prevention and control project of birth defects in Fengxian District was more comprehensive, but the utilization rate of service was not high. The rate of premarital examination was 31.4%, the rate of taking folic acid 35.3% before pregnancy and after 3 months, pre-pregnancy examination rate 28.6% and pre-pregnancy consultation rate 12.0 %, Eugenics training rate of 22.1%, 12 weeks before the pregnancy card rate was 55.3%. Conclusion: It is suggested that a district-level coordination mechanism should be set up to improve the scientific management level so as to create a prenuptial-preconception-perinatal health care model, improve service utilization and improve primary prevention of birth defects.