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目的:描述中国1993～2008年代表不同社会经济发展程度的地区类型已婚育龄妇女产前、产时和产后保健利用的变化情况,并探讨其中存在的问题。方法:通过卫生部发布的1993、1998、2003、2008年4次国家卫生服务调查报告中的有关数据,筛选部分关键指标分地区类型、分时段反映15～49岁已婚育龄妇女孕产期保健服务利用水平的变化和其中存在的问题。结果:在1993-2008年间,孕早期检查率、产前检查率、住院分娩率和产后访视率分别从37.0%、69.5%、38.7%和46.0%升至65.2%、94.4%、88.6%和55.6%,剖宫产率从2.35%增至27.20%;产前保健、产时保健和产后保健各项指标的城乡差别均有不同程度缩小;2008年4类农村地区住院分娩率仅为64.30%,大城市剖宫产率高达63.00%。结论:中国孕产期保健服务利用水平在过去十余年间有了较大提高,但孕早期检查和产后访视两项指标仍处于较低水平。多数指标之间的城乡差距不断缩小,但4类农村地区住院分娩率还不理想。剖宫产率在全国范围内迅速攀升,已经远远超过正常水平,需予以重视和适当引导。
OBJECTIVE: To describe the changes in the utilization of antenatal, postnatal and postpartum health care among married women of childbearing age in China from 1993 to 2008 representing different degrees of social and economic development, and to discuss the existing problems. Methods: According to the data of 4 national health service surveys released by the Ministry of Health in 1993, 1998, 2003 and 2008, some key indicators were screened out by region type, which reflected the maternal health care of married women of childbearing age from 15 to 49 years Changes in the level of service utilization and the problems that exist. Results: During the first trimester, the rates of prenatal examination, prenatal examination, hospital delivery and postnatal visits increased from 37.0%, 69.5%, 38.7% and 46.0% to 65.2%, 94.4% and 88.6% respectively during 1993-2008 55.6%; the rate of cesarean section increased from 2.35% to 27.20%; the difference between urban and rural areas in prenatal, obstetrical and postnatal care was reduced to some extent; in 2008, the hospital delivery rate in four rural areas was only 64.30% Cesarean section rates in big cities are as high as 63.00%. Conclusion: The level of utilization of maternal health care in China has greatly increased in the past ten years. However, the indexes of early pregnancy and postpartum visits are still at a low level. The gap between urban and rural areas among most indicators has been shrinking, but the hospital delivery rate in 4 rural areas is still not satisfactory. Cesarean section rate in the rapid rise across the country, has far exceeded the normal level, need to be given attention and appropriate guidance.