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目的了解育龄妇女计划怀孕现状,分析计划怀孕对育龄妇女孕前-围孕期实施神经管缺陷一级预防措施的影响。方法采用横断面调查方法,在山东省随机选取两县(区)妇幼保健院,于2008年1～2月对医院内的所有育龄妇女进行面访。结果研究对象最近一次妊娠为计划怀孕的占68.7%,其中生育年龄在24～29岁以及30岁以上的妇女计划怀孕率分别为72.2%和73.4%,显著高于23岁及以下妇女(P<0.05);计划怀孕可促使育龄妇女实施优生优育健康教育、遗传优生咨询、孕前健康检查和叶酸服用,较非计划怀孕分别增高了49.9%、65.3%、77.90%和69.0%;调整其他因素的影响后,计划怀孕与健康教育对遗传优生咨询和孕前健康检查的实施存在协同作用,交互效应超额相对危险度分别为4.59和4.26;计划怀孕与遗传咨询对叶酸的服用亦存在协同作用,超额相对危险度为6.71。结论育龄妇女实施计划怀孕可明显促进神经管缺陷各项一级预防措施的实施,且与各项措施间存在协同作用。
Objective To understand the planned pregnancy status of women of childbearing age and analyze the effect of planned pregnancy on the primary preventive measures of neural tube defects during pregnancy and perinatal period in women of childbearing age. Methods A cross-sectional survey method was used to randomly select two county (district) MCH centers in Shandong Province. From January to February 2008, all women of child-bearing age in the hospital were interviewed. Results The most recent pregnancies accounted for 68.7% of all pregnancies scheduled for pregnancy. Among them, the planned pregnancy rates of women aged 24 to 29 years and those over 30 years old were 72.2% and 73.4%, respectively, significantly higher than those of women aged 23 and under (P < 0.05). The planned pregnancy could promote 49.9%, 65.3%, 77.90% and 69.0% of women of childbearing age who were educated in prenatal and postnatal care, genetic counseling, prenatal health check-up and folic acid intake, respectively. The planned pregnancy and health education had synergistic effects on genetic predisposition counseling and pre-pregnancy health check-ups, with the relative relative risk of interaction of 4.59 and 4.26 respectively. There was also a synergistic effect of planned pregnancy and genetic counseling on the use of folic acid, with over-relative risk The degree is 6.71. Conclusions Pregnant women of childbearing age plan pregnancy can significantly promote the implementation of various primary prevention measures of neural tube defects and have synergistic effect with other measures.