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目的:通过开展孕前服务、孕产期保健和产前先天性缺陷筛查,探讨预防及减少出生缺陷方面的对策,调查影响优生优育的相关因素,为提高出生人口素质提供科学依据。方法:采用随机抽样,普查方法,对10120例孕产妇开展孕前、孕产期优生优育系列化服务,并对相关因素进行了因果性和前瞻性研究。结果:在10120例孕产妇中,发现病理妊娠231例,发生率2.28%,其中死胎发生率0.19%,自然流产发生率0.98%,胎儿畸形发生率0.54%,宫外孕发生率0.03%。在分娩过程中,死产发生率0.19%。严重产伤和新生儿窒息发生率0.22%,新生儿先天性缺陷发生率2.43%。在优生优育相关因素调查中发现,山区、接触农药、病毒感染、营养不良、近亲婚配及有家族遗传病史者和既往有病理妊娠史者,病理妊娠发生率均高于无以上因素者。结论:开展孕前咨询及孕期保健,进行产前诊断和终止病理妊娠,可有效地减少先天性缺陷发生率。
OBJECTIVE: To explore the strategies to prevent and reduce birth defects by screening prenatal services, maternal health care and prenatal diagnosis of congenital defects, and to investigate the related factors that affect prenatal and postnatal care so as to provide a scientific basis for improving the quality of birth population. Methods: Randomized sampling and census methods were used to carry out the serialization of prenatal and postnatal maternity and prenatal and postnatal care on 10,120 pregnant women, and causal and prospective studies were conducted on related factors. Results: Among 10,120 pregnant women, 231 cases were found with pathological pregnancy, the incidence rate was 2.28%. The incidence of stillbirth was 0.19%, spontaneous abortion rate was 0.98%, fetal malformation rate was 0.54% and ectopic pregnancy rate was 0.03%. During childbirth, the incidence of stillbirth 0.19%. The incidence of severe birth trauma and neonatal asphyxia was 0.22%, the incidence of neonatal congenital defects was 2.43%. In the survey of related factors of prenatal and postnatal care, the incidence of pathological pregnancy in mountainous areas exposed to pesticides, viral infections, malnutrition, cousins with marital history and previous history of family history was higher than those without. Conclusion: Pre-pregnancy counseling and prenatal care, prenatal diagnosis and termination of pathological pregnancy can effectively reduce the incidence of congenital defects.