关键词: 计划怀孕；神经管缺陷；预防措施；交互作用；一级预防

Abstract:

Objective  To find out the current situation of pregnancy planning of women at childbearing age, and to analyze the effects of pregnancy planning on promoting neural tube defects (NTD) primary prevention measures during the pre-conceptual and peri-conceptual periods. Methods  From January to February, 2008, using cross-sectional survey, we carried out interviews with all women of  childbearing age from Maternal and Child Health (MCH) Institutions in two counties randomly selected in Shandong Province about the implementation of the NTD primary prevention measures. Results  Among all the subjects, 68.7% had pregnancy planning for the last pregnancy and 31.3% did not. The pregnancy planning rates of women between 24 and 29 years old and those aged above 30 were 72.2% and 73.4% respectively, which were much higher than that of women aged 23 and below (P＜0.05). Pregnancy planning allowed women of childbearing age to carry out health education, genetic counseling, pre-concepual  health examinations and peri-conceptiual folic acid intake, the rates of which increased by 49.9%, 65.3%, 77.90% and 69.0% respectively;after adjusting the effects of other factors. Pregnancy planning and health education had synergistic effects on genetic counseling and preconcepual health examinations, RERI (relative excess risk due to interaction) being 4.59 and 4.26 respectively. Pregnancy planning and genetic counseling had synergistic effects on folic acid intake, RERI being 6.71. Conclusion  Pregnancy planning could significantly promote the implementation of NTD primary prevention measures and there exist synergistic effects between pregnancy planning and other primary prevention measures.

Key words: Pregnancy planning; Neural tube defects; Preventive measures; Interaction; Primary prevention