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山东大学学报(医学版) ›› 2010, Vol. 48 ›› Issue (4): 142-146.

• 论文 • 上一篇    下一篇

计划怀孕对神经管缺陷一级预防措施实施的影响

宫蕊1,孟才2,孙喜红1,王志萍1,赵仲堂1   

  1. 1. 山东大学公共卫生学院流行病与卫生统计学研究所, 济南 250012;
    2. 临沂市人民医院妇产科, 山东 临沂 276000
  • 收稿日期:2009-11-15 出版日期:2010-04-16 发布日期:2010-04-16
  • 通讯作者: 王志萍(1962- ),女,教授,博士,主要从事生殖健康流行病学研究。 Email:zhipingw@sdu.edu.cn
  • 作者简介:宫蕊(1984- ),女,博士研究生,主要从事生殖健康流行病学研究。
  • 基金资助:

    国家“十一五”科技支撑计划-重大出生缺陷和遗传病的防治研究项目(2006BAI05A01)

Effect of pregnancy planning on primary prevention measures for neural tube defects

GONG Rui1, MENG Cai2, SUN Xihong1, WANG Zhiping1, ZHAO Zhongtang1   

  1. 1. Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan 250012, China;  2. Department of Gynecology and Obstetrics, Linyi People′s Hospital, Linyi 276000, Shandong, China
  • Received:2009-11-15 Online:2010-04-16 Published:2010-04-16

摘要:

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。

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

中图分类号: 

  • R181.2
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