摘要
目的 研究产前检查次数及有关高危因素与围生儿死亡的关系。 方法 对 1996年～中美预防神经管畸形合作项目监测的 2 7个市县 14 14 0 4例孕产妇及其分娩的 14 2 346例胎婴儿监测孕产妇的产检次数、职业、文化程度、出生体重等 ,通过变量分组及采用 L ogistic回归控制混杂变量的方法研究孕产妇的产前检查次数、有关高危因素与围生儿死亡的关系。 结果 无论是高危组孕产妇还是非高危组孕产妇 ,随着产前检查次数的增加 ,围生儿死亡率均明显下降 ;围生儿死亡率孕期未产检组 (5 9.8‰ )与产检 5次～组 (7.2 7‰ )比较 ,差异有显著性 (χ2 =186 1.2 9,P<0 .0 0 0 0 1) ,前者围生儿死亡率是后者的 7.9倍。多因素 L ogistic回归分析显示 ,孕产妇的职业、文化程度、年龄、产检次数 ,胎婴儿的孕周、出生体重、重大畸形等均是与围生儿死亡相关的重要因素。经多变量调整以后 ,产检 5～、>8次的孕产妇与未做产检的孕产妇相比 ,OR值分别为 0 .5 72、0 .395。 结论 增加产前检查次数是减少围生儿死亡最简便、最有效的方法 ;文化程度较低、从事农业劳动的孕产妇是需要加强围生保健的重点人群 ;非高危孕产妇适宜的产检次数应大于 5次 ,理想的应达到 8次 ,而高危孕产妇应酌情增加产前检查次数。
Objective To investigate the relationship of prenatal vistis with perinatal outcome. Methods We used population based perinatal health care surveillance data to determine the number of prenatal visits and perinatal outcome.These women were divided into different groups by the number of prenatal visits,maternal occupation,maternal education,newbore birthweight.Logistic regression model was used to control for confounders. Results A greater number of prenatal visits were associated with a lower risk of perinatal death,whether or not other risk factors were present.Among women with no prenatal visits,1～ prenatal visits,and 5～ prenatal visits during third trimester,the perinatal mortality rates were 59.8/1 000 births,25.8/1 000 births and 7.6/1 000 births,respectively.Logistic regression analysis showed that the following variables such as maternal occupation,maternal education,maternal age,the number of prenatal visits,gestational age at birth,birthweight and the major external structural birth defects were associated with perinatal mortality.Furthermore,the multivariate adjusted relative risks for 5.6 and >8 prenatal visits were 0.572 and 0.395 respectively compared with those without prenatal visits. Conclusion Increasing the number of prenatal visits at least 5 prenatal visits is recommended for all women (optimal number is 8),and more than 8 prenatal visits are recommended for those with additional risk factors.Farmers and those with minimal education are at higher risk and may benefit to most from improved perinatal health care.natal health care.
出处
《中国生育健康杂志》
2004年第3期150-153,共4页
Chinese Journal of Reproductive Health
基金
美国疾病控制中心 980 75号项目经费资助
