摘要
目的了解上海市长宁区管理的重点孕产妇变化趋势,为完善重点孕产妇管理模式、优化服务提供依据。方法分析2015-2020年上海市长宁区10家社区卫生服务中心管辖的重点孕产妇相关资料。各社区卫生服务中心早孕建册门诊医生根据"妊娠风险预警初筛表"对每一位建册孕妇进行筛查,对风险可疑者填写"重点孕妇转诊单"。助产机构对社区筛查阳性转诊的孕妇进行妊娠风险预警评估,完成"重点孕妇转诊单"回执的填写。对社区建册时无异常的孕妇在产科初诊时进行首次风险评估,填写"重点孕妇报告单",孕28~32周、36~37周进行第二、三次风险评估。结果(1)长宁区重点孕产妇总确诊率为54.48%,差异有统计学意义(P<0.001),且呈逐年上升趋势;除2017年外本市户籍与非本市户籍重点孕产妇发生率有统计学意义(P<0.05),且本市户籍(42.52%~70.11%)高于非本市户籍(38.88%~63.55%)。(2)在各风险预警类别中本市户籍和非本市户籍重点孕妇构成比差异无统计学意义(P>0.05);黄色预警中居于前3位的风险因素为:BMI>24 kg/m^(2)、年龄≥35岁及瘢痕子宫。(3)社区建册初筛阳性总转诊率为48.88%,不同年份间差异有统计学意义(P<0.001),亦呈逐年上升趋势。结论加强重点孕产妇管理及优生优育宣教,尤其该市户籍重点孕妇的管理,优化服务模式,降低剖宫产率,保障母婴安全。
Objective To understand the change trend of key pregnant women in Changning District of Shanghai in recent years,and provide a basis for improving management mode and optimizing the service.Methods The data of key pregnant women in 10 community health service centers in Changning District of Shanghai from 2015 to 2020 were analyzed.The pregnant women were screened according to pregnancy risk early warning screening table by outpatient doctors in community health service centers,the suspected pregnant women were recorded by key pregnant women referral letter,early warning assessment of pregnancy risk was performed in pregnant women with positive result in community health service centers by midwifery institutes,return receipt of key pregnant women referral letter was filled,the pregnant women without abnormal result in community health service centers were evaluated for pregnancy risk during the first obstetric visit,key pregnant women report card was filled,the second risk assessment and the third risk assessment were performed during 28-32 gestational weeks and 36-37 gestational weeks,respectively.Results The total definite diagnosis rate of key pregnant women in Changning District of Shanghai was 54.48%(P<0.001),showing an increasing trend year by year,there was no statistically significant difference in incidence rate of key pregnant women between local population and migrant population except 2017(P<0.05),the incidence rate of key pregnant women in local population(42.52%-70.11%)was higher than that in migrant population(38.88%-63.55%).Among the types of risk early warning,there was no statistically significant difference in proportion of key pregnant women between local population and migrant population(P>0.05);the top three risk factors of yellow warning were body mass index>24 kg/m^(2),≥35 years old,and scarred uterus;the total referral rate of pregnant women with positive result of primary screening in community health service centers was 48.88%,there was statistically significant difference among different years(P<0.001),which increased year by year.Conclusion The management of key pregnant women and eugenics education should be strengthened,more attention should be paid to local key pregnant women,the service mode should be optimized,cesarean section rate should be reduced to ensure maternal and child safety.
作者
施云美
程诗洋
陈莉
秦倩
SHI Yun-Mei;CHENG Shi-Yang;CHEN Li(Department of Maternal Health Care,Maternity and Child Care Institute,Maternal and Child Health Care Hospital of Changning District,Shanghai,200051,China)
出处
《中国妇幼保健》
CAS
2021年第17期4083-4087,共5页
Maternal and Child Health Care of China
关键词
重点孕妇
妊娠风险
孕产期保健
Key pregnant woman
Pregnancy risk
Maternal health care
