【摘要】：目的： 通過調查孕產(chǎn)婦孕前保健和妊娠結局情況，了解不良妊娠結局發(fā)生率，探討孕前保健對妊娠結局的影響，為加強孕前保健服務工作，降低不良妊娠結局的發(fā)生提供科學依據(jù)和有利數(shù)據(jù)支持。 方法： 本研究采用現(xiàn)況調查的方法，于2012年7月1日至2012年12月31日期間，在湖南省隨機抽取的5個市級婦幼保健院和5個縣級婦幼保健院住院分娩的產(chǎn)婦；調查內容：孕產(chǎn)婦、丈夫及家庭的一般情況、孕前保健情況、妊娠結局情況等。共發(fā)放1000份問卷，回收995份，最后有效問卷958份，有效率95.8%。使用Epidata3.1建立數(shù)據(jù)庫，應用SPSS19.0進行統(tǒng)計分析。孕產(chǎn)婦一般情況及妊娠結局情況采用描述性統(tǒng)計分析，使用χ2檢驗對妊娠期高血壓疾病、妊娠合并糖尿病、早產(chǎn)、病理妊娠引產(chǎn)和產(chǎn)后出血進行單因素分析；將單因素分析有統(tǒng)計學意義的因素進行多因素Logistic逐步回歸分析。以ａ=0.05為檢驗水準。 結果： 1.本次調查，妊娠期高血壓疾病的發(fā)病率為12.2%，妊娠合并糖尿病的發(fā)病率為3.7%，早產(chǎn)的發(fā)生率為8.4%，病理妊娠引產(chǎn)的發(fā)生率為2.3%，產(chǎn)后出血的發(fā)生率為9.4%。 2.單因素χ2分析結果：母親年齡、父母親受教育程度、家庭收入水平、孕前保健咨詢和孕前醫(yī)學檢查、父母親孕前吸煙和飲酒、接觸有毒有害物質、母親孕前頻繁接觸動物、吸食毒品、母親孕前肥胖、壓力過大、患有疾病、是否接種疫苗以及孕前3個月內是否增補葉酸對不良妊娠結局的影響有統(tǒng)計學意義（Р＜0.05）。 3.多因素Logistic回歸分析結果：高齡（OR=1.435）、有生育史（OR=1.938）、意外妊娠（OR=4.672）、頻繁服用避孕藥物（OR=2.576）為妊娠高血壓疾病的危險因素；孕前被動吸煙回避（OR=0.314）是妊娠高血壓的保護因素,城市孕產(chǎn)婦比農村（OR=0.580）的更易患妊娠期高血壓疾��；孕產(chǎn)婦孕前飲酒（OR=2.338）、吸煙（OR=2.338）、孕前患有疾�。∣R=2.761）、有過生育史（OR=2.379）是妊娠合并糖尿病的危險因素，被動吸煙主動回避（OR=0.384）是保護因素；丈夫孕前吸煙（OR=1.616）、孕產(chǎn)婦孕前頻繁接觸動物（OR=2.030）為早產(chǎn)的危險因素，孕前避免體重過低（OR=0.598）和家庭高收入（OR=0.642）是早產(chǎn)的保護因素；孕產(chǎn)婦孕前肥胖（OR=2.617）、患有疾�。∣R=4.379）、孕產(chǎn)婦孕前吸煙（OR=6.667）、孕前頻繁接觸動物（OR=6.752）及丈夫孕前經(jīng)常飲酒（OR=5.456）為病理妊娠引產(chǎn)的危險因素；孕產(chǎn)婦高學歷（OR=0.385）及孕前增補葉酸（OR=0.102）為保護因素；孕產(chǎn)婦孕前6個月內進行醫(yī)學檢查（OR=0.634）、孕前被動吸煙回避（OR=0.464）是產(chǎn)后出血的保護因素，，孕產(chǎn)婦孕前患�。∣R=1.701）、既往分娩史（OR=2.287）是產(chǎn)后出血的危險因素。 結論： 1.妊娠期高血壓疾病的發(fā)病率為12.2%，妊娠合并糖尿病的發(fā)病率為3.7%，早產(chǎn)的發(fā)生率為8.4%，病理妊娠引產(chǎn)的發(fā)生率為2.3%，產(chǎn)后出血的發(fā)生率為9.4%。 2.不良妊娠結局的主要影響因素有：母親年齡、父母親受教育程度、家庭收入水平、孕前保健咨詢和孕前醫(yī)學檢查、父母親孕前吸煙和飲酒、接觸有毒有害物質、母親孕前頻繁接觸動物、吸食毒品、母親孕前肥胖、壓力過大、患有疾病。
[Abstract]:Purpose: To investigate the incidence of adverse pregnancy outcome by investigating the maternal and maternal health and the outcome of the pregnancy, and to explore the effect of the pre-pregnancy health care on the outcome of the pregnancy, and to provide the scientific basis and data support for strengthening the pre-pregnancy health care service and reducing the occurrence of the adverse pregnancy outcome. Hold on. Method: The present study adopted the method of current status survey. During the period from July 1,2012 to December 31,2012, five levels of maternal and child health care and 5 maternal and child health care homes and five maternal and child health care homes were randomly selected in Hunan Province, and the survey was conducted. Capacity: General situation of pregnant women, husbands and families, pre-pregnancy care, pregnancy Outcome, etc. A total of 1000 questionnaires were issued,995 were recovered,958 in the last valid questionnaire and the effective rate 95.8%. Using Epidata3.1 to set up a database, apply SPSS19.0 The statistical analysis was performed on the general situation of the pregnant women and the outcome of the pregnancy, and the pregnancy-induced hypertension, the pregnancy and the diabetes, the premature birth, the induced labor of the pathological pregnancy and the postpartum hemorrhage were carried out by using the 2-2 test. single-factor analysis; multi-factor logistic analysis of single-factor analysis with statistical significance Step regression analysis. to test The results were as follows:1. The incidence of hypertension in pregnancy was 12.2%, the incidence of pregnancy with diabetes was 3.7%, the incidence of premature birth was 8.4%, and the incidence of induced labor in the pathological pregnancy was 2.3%, and the postpartum hemorrhage. The incidence rate was 9.4%.2. The results of single factor analysis 2: the age of the mother, the degree of education of the parents, the level of the family income, the pre-pregnancy care consultation and the pre-pregnancy medical examination, the pre-pregnancy smoking and drinking of the parents, the contact with the toxic and harmful substances, the frequent contact of the animals before the mother was pregnant, The effect of folic acid on the outcome of an adverse pregnancy is statistically significant in the case of a drug, a mother who is obese before the pregnancy, an excessive pressure, a disease, whether or not a vaccine is administered, and whether or not the addition of folic acid in the first 3 months of the pregnancy has an impact on the outcome of the poor pregnancy 3. Logistic regression analysis of multiple factors: The results of multi-factor logistic regression: the advanced age (OR = 1.435), the history of birth (OR = 1.938), the accidental pregnancy (OR = 4.672), the frequent use of the contraceptive (OR = 2.576) is the risk factor of the hypertensive disorder of the pregnancy; the passive smoking avoidance (OR = 0.31) 4) It is the protective factor of pregnancy and hypertension, and the ratio of urban and maternal to the rural (OR = 0.580) is more likely to be a pregnancy-induced hypertension disease; the pre-pregnancy alcohol consumption (OR = 2.338), smoking (OR = 2.338), the pre-pregnancy (OR = 2.761), and the history of pregnancy (OR = 2.379) are the risk factors of the pregnancy and the diabetes, and the active avoidance of passive smoking (O R = 0.384) was a protective factor; pre-pregnancy smoking (OR = 1.616), and frequent contact of the animals (OR = 2.030) to the risk factors for preterm birth, avoiding low body weight (OR = 0.598) and high family income (OR = 0.642) before pregnancy was a protective factor for preterm birth; pregestational obesity (OR = 2.617), risk of suffering There were diseases (OR = 4.379), pre-pregnancy smoking (OR = 6.667), pre-pregnancy frequent contact animals (OR = 6.752) and pre-pregnancy frequent alcohol consumption (OR = 5.456) as a risk factor for the induction of a pathological pregnancy; maternal high education (OR = 0.385) and pre-pregnancy supplementation of folic acid (O R = 0.102) was the protection factor; the medical examination (OR = 0.634) was performed within 6 months of the first pregnancy, and the passive smoking avoidance (OR = 0.464) was the protective factor for postpartum hemorrhage, the pre-pregnancy disease (OR = 1.701), and the history of previous delivery (OR = 2.2 87) The risk factors of postpartum hemorrhage were:1. The incidence of hypertension in pregnancy was 12.2%, the incidence of pregnancy with diabetes was 3.7%, the incidence of premature labor was 8.4%, and the incidence of induced labor in the pathological pregnancy was 2. 3%, the incidence of postpartum hemorrhage was 9.4%.2. The main influencing factors of the adverse pregnancy outcome were: the age of the mother, the level of education of the parents, the level of the family income, the pre-pregnancy care consultation and the pre-pregnancy medical examination, the pre-pregnancy smoking and the drinking of the parents, and the contact with the toxic substances. It's harmful to your mother. You're in contact with animals before you get pregnant.
【學位授予單位】：南華大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R714.2

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