本文選題：育齡夫婦 + 不良妊娠結(jié)局��； 參考：《昆明醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：通過調(diào)查大理州祥云縣已婚育齡夫婦的妊娠結(jié)局情況,利用統(tǒng)計(jì)學(xué)方法、結(jié)合“健康生態(tài)學(xué)模型”,從被調(diào)查對象的個(gè)人情況、心理和行為生活方式、生活工作環(huán)境、妊娠早期情況以及孕前體格檢查五大方面分析有可能導(dǎo)致不良妊娠結(jié)局發(fā)生的影響因素,并將分析得出的影響因素結(jié)合本研究的理論框架歸類為上、中、下游水平加以討論,探討各種影響因素與不良妊娠結(jié)局的關(guān)系,為祥云縣制定不良妊娠結(jié)局三級預(yù)防策略提供依據(jù)。 方法：本研究選取大理州祥云縣于2009年1月1日0時(shí)-2010年12月31日24時(shí)產(chǎn)生妊娠結(jié)局的1060對育齡夫婦為研究對象,采用回顧性調(diào)查分析法,自制問卷收集定性定量資料,以育齡夫婦雙方的個(gè)人情況、心理和行為生活方式、生活工作環(huán)境、妊娠早期情況以及孕前體格檢查等五大方面的相關(guān)因素為自變量,以妊娠結(jié)局為因變量,按α=0.05的水準(zhǔn)進(jìn)行單因素非條件Logistic回歸分析,篩選出與不良妊娠結(jié)局有統(tǒng)計(jì)學(xué)意義的相關(guān)因素(P0.05),并對篩選出的相關(guān)因素按α=0.05的水準(zhǔn)進(jìn)行多因素非條件Logistic回歸分析和主成分分析。 結(jié)果： 1、調(diào)查收集的1060例妊娠結(jié)局中,正式進(jìn)入統(tǒng)計(jì)分析的有1057例,有效應(yīng)答率為99.72%;正常妊娠結(jié)局990例,不良妊娠結(jié)局67例,不良妊娠結(jié)局的陽性檢出率為6.34%; 2、經(jīng)單因素Logistic回歸分析,篩選出可能會導(dǎo)致不良妊娠結(jié)局發(fā)生的影響因素21個(gè)(P0.05),分別是妻子年齡20歲或34歲(OR值=0.925)、丈夫年齡20歲或34歲(OR值=0.930)、妻子孕前尿液檢查異常(OR值=0.897)、丈夫孕前尿液檢查異常(OR值=0.642)、丈夫孕前血細(xì)胞分析異常(OR值=0.662)、妻子受教育年限≤9年(OR值=1.982)、丈夫有先天性心臟病家族史(OR值=1.102)、丈夫有糖尿病家族史(OR值=1.104)和丈夫有聽力障礙家族史(OR值=1.101)、妻子貧血史(OR值=2.220)、妻子胎死宮內(nèi)生育史(OR值=5.102)、妻子日常飲食單調(diào)(OR值=5.108)、丈夫日常飲食單調(diào)(OR值=6.557)、妻子與親友關(guān)系緊張(OR值=14.868)、妻子未正確服用葉酸(OR值=1.187)、妊娠早期陰道流血(OR值=27.949)、妊娠早期腹痛(OR值=7.738)、妊娠早期發(fā)熱(OR值=11.204)、妊娠早期被動吸煙(OR值=1.553)、妻子孕前BMI低于或高于標(biāo)準(zhǔn)BMI(OR值=1.881)、丈夫孕前BMI低于或高于標(biāo)準(zhǔn)BMI(OR值=1.720);其中保護(hù)因素5個(gè)(OR值1),危險(xiǎn)因素16個(gè)(OR值1)： 3、經(jīng)主成分分析,不良妊娠結(jié)局的影響因素69.8%以上的信息可以由前7個(gè)主成分解釋,其中第1主成分是妻子受教育年限≤9年和妻子未正確服用葉酸； 4、經(jīng)多因素Logistic回歸分析,進(jìn)入回歸方程(P0.05)的有妻子年齡20歲或34歲(OR值=0.902)、妻子孕前BMI低于或高于標(biāo)準(zhǔn)BMI(OR值=1.116)、妻子妊娠早期被動吸煙(OR值=4.618)、妻子妊娠早期陰道流血(OR值=5.125)： 5、21個(gè)育齡夫婦不良妊娠結(jié)局影響因素的構(gòu)成中,歸類于上游水平的影響因素1個(gè),歸類于中游水平的影響因素5個(gè),歸類于下游水平的影響因素15個(gè)。 結(jié)論：祥云縣農(nóng)村育齡夫婦不良妊娠結(jié)局的影響因素中,對不良妊娠結(jié)局影響程度最大的是妻子的受教育年限≤9年和未正確服用葉酸,影響程度次之的是夫婦孕前體格檢查的各項(xiàng)生理指標(biāo),影響程度較小的是夫婦心理、行為生活方式,其中不良妊娠結(jié)局的影響因素主要集中在歸類于下游水平的相關(guān)因素中。 建議：不良妊娠結(jié)局的三級預(yù)防應(yīng)當(dāng)結(jié)合育齡夫婦不同方面的各種影響因素,級預(yù)防應(yīng)以推進(jìn)孕前優(yōu)生健康檢查、免費(fèi)增補(bǔ)葉酸、優(yōu)生優(yōu)育健康教育為主,二級預(yù)防應(yīng)以早發(fā)現(xiàn)、早診斷、早治療不良妊娠結(jié)局為主,三級預(yù)防應(yīng)以新生兒疾病篩查為主。
[Abstract]:Objective: by investigating the pregnancy outcome of married couples of childbearing age in Xiangyun County, Dali, by using statistical methods and combining "health ecology model", the analysis of five aspects of the individual situation, psychological and behavioral lifestyle, life working environment, early pregnancy and pre pregnancy physical examination may lead to bad results. The influencing factors of pregnancy outcome, and the analysis of the influencing factors combined with the theoretical framework of this study, are classified into the upper, middle and lower levels to discuss the relationship between the various factors and the adverse pregnancy outcome, and provide the basis for the formulation of the three level prevention strategy for the bad pregnancy outcome in Xiangyun County.
Methods: This study selected 1060 pairs of childbearing age couples in Xiangyun County, Dali, in January 1, 2009, 0 -2010 and 24 in December 31st, using a retrospective survey and analysis method. The questionnaire collected qualitative and quantitative data by self-made questionnaire, with the personal situation, psychological and behavioral lifestyle, life working environment and pregnancy induced pregnancy in the couples of childbearing age. Five major factors, such as early pregnancy and pre pregnancy physical examination, were independent variables. With pregnancy outcome as the dependent variable, a single factor unconditional Logistic regression analysis was carried out according to the level of alpha =0.05, and a statistical correlation factor (P0.05) was selected for the adverse pregnancy outcome (P0.05), and the related factors were selected according to the level of alpha =0.05. Multivariate Logistic regression analysis and principal component analysis were used.
Result錛，

本文編號：1940544