高原与平原地区围产期保健相关因素分析

Health Care-related factors for perinatal women in altitude and plain region

  • 摘要: 目的 研究高原地区产妇孕期保健及产科干预措施与平原地区的差异,以期提高高原地区的产科质量。方法 收集并总结2009年10月-2010年9月高原地区(高原组)及平原地区(平原组)住院分娩产妇667例的临床资料,将孕期保健、产科并发症、剖宫产率及围产儿出生等相关情况进行多因素分析。结果 高原组产妇孕期定期产前检查率(10.34%)显著低于平原组(94.67%),P<0.01;妊娠期高血压病、羊水过少为高原组产科并发症前两位,发生率分别为13.34%和9.15%,显著高于平原组(P<0.01);高原组剖宫产率(20.54%)低于平原组(40.17%),P<0.01;高原组足月新生儿平均出生体质量(3 095.17±433.53)g低于平原组(3 487.32±468.89)g,P<0.01;高原组新生儿窒息率(5.10%)、早期新生儿死亡率(0.75%)、足月低出生体重儿发生率(5.85%)均高于平原组,P<0.05。结论 普及妇幼卫生知识,加强孕产妇系统管理,积极防治产科并发症特别是妊娠期高血压和羊水过少,提高医疗技术及加大必要医疗设备投入,是提高高原地区产科质量的重要措施。

     

    Abstract: Objective To study the difference of health care for pregnant women and obstetric interfere measures in altitude and plain region in order to improve the health care in altitude region. Methods Clinical data about 667 hospitalized parturients in altitude region(altitude group) and plain region(plain group) from October 2009 to September 2010 were collected.Factors related with health care,obstetric complications,children birth rates by cesarean section and in perinatal period were analyzed by multivariate analysis. Results The regular antenatal examination rate for pregnant women was significantly lower in altitude group than in plain group(10.34% vs 94.67%,P<0.01).The incidence of hypertension and hypamnion was 13.34% and 9.15%,respectively,in altitude group,which was significantly higher than that in plain group(P<0.05).The children birth rate by cesarean section was significantly lower in altitude group than in plain group(20.54% vs 40.17%,P<0.01).The average body weight of full-term neonates was lower in altitude group than in plain group(3 095.17±433.53g vs 3 487.32±468.89g,P<0.01).The incidence of asphyxia,early mortality,and low birth weight in neonates was 5.10%,0.75% and 5.85% in altitude group,which was higher than that in plain group(P<0.05). Conclusion Popularizing the knowledge of maternal and child health,strengthening the management of pregnant and parturients,actively preventing and treating obstetric complications especially hypertension and hypamnion,improving medical techniques and equipments are the important measures for improving the health care in altitude region.

     

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