重庆市计划妊娠人群健康现状及风险因素分析

发布时间：2019-06-11 09:32

【摘要】：目的:调查重庆市计划妊娠人群的健康现状,分析该类人群的健康状况在不同的年龄段、文化程度、职业、民族等等之间的分布,依照孕前优生健康检查风险评估标准对计划妊娠人群进行评估分类,探讨风险人群的影响因素,为改善重庆市计划妊娠人群的健康状况提供科学依据,促进优生优育。方法:本研究按地区分层依照每个地区计划妊娠人口的比例进行多阶段整群随机抽样。在全市40个区县抽取符合生育政策的共10786人即5393对计划妊娠夫妇进行问卷调查和相关的体格检查。调查计划妊娠人群的人口社会学特征、既往疾病史、孕育史、家族史、不良生活习惯、环境有毒有害物质接触史、社会心理压力因素并进行健康体检。回收有效问卷9384份,回收率为87%。采用Epi Data3.2统计软件建立数据库,用双录的方式录入数据,按照孕前优生风险评估标准对计划妊娠人群进行分类,并依此划分为一般人群和风险人群。用SPSS17.0统计软件对样本资料进行统计学分析,用现况调查的方法进行研究,计数资料用率、构成比进行描述,对相关因素与风险人群的关系进行卡方检验。对可能影响计划妊娠人群的健康风险因素采用多因素非条件Logistic回归分析。结果1.重庆市9384名即4692对计划妊娠夫妇中,男性参检人群中风险人群占5.86%,一般人群占比94.14%;女性参检人群中风险人群占28.64%,一般人群占比71.36%;风险人群比例较低;2.经单因素分析,检出男性风险人群的危险因素有年龄(χ2=14.5723,P=0.0001)、地区(χ2=31.5502,P0.0001)、乙肝疾病史(χ2=60.9689,P0.0001)、乙肝疫苗接种史(χ2=12.6811,P=0.0004)、体重指数异常(χ2=6.5551,P=0.0377)、血压异常(χ2=6.1461,P=0.0132)、HBs Ab(χ2=842.0512,P0.0001);经多因素logistic回归分析,有统计学意义的结果中:乙肝疾病史(OR=6.587)、BMI≥24.00(OR=1.577)、高血压(OR=1.836)是男性风险人群的危险因素;而20≤年龄35(OR=0.613)、渝东南生态保护区相对于都市功能核心区(OR=0.434)、乙肝疫苗接种史(OR=0.608),HBs Ab阳性(OR=0.383)是男性风险人群的保护因素。3.经单因素分析,检出女性风险人群相关的危险因素有地区(χ2=45.4756,P0.0001)、民族(χ2=5.8426,P=0.0156)、文化程度(χ2=94.9953,P0.0001)、职业(χ2=25.4574,P=0.0004)、乙肝疾病史(χ2=6.0067,P=0.0143)、风疹疫苗接种史(χ2=8.2669,P=0.0040)、生活/工作压力(χ2=11.6018,P=0.0007)、经济压力(χ2=12.9845,P=0.0003)。经多因素logistic回归分析,有统计学意义的结果中:地区中城市发展新区(OR=1.641)、渝东北生态涵养发展区(OR=1.65)、渝东南生态保护区(OR=2.028)相对于都市功能核心区、乙肝疾病史是女性风险人群的危险因素;而文化程度中高中(OR=0.114)和大学(OR=0.371)相对于小学及以下、工人相对于农民(OR=0.656)、风疹疫苗接种(OR=0.686)是女性风险人群的保护因素。结论本研究通过分析重庆市9384名(4692对夫妇)计划妊娠人群健康现状和风险研究,分别从社会人口学特征、体格检查、实验室检查情况分析,并依照风险因素进行分类,对相关风险因素进行统计学分析。得出如下结论:1.本文通过健康检查、风险评估,结果显示,重庆市计划妊娠人群总体健康状况较好,风险人群所占比例较低;2.重庆市计划妊娠人群中,风险人群中女性比男性比例高,应加强对女性计划妊娠人群的孕前保健工作,引导女性增强优生优育意识,增加医疗保健服务的利用率;3.乙型肝炎疾病史、肥胖、高血压是男性风险人群的主要危险因素。适龄生育、适宜环境和乙肝表面抗体阳性是男性风险人群的保护因素。应对男性加强宣传教育,加强男性计划妊娠人群的健康管理,避免危险因素;4.女性风险人群的危险因素是乙型肝炎疾病史、地区经济水平落后、职业暴露。保护因素是文化程度高、职业暴露少和接种风疹疫苗。应积极提高女性的受教育程度,增强女性的自我保健意识,提高自我保护能力。
[Abstract]:Objective: To investigate the health status of the pregnant population in Chongqing, and to analyze the distribution of the health status of the population in different age groups, the degree of culture, the occupation, the nationality and so on. To explore the influencing factors of the risk population, to provide the scientific basis for improving the health status of the pregnant women in Chongqing, and to promote the good and healthy development. Methods: A multi-stage cluster random sampling was conducted according to the proportion of the pregnant population in each district according to the regional stratification. A total of 107,86 persons,5393, who were in line with the reproductive policy in 40 districts of the city, were investigated and the relevant physical examination was conducted. The demographic and social characteristics of the pregnant population of the planned pregnancy, the history of previous diseases, the history of inoculation, the family history, the bad living habits, the contact history of the toxic and harmful substances in the environment, the factors of social stress and the physical examination of the health were investigated. The effective rate of recovery was 9384 and the recovery rate was 87%. The database was established by using Epi Data3.2 statistical software, and the data were recorded in a two-record manner. The planned pregnancy population was classified according to the pre-pregnancy risk assessment standard and classified into the general population and the risk group. The statistical analysis of the sample data was carried out by using the SPSS17.0 statistical software, and the method of current status investigation was used to study the data rate and the composition ratio, and the relationship between the related factors and the risk population was chi-square test. A multi-factor, non-conditional logistic regression analysis was used for the health risk factors that might affect the planned pregnancy population. Results 1. Of the 9384 pregnant couples in Chongqing, the risk group was 5.86%, the general population was 94.14%, the risk group was 28.64%, the general population was 71.36%, and the proportion of the risk group was lower. The risk factors of the male risk group were analyzed by single factor analysis. The risk factors of the male risk group were age (2 = 14.5723, P = 0.0001), the history of hepatitis B (2 = 60.9689, P.0001), the history of hepatitis B vaccine (2 = 12.6811, P = 0.0004), the body weight index was abnormal (Sup2 = 6.5551, P = 0.0377), and the blood pressure was abnormal (Sup2 = 6.1461, P = 0.0132). The history of hepatitis B disease (OR = 6.587), BMI of 24.00 (OR = 1.577) and high blood pressure (OR = 1.836) were the risk factors of the male risk group, and 20% of age 35 (OR = 0.613). Compared with the core area of urban function (OR = 0.434), the history of hepatitis B vaccination (OR = 0.608), the positive of HBs Ab (OR = 0.383) was the protection factor of the male risk group. The risk factors associated with the women's risk groups were analyzed by single factor analysis (2 = 45.4756, P = 0.0156), nationality (Sup2 = 5.8426, P = 0.0156), degree of culture (Sup2 = 94.9953, P.0001), occupation (Sup2 = 25.4574, P = 0.0004), history of hepatitis B (2 = 6.0067, P = 0.0143), and history of vaccination with rubella (Sup2 = 8.2669, P = 0.0040). Life/ working pressure (Sup2 = 11.6018, P = 0.0007), Economic pressure (Sup2 = 12.9845, P = 0.0003). Based on the multi-factor logistic regression analysis, there are statistical significance: in the region, the urban development new area (OR = 1.641), the northeast-Chongqing ecological conservation and development area (OR = 1.65), and the southeast-southeast ecological protection area (OR = 2.028) are relative to the core area of the urban function, and the history of the hepatitis B disease is the risk factor of the female risk group; The high school (OR = 0.114) and the university (OR = 0.371) in the degree of culture were compared with the primary and the following, and the worker was relative to the farmer (OR = 0.656), and the rubella vaccination (OR = 0.686) was the protection factor for the female risk population. Conclusion The present study analyzed the health status and risk of 9384 (4692 couples) in Chongqing, and analyzed the relevant risk factors from the social and demographic characteristics, physical examination and laboratory examination, and classified them according to the risk factors. The following conclusions are drawn:1. The results of health examination and risk assessment show that the overall health status of the pregnant population in Chongqing is good, and the proportion of the risk population is lower; In the pregnant population of Chongqing, the proportion of women in the risk group is higher than that of the male, and the pre-pregnancy health-care work of the pregnant population of the female plan should be strengthened to guide the female to enhance the awareness of the quality and care and increase the utilization rate of the health care service; Hepatitis B disease history, obesity, hypertension are the main risk factors of the male risk population. Age-appropriate fertility, proper environment and positive anti-hepatitis B antibody are the protective factors of the male risk population. To strengthen the publicity and education of men, strengthen the health management of the male plan pregnant population, and avoid the risk factors;4. The risk factors of the female risk group are the history of the hepatitis B disease, the backward of the regional economy and the occupational exposure. The protection factor is the high degree of culture, the low occupational exposure and the vaccination of rubella. The education of women should be improved, the self-care consciousness of women should be enhanced, and the self-protection ability should be improved.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R169.1

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