基于湖南省第1次卫生服务调查分析孕产期妇女产前检查和#br# 产后访视情况及其影响因素

目的：利用湖南省第1次卫生服务调查数据，评价湖南省2008年至2013年孕产期妇女产前检查和产后访视情况并分析其影响因素。方法：采用2013年湖南省第1次卫生服务调查中孕产期妇女产前检查和产后访视的数据，根据2009年国家基本公共卫生服务规范中孕产期妇女须进行5次及以上产前检查和2次及以上产后访视的要求，计算产前检查和产后访视未达标率，采用率和构成比描述产前检查和产后访视情况，利用logistic回归模型，分析影响产前检查和产后访视未达标率的因素。结果：本研究共纳入1 035名妇女，其中产前检查未达标率为40.12%(95% CI：24.91%~55.33%)，产后访视未达标率为64.88%(95% CI：39.70%~90.06%)。调整其他因素后，相较于最低收入家庭，中等、较高收入家庭妇女产前检查未达标率较低，其优势比分别为0.41和0.39；相较于初产妇，经产妇的产前检查未达标率较高，优势比为1.54；相较于15~24岁妇女，25~34，35~64岁组妇女的产后访视未达标率较低，其优势比分别为0.45和0.37；相较于最低收入家庭，较低、中等、较高收入家庭妇女产后访视未达标率较低，其优势比分别为0.50，0.46和0.54；相较于初产妇，经产妇的产后访视未达标率较高，优势比为2.30。结论：湖南省孕产期妇女产前检查和产后访视未达标率较高，当地政府部门可对低收入家庭、低年龄组、经产妇人群等采取措施，以降低未达标的 比例。

Analysis of the status and influential factors for prenatal care and postpartum visit among pregnant women based on the First Health Service Survey in Hunan Province

Objective: To evaluate the status and influential factors for prenatal care and postpartum visit among pregnant women in Hunan Province from 2008 to 2013 based on the data from the First Health Service Survey in Hunan Province. Methods: Based on the data of prenatal care and postpartum visit among pregnant women from the First Health Service Survey of Hunan Province in 2013, proportion of pregnant women, who didn’t meet the criteria for prenatal care and postpartum visit, were calculated (≥5 times for prenatal care and ≥2 times for postpartum visit, according to the National Basic Public Health Service program, 2009 Edition). Multivariable logistic regression models were used to identify the influencial factors. Results: A total of 1 035 eligible women were included in data analysis. The proportion of pregnant women who did not meet the criteria were 40.12% (95% CI 24.91%-55.33%) for prenatal care and 64.88% (95% CI 39.70%-90.06%) for postpartum visit. After adjusting other confounding factors, pregnant women with middle- and high-income had lower proportions of not meeting the criteria than those with low-income, with adjusted odds ratios of 0.41 and 0.39, respectively. Multiparae had higher proportion of not meeting the criteria than primiparas, with adjusted odds ratio of 1.54, and pregnant women with age 25-34 years and 35-64 years had lower proportions of not meeting the criteria than those with age 15-24 years. In term of postpartum visit, pregnant women with middle- to high-income had lower proportions of not meeting the criteria than those with low-income, with adjusted odds ratios of 0.50, 0.46 and 0.54, respectively; multiparae had higher proportion of not meeting the criteria than primiparas, with the adjusted odds ratio of 2.30. Conclusion: Proportions of pregnant women of not meeting the criteria are high in Hunan Province. Local government should strengthen the management to decrease the proportions of pregnant women who do not meet the standard in prenatal care and postpartum visit, especially for those mulparae with low family income and young age.