不同性质助产机构分娩产妇围产保健获取情况比较

目的调查不同性质助产机构产妇的围产保健获取情况,分析在孕产妇系统管理方面存在的差距,明确围产保健工作重点。方法采用分层整群随机抽样方法,抽取2014年4~6月在广州市花都区妇幼保健机构、三级综合公立医院、一级综合公立医院和民营助产机构各一间住院分娩产妇共1406例,回顾性分析其围产保健获取情况。结果高危妊娠三级转诊得到较好落实,一级医院（27.61%）和民营医院（7.46%）高危壬辰比例明显低于妇幼保健机构（61.07%）和三级医院（53.65%）。妇幼保健机构分娩产妇围产保健获取情况整体优于其他医疗机构。民营医疗机构以流动人口为主,占72.03%,产妇围产保健获取比例较低。结论加强孕期保健宣教和流动人口管理,提高群众孕产期保健意识,针对不同性质助产机构产妇的特点,采取针对性措施,提高孕产妇的生殖保健水平。     

不同程度妊娠肝内胆汁淤积症与围产儿预后的关系

目的　探讨妊娠肝内胆汁淤积症 (intrahepaticcholestasisofpregnancy ,ICP)患者胆汁酸、转氨酶和胆红素变化与围产儿预后的关系。　方法　将 116例妊娠肝内胆汁淤积症患者根据血清总胆汁酸、谷丙转氨酶及总胆红素的变化分为轻、中、重 3组 ,对其分娩方式、围产儿结局进行比较。　结果　羊水污染发生率、新生儿窒息率、剖宫产率各组均有显著性差异 (P <0 .0 5或P <0 .0 1)。　结论　妊娠肝内胆汁淤积症患者胆汁酸愈高 ,肝功能损害愈重剖宫产率愈高 ,围产儿预后愈差。     

Perinatal Survival and Predictors of Mortality among Mothers with Hypertensive Disorders of Pregnancy at Antenatal care Clinics in Gamo Zone Public Hospitals

BackgroundPregnancy induced hypertension represents a significant public health problem throughout the world, which may complicate 0.5%–10% of all pregnancies. It is the leading cause of maternal as well perinatal mortality and morbidity worldwide. Pregnancy induced hypertension is a multisystem disorder unique to pregnancy and results in high perinatal mortality. The objective of this study was to determine the survival status, incidence and predictors of perinatal mortality among mothers with pregnancy induced hypertension at antenatal clinics of Gamo Zone public hospitals.MethodsFacility-based retrospective cohort study was conducted among selected 576(192 exposed and 384 unexposed) antenatal care attendants'' record at Gamo Zone public hospitals from 1^st January 2018 to 31^st December 2018. Data were entered into Epi data version 3.02 and exported to SPSS V 25 for analysis. Kaplan Meier survival curve together with log rank test was fitted to test the survival time. Statistical significance was declared at P-value ≤0.05 using cox proportional hazard model.ResultThe incidence of perinatal mortality was 124/1000 births. The cumulative proportion of surviving at the end of 4^th, 8^th, 12^th and 16^th weeks of follow-up among the exposed groups was 96.9%, 93.5%, 82.1% and 61.6% respectively whereas it was 99.5%, 98.9% and 98.5% at the end of 4^th, 8^th and 12^th weeks of follow-up for the non-exposed groups respectively. Parity of ≥5(AHR: 6.3; 95%CI: 1.36,10.55), mothers who delivered at <34 weeks of gestation(AHR:7.8; 95%CI: 2.6,23.1), being preterm(AHR:6; 95%CI: 5.3,19.2), perinatal birth weight ≤2500gm(AHR:6.1; 95&CI: 1.01,37.9), vaginal deliveryn(AHR:2.7; 95%CI:1.13,6.84), maternal highest systolic blood pressure level ≥160mmHg (AHR: 2.3; 95%CI: 1.02,5.55) and prepartum onset of pregnancy induced hypertension (AHR: 6; 95%CI: 5.3,19.2) were statistically significant in multivariable analysis.ConclusionThe risk of perinatal mortality was high among the mothers with pregnancy induced hypertension compared to those of pregnancy induced hypertension free mother,s and the perinatal mortality rate was high. High parity, low gestational age, low number of antenatal care visits, low birth weight, vaginal delivery, antepartum onset of pregnancy induced hypertension and highest maternal systolic blood pressure level were the independent predictors of perinatal mortality.     

围产保健与妊高征的发生及其母儿并发症

为探讨产前保健对妊高征发病率和母儿并发症发生率的影响，根据妊高征治疗的阶段性变化，回顾分 析了北京妇产医院１９８０年１月～１９９８年１２月期间４个阶段的妊高征病例。结果显示：妊高征总发病率逐年降低，而 重度妊高征的发病率相对升高。在该院无产前检查的重度妊高征比例显著增加，在妊高征并发死胎和早期新生儿死亡病 例中，无产前检查者显著增加，子痫孕妇中大部分为无产前检查者并来源于外地。因此作者认为，加强产前保健可以降 低妊高征的发病率，只有更大范围地健全和加强围产保健，才能降低妊高征对母儿的危害。     

How families of children with complex care needs participate in everyday life

While we have some understanding of the impact caring for children with complex care needs has on families, little is known about how these families experience participation. This longitudinal qualitative study aimed to extend our limited understanding of how the changing geographies of care influence the ways that Canadian families with children with complex care needs participate in everyday life. The findings in this article focus on parents' conceptualizations of participation including their perspectives of participation involving themselves, their children, and their family unit. Sixty-eight parents from 40 families took part in the study. Conradson's (2005) conceptualization of therapeutic landscapes that focuses on the relational dimensions of the self-landscape encounter guided the study. Data collection methods included ethnographic methods of interviewing and photovoice. As a summary of their views, parents within this study described participation as a dynamic and reciprocal social process of involvement in being with others. For participation in everyday life to be meaningful, the attributes of choice, safety, acceptance, accessibility, and accommodation had to be present. Participation was valued by parents because it resulted in positive outcomes. Overall, meaningful participation contributed to them and their children having a life. Having a life referred to being involved in a place where families feel that they belong, are accepted, and are able to contribute to the landscape they participate in. The decision to choose to participate became contingent upon the availability of resources and the parents' ability to harness them. Harnessing resources referred to the work parents must do to get the necessary resources to make it possible for them and their children to have a life. Having a life for parents required significant physical, mental, psychological and spiritual work by parents. At times the personal resources of parents were so taxed that the possibility for meaningful participation was something less than what they desired. The families' stories raise questions of societal obligations to promote meaningful participation. This study lends support for further improvements that may enrich the lives of families with children with complex care needs.     

陕西省农村育龄妇女围孕期产检次数与新生儿低出生体重间关系的研究

目的 探讨陕西省农村地区育龄妇女围孕期产检次数与新生儿低出生体重（LBW）间的关系。方法 采用分层多阶段随机抽样方法,以问卷调查方式收集2010－2013年陕西省农村地区怀孕且结局明确的育龄妇女及其子女的相关信息。计数资料采用百分比描述,计量资料采用x±s描述,率的比较采用 χ²检验。将新生儿是否为LBW及围孕期产检次数分组分别作为因变量和自变量纳入广义多因素Poisson回归模型,同时控制相关混杂因素进行分析。结果 2010－2013年18 911名农村育龄妇女末次怀孕结局所生育的活产单胎新生儿中LBW发生率为3.75%。围孕期产检次数最多为15次（0.70%）,最少为0次（0.70%）,平均为（5.65±2.74）次;其中≥10次占12.37%,≥7次占28.52%,≥5次占62.80%,< 4次占21.49%。广义Poisson回归显示,在控制其他混杂因素后,各比较组与参照组相比,差异均有统计学意义,围孕期产检次数< 4次组新生儿LBW发生率是> 7次组的1.61倍（OR=1.61,95%CI：1.31～2.00）,< 4次组是4～7次组的1.23倍（OR=1.23,95%CI：1.04～1.45）。结论 陕西省农村地区育龄妇女随着围孕期产检次数的增多,新生儿LBW发生率逐渐降低。     

Perinatal Outcomes and Associated Factors among women with hypertensive Disorders of Pregnancy Delivered in Jimma Zone Hospitals,Southwest Ethiopia

BackgroundHypertensive disorders of pregnancy are multisystem diseases that increase the risk of adverse perinatal outcomes worldwide. It Led to early and late serious health consequence on the baby, with a significant proportion occurring in low-income countries. Hence the objective of this study was to determine perinatal outcomes and associated factors among women with hypertensive disorders of pregnancy delivered in Jimma zone hospitals.MethodA Facility based cross-sectional study design was employed from March to May 2020 on 211 hypertensive women delivered in the four randomly selected hospitals. The data were collected by reviewing medical record and face to face interview using consecutive sampling technique. Binary and multivariable logistic regression was performed to identify association.ResultNinety-one (43.1%) of fetuses developed unfavorable perinatal outcome. Inability to read and write (AOR=2.5; 95% CI:1.03–6.17), being primipara (AOR=4.6; 95% CI:1.6–13.2) and multi-para (AOR=3.1; 95% CI:1.09–9.17), Lack of antenatal care visit (AOR=4.2; 95% CI:1.2–15.01), having preeclampsia (AOR=4.2; 95% CI:1.1–16.6) and eclampsia (AOR=5.8; 95% CI:1.2–26.2) and late provision of drug (AOR=3.9;95% CI:1.9–7.9) were independent factors.ConclusionPregnancy complicated with hypertensive disorders was associated with increased unfavorable perinatal outcomes. Preeclampsia and eclampsia, inability to read and write, primipara and multipara, lack of antenatal care and late provision of drug were factors associated with unfavorable perinatal outcomes.     

Maternal healthcare for women with physical disabilities in Northern Vietnam: perspectives of healthcare providers

BackgroundPregnancy among women with physical disabilities is common around the world; however, there are limited qualitative studies that explore the perspectives of healthcare providers toward pregnant women with disabilities outside of the Global North.ObjectiveThis article explores perspectives and experiences of maternal healthcare providers in the delivery of services to women with physical disabilities in Northern Vietnam.MethodsSemi-structured interviews were conducted with 14 healthcare providers who worked in public and/or private healthcare North Vietnamese facilities where maternal services were provided. Data were thematically analyzed.ResultsThe participants included six males and eight females. Ten were obstetricians/gynecologists, one was a doctor specializing in obstetric imaging diagnosis, three were midwives, and one was a midwife/assistant doctor. Four themes were identified. In the first theme, providers attached provisos to the right to motherhood including the view that the women were limited to one child and should undergo prenatal screenings for fetal abnormalities. In the second theme, the providers reported that disability was not incorporated into their education; this led to half of them lacking confidence in providing appropriate maternal healthcare services for women with physical disabilities. The third theme found that although women with physical disabilities were considered as a priority group, decisions around who was seen before others or provided with fee discount/exemption were left in the hands of staff. The fourth theme identified that some providers overlooked their needs for physical accessibility and independence.ConclusionThis study shows that maternal healthcare providers in Vietnam discounted the needs of women with physical disabilities. The needs of women with disabilities should be included in the training of maternal healthcare providers in Vietnam.     

Trauma-informed co-production: Collaborating and combining expertise to improve access to primary care with women with complex needs

Introduction

Health, social care, charitable and justice sectors are increasingly recognising the need for trauma-informed services that seek to recognise signs of trauma, provide appropriate paths to recovery and ensure that services enable people rather than retraumatise. Foundational to the development of trauma-informed services is collaboration with people with lived experience of trauma. Co-production principles may provide a useful framework for this collaboration, due to their emphasis on lived experience, and intent to address power imbalances and promote equity. This article aims to examine trauma-informed and co-production principles to consider the extent to which they overlap and explore how to tailor co-production approaches to support people who have experienced trauma.

Methods

Bridging Gaps is a collaboration between women who have experienced complex trauma, a charity that supports them, primary care clinicians and health researchers to improve access to trauma-informed primary care. Using co-production principles, we aimed to ensure that women who have experienced trauma were key decision-makers throughout the project. Through reflective notes (n = 19), observations of meetings (n = 3), interviews with people involved in the project (n = 9) and reflective group discussions on our experiences, we share learning, successes and failures. Data analysis followed a framework approach, using trauma-informed principles.

Results

Co-production processes can require adaptation when working with people who have experienced trauma. We emphasise the need for close partnership working, flexibility and transparency around power dynamics, paying particular attention to aspects of power that are less readily visible. Sharing experiences can retrigger trauma. People conducting co-production work need to understand trauma and how this may impact upon an individual's sense of psychological safety. Long-term funding is vital to enable projects to have enough time for the establishment of trust and delivery of tangible results.

Conclusions

Co-production principles are highly suitable when developing trauma-informed services. Greater consideration needs to be given as to whether and how people share lived experiences, the need for safe spaces, honesty and humility, difficult dynamics between empowerment and safety and whether and when blurring boundaries may be helpful. Our findings have applicability to policy-making, funding and service provision to enable co-production processes to become more trauma-informed.

Public Contribution

Bridging Gaps was started by a group of women who have experienced complex trauma, including addiction, homelessness, mental health problems, sexual exploitation, domestic and sexual violence and poverty, with a general practitioner (GP) who provides healthcare to this population, alongside a support worker from the charity One25, a charity that supports some of the most marginalised women in Bristol to heal and thrive. More GPs and healthcare researchers joined the group and they have been meeting fortnightly for a period of 4 years with the aim of improving access to trauma-informed primary care. The group uses co-production principles to work together, and we aim to ensure that women who have experienced trauma are key decision-makers throughout our work together. This article is a summary of our learning, informed by discussion, observations and interviews with members of the group.     

免费建册在流动人口孕产妇系统保健管理中的作用

目的探索在流动人口孕产妇系统保健管理中免费为其建立孕产妇保健手册(建册)的作用。方法回顾性分析上海市静安区2007-2011年流动人口孕产妇系统保健情况年度报表数据。结果 2007-2011年每年度早孕建册率和系统保健管理率分别为31.96%、28.90%;49.48%、48.70%;53.54%、47.63%;69.33%、66.84%;83.92%、83.33%。结论免费建册的举措可以吸引更多的流动人口孕妇及早建册,从而提高早孕建册率和系统保健管理率,但对降低产后拒访率作用不明显。     

农村地区已婚妇女围生期保健认知现状调查

目的:了解农村地区已婚妇女围生期保健知识掌握状况、获取途径以及当地医疗卫生资源利用状况,分析造成这种状况的影响因素,以便为今后开展有针对性的干预措施提供依据。方法:自行设计问卷,对山东省部分农村地区已婚妇女进行围生期保健知识调查并对结果进行统计分析。结果:农村地区已婚妇女已具有一定的围生期保健知识,但掌握水平有待进一步提高;围生期保健知识获取途径比较单一,医疗卫生资源利用不足。结论:相关部门应根据农村地区特点,开展有针对性的围生期健康教育。     

中国老年人口的健康、负担及家庭照料

随着我国人口的老龄化，失能老年人口数量和比重将会有较大程度的增加，有更多的老年人需要长期护理与照顾。由家庭提供长期护理越来越难以维持，因此，由正式机构提供的长期护理将会有很大的发展空间，我国对于老年人口长期护理的负担将会有很大的增长。     

Collaborative care needs and preferences of primary care patients with multimorbidity

OBJECTIVE To explore the collaborative care needs and preferences in primary care patients with multiple chronic illnesses. DESIGN Focus groups utilizing a series of open-ended questions elicited self-identified problems, experiences in communicating with providers, self-management needs, and preferences for monitoring and follow-up. Responses were organized and interpreted in light of the essential elements of collaborative care for chronic illness. SETTING AND PARTICIPANTS Sixty patients having two or more chronic illnesses at eight geographically dispersed primary care clinics within the Veterans Health Administration in the United States. RESULTS Identified problems included poor functioning, negative psychological reactions, negative effects on relationships and interference with work or leisure. Polypharmacy was a major concern. Problematic interactions with providers and the health care system were also mentioned, often in relation to specialty care and included incidents in which providers had ignored concerns or provided conflicting advice. Most participants, however, expressed overall satisfaction with their care and appreciation of their primary care physicians. Knowledge and skills deficits interfered with self-management. Participants were willing to use technology for monitoring or educational purposes if it did not preclude human contact, and were receptive to non-physician providers as long as they were used to augment, not eliminate, a physician's care. CONCLUSIONS Findings are consistent with the basic tenets of patient-centred, collaborative care, and suggested that health care can be organized and delivered to meet the complex needs of patients with multimorbidity.     

General health,health conditions,and current pregnancy among U.S. women with and without chronic physical disabilities

BackgroundAlthough increasing numbers of reproductive-age U.S. women with chronic physical disabilities (CPD) are becoming pregnant, little is known about their general health or comorbid health conditions.ObjectivesTo explore general health and comorbid health conditions among women with and without CPD by current pregnancy status.MethodsWe analyzed responses of 47,629 civilian, noninstitutionalized women ages 18–49 from the 2006–2011 National Health Interview Surveys. The survey asks about: various movement difficulties; selected adult health conditions; self-reported general health; and current pregnancy. We identified women with CPD using responses from 8 movement difficulty questions.Results6043 (12.7%) women report CPD. Among nondisabled women, 3.8% report current pregnancy, as do 2.0% of women with CPD. Among currently pregnant women with CPD, 29.1% report fair or poor health, compared with only 3.2% of nondisabled pregnant women. Currently pregnant women both with and without CPD are significantly less likely to report coexisting health conditions than nonpregnant women. Nonetheless, among currently pregnant women with CPD, only 24.5% report no coexisting conditions, while 28.7% report 1, 22.8% report 2, 13.2% report 3, and 10.8% report 4–6 health conditions. In a multivariable regression controlling for age category, health status, and health conditions, CPD is not statistically significantly associated with current pregnancy.ConclusionsAccording to national survey data, it appears that pregnant women with CPD may have a complex mix of health problems and often experience fair or poor health. Better understanding the obstetrical and subspecialty needs of these women with multimorbidities requires additional investigation.     

妊娠合并心脏病患者不同心功能状态对孕妇及围产儿的影响

目的探讨妊娠合并心脏病患者不同心功能状态对孕妇及围产儿的影响。方法采用回顾性调查的方法,选取本院2011年1月-2013年6月妊娠合并心脏病孕产妇127例,分析孕产妇分娩情况,胎儿和新生儿的生长、并发症等各项指标。结果Ⅲ~Ⅳ级产妇平均分娩孕周(36.07±5.48周)与Ⅰ~Ⅱ级(38.91±7.25周)比较,差异有统计学意义(P0.05);Ⅲ~Ⅳ级顺产为25.45%(14/55),低于Ⅰ~Ⅱ级44.44%(32/72),差异有统计学意义(P0.05);Ⅲ~Ⅳ级终止妊娠为20.00%(11/55),高于Ⅰ~Ⅱ级,差异有统计学意义(P0.05);Ⅲ~Ⅳ级产妇心衰为27.27%(15/55),高于Ⅰ~Ⅱ级2.78%(2/72),差异有统计学意义(P0.05)。Ⅲ~Ⅳ级新生儿平均体重为(2 517.83±260.27)g,明显低于Ⅰ~Ⅱ级(3 201.54±322.42)g,差异有统计学意义(P0.05);Ⅲ~Ⅳ级新生儿窒息、早产儿和围生儿死亡分别为34.55%(19/55)、29.09%(16/55)和10.90%(6/55),均高于Ⅰ~Ⅱ级,差异有统计学意义(P0.05)。结论妊娠合并心脏病患者心脏功能状态与产妇及围产儿结局密切相关,孕产妇心功能越低,早产发生率增高,孕产妇和新生儿并发症增加,新生儿预后较差。应加强监护和治疗,减少孕妇及新生儿的并发症,提高存活率。     

Internet networks as a source of social support for women with mobility disabilities during pregnancy

BackgroundSocial support during pregnancy is important for the health of mother and baby, yet little is known about social support available to women with disabilities during pregnancy. Internet social networks are one emerging source of social support, and social networks may help connect mothers with similar disabilities.ObjectiveTo examine the perceptions of women with mobility impairments about social support received during pregnancy from three sources: women with similar disabilities and previous pregnancy known in-person, women with similar disabilities and previous pregnancy met via online social networks, and healthcare providers.MethodsFor this cross-sectional study, an online survey of women with mobility impairments examining emotional and informational social support during pregnancy was distributed through email lists, social media and snowball recruitment. Wilcoxon signed-rank tests were conducted to examine differences in social support received by source.ResultsResponses from 63 eligible women were received. The majority of participants (n = 32, 51%) were connected both in-person and online to women with similar disabilities who had been pregnant, but 15 women (24%) were not connected to any women with similar disabilities who had been pregnant. Scores for informational social support from women met online were significantly higher than from women known in-person (p < .01) and from healthcare providers (p < .01). Scores for emotional social support from women met online were significantly higher than from women known in-person (p < .05).ConclusionsInterventions promoting online connections may help leverage an underutilized source of social support for women with mobility impairments seeking social support during pregnancy.     

614例重度子痫前期母儿妊娠结局的比较分析

目的:分析重度子痫前期临床特征、妊娠结局及围产儿死亡的预后因素,为提高围产期保健干预提供参考。方法:回顾性分析614例重度子痫前期患者,并根据其发病孕周分为<32周组52例,32～<34周组52例,34～<37周组127例;≥37周组383例。分析患者的一般临床资料、保健情况和妊娠结局,比较产妇并发症及围产儿预后情况。结果:614例重度子痫前期患者中,孕妇死亡2例,子宫切除4例,围产儿总数579例,其中围产儿死亡18例。发病在<32周组和32～<34周组的HELLP综合征、围产儿死亡、出生缺陷、新生儿窒息的比例大于其他两组(P<0.05),而分娩孕周则低于其他两组(P<0.05)。重度子痫前期患者的发病时间与围产儿死亡存在强相关:患者发病孕周<34周的OR值为38.09(1.72～842.86)。结论:34周前发病的重度子痫前期患者容易出现母儿不良预后,且发病越早,母儿预后越差。加强宣教,提高人群的自我保健和及时就诊意识,有利于重度子痫前期早期诊断、早期治疗,减少患者并发症和不良妊娠结局的发生。     

北京市海淀区妊娠期妇女口腔保健认知状况及行为的调查分析

目的:了解北京市海淀区妊娠期妇女对口腔保健知识的知晓度及口腔保健行为的实施状况。方法:对北京市海淀区妊娠期妇女进行问卷调查,内容涉及口腔保健知识及刷牙、使用牙线等口腔保健行为方面的问题,并对结果与妊娠期妇女的学历、家庭月收入进行统计学分析。结果:中等以下学历的妊娠期妇女口腔保健的认知程度及行为明显低于高等学历及研究生以上学历者,而高等学历及研究生以上学历者之间未见明显差异;不同家庭月收入者在口腔保健认知及行为方面未见明显差异;口腔保健行为整体水平欠佳。结论:应继续加强妊娠期妇女的口腔保健教育及行为改进,对中等以下学历者应更加重视。     

不同程度碘缺乏孕妇甲低的发生率及对围产结局的影响

目的:了解不同程度碘缺乏孕妇甲低的发生率及对围产结局的影响。方法:对入选的734例孕妇筛查尿碘,根据尿碘值分为对照组、轻度缺碘组、中度缺碘组和重度缺碘组4组,B超测量甲状腺体积,同时检测孕妇血清TSH、T4、T3、TG、FT3、FT4水平,观察缺碘性甲低的发生率,并随诊新生儿脐血TSH、T4、T3、TG、FT3、FT4水平,与对照组比较,了解不同程度碘缺乏对围产结局的影响。结果:①孕妇亚临床型甲低的发生率为32.29%,对照组、轻度缺碘组、中度缺碘组3组亚临床型甲低的发生率递增,差异有统计学意义(P<0.05);重度缺碘组亚临床型甲低的发生率低于对照组,差异有统计学意义(P<0.01);②孕妇甲低的发生率为5.23%(29/554),对照组为0,轻度缺碘组、中度缺碘组、重度缺碘组甲低的发生率依次递增,差异有统计学意义(P<0.001),缺碘程度与甲低的发生率呈正相关;③甲状腺增大的发生率为87.00%,对照组为0,轻度缺碘组、中度缺碘组、重度缺碘组甲状腺增大的发生率依次升高,差异有统计学意义(P<0.001),同时监测TG含量与甲状腺增大的发生率和缺碘的程度呈正相关(P<0.001);T3、TSH的含量随甲状腺增大的发生率轻度升高(P<0.05);各组甲状腺结节的发生率差异无统计学意义(P>0.05);④新生儿亚甲低的发生率为2.71%,对照组为0,轻度缺碘组、中度缺碘组、重度缺碘组新生儿亚甲低的发生率依次递减,差异有统计学意义(P<0.05);⑤新生儿甲低的发生率为0.36%,全部来自重度缺碘组,与其他各组间差异有统计学意义(P=0.000);⑥妊娠合并症如FGR、妊高征、胎儿宫内窘迫、早产的发生率明显高于对照组,差异有统计学意义(P<0.01);流产、胎死宫内、胎盘早剥、产后出血等的发生率也较对照组高,差异有统计学意义(P<0.05)。结论:①孕妇碘缺乏会使其甲低、亚临床型甲低的发生率增加,甲状腺不同程度增大,增加新生儿甲低、亚临床型甲低的发生率,并可诱发多种围产期合并症;②孕期监测尿碘,异常者监测甲状腺功能,及时发现并积极治疗缺碘性疾病。