阳江市1230例孕产妇的孕产期保健状况调查

目的 了解阳江市1230例孕产妇的孕产期保健现状,为提高孕产期保健质量提供依据.方法 采用分层整群随机抽样方法,对阳江市3个县(区)1230例孕产妇的基本情况,孕期保健知识及服务状况、妊娠分娩期健康状况等4个方面进行人户问卷横断面调查,并对结果进行统计分析.结果 本次研究有效问卷1220份,产妇对孕产期保健知识总体知晓...     

Health literacy and knowledge of antenatal care among pregnant women

Health literacy has a direct impact on pregnancy from the perspectives of both the mother and the baby. This study aimed to determine the level of health literacy and assess the knowledge of antenatal care among pregnant women. From among all pregnant women who presented to the hospital's obstetric polyclinic during the study's timeline, the study group consisted of 460 women who agreed to take part (492 women were invited and a response rate of 93.5% was achieved). A questionnaire prepared based on the literature in line with the study's objectives was completed by the participants under supervision. The Turkish Health Literacy Scale (THLS-32) was used to assess health literacy. In order to determine the women's prenatal care knowledge levels, a total of 20 knowledge-testing statements prepared using the literature were applied, 14 of which were true and six of which were false. The internal consistency of antenatal information questions during pregnancy was made and the Cronbach alpha coefficient was calculated as 0.77. It was determined that 33.9% of the participants had a sufficient level of health literacy. Health literacy was sufficient in young married women (19 years and less) in their first pregnancy and those who had regular reading habits, participated in healthcare activities and received postpartum care at a family health clinic (p < 0.05 for each). While the most accurately evaluated statement about antenatal care was ‘It is normal to experience nausea/vomiting in the first trimester of pregnancy’, the least accurately evaluated statement was ‘Over 35% of women incorrectly believed it was normal to gain 20 kg of weight during pregnancy’. It was found that pregnant women with sufficient health literacy had higher levels of knowledge about antenatal care (p < 0.05). In this study, it was determined that approximately two-thirds of the participants had insufficient health literacy and the women with insufficient health literacy had low levels of knowledge about antenatal care.     

正念疗法对孕妇心理健康的影响

由于特殊的生理心理状态，妊娠分娩可能导致女性心理压力增高，从而影响妊娠结局并导致产后抑郁发病率上升。而针对孕妇心理健康的课程及相关研究较少，孕妇的心理健康问题已成为一个迫切需要解决的社会公众问题。正念疗法是一种基于正念的心理干预方法，其核心在于觉察而不评价，为目前心理治疗领域的主流疗法，能有效缓解压力、减轻焦虑与抑郁，促进身心健康。在慢性疾病患者的精神障碍治疗方面，正念疗法得到了广泛应用并取得了明确的效果。在孕妇的心理干预方面，正念疗法也越来越多地得到应用。目前，针对孕妇的正念减压干预方法包括正念分娩和育儿及以正念为基础的分娩教育，能够减轻孕妇自感压力、增强分娩效能，从而有效改善孕妇的心理健康状况。     

对社区孕产妇进行产前健康教育的效果分析

目的探讨进行产前健康教育对社区孕妇分娩所产生的影响。方法自2009年10月至2011年11月期间对所在社区的125例孕妇实施产前健康教育活动,将其作为实验组,再将125例同期在产科门诊进行常规产检的孕妇作为对照组,比较两组孕妇的分娩方式、自然分娩时间、产后出血量及新生儿窒息发生率等。结果实验组孕妇的自然分娩率高于对照组,而实验组孕妇的剖宫产率低于对照组,两组之间相比差异显著(P<0.05);对照组的第一产程、第二产程与第三产程时间与实验组相比均较长,两组相比差异显著(P<0.05);对照组产后出血例数与新生儿窒息率均高于实验组(P<0.05),两组相比差异具有统计学意义。结论对孕妇在产前进行健康教育能够有效避免产前与产后发生并发症,对保证母婴身体健康具有重要意义。     

吉林省孕产妇母婴健康素养影响因素调查分析

目的调查并分析吉林省孕产妇母婴健康素养现状及影响因素,为提出妇幼健康工作策略提供参考依据。方法以2018年12月-2019年1月在吉林省助产机构接受助产服务的孕产妇为研究对象,开展问卷调查。结果吉林省孕产妇母婴健康素养具备者比例为15. 8%。年龄23岁及以上、家庭人均月收入1 000~3 000元,参加过孕妇学校是具备健康素养的有利因素(P<0. 05);产后,职业为商业、服务业人员、其他和未就业是具备健康素养的危险因素(P<0. 05)。结论吉林省孕产妇母婴健康素养较低,应进一步提高母婴健康素养水平。     

广州地区976例初产妇孕期健康教育需求分析

目的 探讨孕期妇女对健康教育的需求性.方法 设计自拟问卷,对976例广州地区初产妇进行健康教育需求调查.结果 不同文化程度和工作性质的孕妇对健康教育的需求不同,本科以上学者345人,对健康教育的需求率为100%,与其他文化程度者相比,x2=40.908,P＜0.01,科技工作者、公务员和公司职员均对健康教育有需求(100%);与其他职业者相比,x2=21.084,P＜0.05,问卷结果表明,有664(68.03%)人认为以举办孕妇学校的方式进行教育为首选,830人(85.04%)认为分娩时得到医务人员不断的鼓励和支持需求率最高,849人(86.99%)认为孕期保健知识前10项中以教会自我监测胎动的方法需求率占首位.结论 健康教育能有效提高孕妇的健康知识,帮助孕妇消除紧张恐惧心理,对降低产妇、婴儿死亡率具有重要意义.对孕妇进行健康教育需求调查分析,是制定和完善适合个体化健康教育有效而重要的手段.     

武汉市孕产妇健康的现状研究

目的:了解武汉市孕产妇的健康现状。方法:以2007年7月1日～2008年6月30日期间分娩的22 286例产妇为研究对象,结合孕产妇信息保健系统和孕期保健手册对孕产妇的健康状况进行回顾性分析。结果:2008年武汉市孕产妇死亡率为11.09/10万,2003年～2008年武汉市孕产妇死亡率呈现出下降趋势。武汉市孕产妇死亡率处于全国较低水平,羊水栓塞、产科出血、妊娠合并心脏病是近年来引起武汉市孕产妇死亡的前3位原因,宫缩乏力是引起产后出血最常见的病因;尽管近5年高危妊娠的发生率不高,但是中心城区和远城区剖宫产率却持续升高,剖宫产率从2003年的46.26%上升至2008年的65.28%。结论:应加强孕产期的系统保健,尤其有必要加强自然分娩优势的宣传,严格把握剖宫产指征,采取各种有力措施降低剖宫产率。     

Improvement in maternal health literacy among pregnant women who did not complete compulsory education: policy implications for community care services

This paper examined factors that influence the improvement in maternal health literacy among pregnant women in Paraguay, including those who did not complete compulsory education but participated in a community-based antenatal care program. Structured interviews were conducted to evaluate the pregnant women's maternal health literacy during their first, second, and third visits to the program in the Caazapa Region. The associations between individual maternal health knowledge scores and its gains, healthcare personnel capabilities, available health facility equipment, community social network, and living environment were analyzed by multiple regression analysis. The mean maternal health knowledge score from 124 women who completed three-consecutive assessments increased between the first and third interviews. Higher capabilities of healthcare personnel and better living environment were significantly related to gains in the maternal health knowledge score (p<0.01). Wider application of a community-based antenatal care program to meet the needs of those who are functionally illiterate in the standard language of the country, training for community healthcare personnel to improve capabilities, and resources for social network in the community would contribute to the improvement in maternal health literacy.     

Improved perinatal health through qualified antenatal care in urban Phnom Penh,Cambodia

Objectives  The aim of this study is to examine the utilities of antenatal care with comprehensive health education qualified in Phnom Penh for the health of mothers and infants during perinatal and postpartum periods. Attention was given to the existing socioeconomic disparties among women in this urban area, and the utilities were discussed irrespective of socioeconomic status. Methods  A total of 436 pregnant women in an urban area in Phnom Penh were selected using a complete survey in randomly sampled villages and were followed up. Participating in antenatal care with comprehensive health education at least three time was regarded as the use of “qualified antenatal care” during pregnancy. In this study, we investigated the independent associations of the use of qualified antenatal care with the following outcome variables after the adjustment for the influence of socieconomic variables: postpartum maternal health knowledge, postpartum maternal anemia, low birth weight, and infant immunization. Results  Of the 314 subjects who completed the follow-up examination, 66.8% used qualified antenatal care during pregnancy. The use of qualified antenatal care was positively associated with postpartum maternal health knowledge (OR=2.38, 95% CI: 1.12–5.05). and reductions in the incidences of postpartum anemia (OR=0.22,95% CI: 0.05–0.95) and low birth weight (OR=0.05,95% CI: 0.01–0.39) after the adjustment of the influence of socioeconomic status. The infants born to mothers who used qualified antenatal care had significantly higher coverage of BCG, DPT₁, and DTP₃ immunizations (P<0.001,P<0.001, andP<0.01, respectively), independent of their socioeconomic conditions. Conclusion  This study shows the solid utilities of qualified antenatal care in Phnom Penh for perinatal health.     

The risk of being ‘too honest’: drug use,stigma and pregnancy

In this article, I examine the ways in which risk is constructed and managed by those involved in the pregnancy and childbirth of women who use drugs, including the women themselves. I discuss how constructions of risk influence maternal care outcomes and the understanding of choice, often in the form of stigmatisation. In this article, I draw on data from a qualitative research study that I conducted in 2011 in a western Canada city in which I interviewed 13 pregnant and parenting women who had used drugs during their pregnancy. In this article, I show how the everyday risk construction of pregnancy, labour and delivery is compounded significantly by drug use and the stigmatisation associated with this perceived risk-taking behaviour. The participants in the study often internalised this understanding of risk and this manifested itself in delays in accessing maternal health and social care services. The women in the study had different understandings of risk and these were structured by the women’s own understanding of general risk factors during their pregnancy, as well as their experiences of the constructions of risk and risk management by health and social care professionals. While structural life chances can constrain women’s feelings of self-efficacy, services that promote clients’ ability to make choices can facilitate reduced stigmatisation and facilitate the development of more compassionate and autonomous approaches to risk management.     

The impact of a planned health educational program on the compliance and knowledge of Jordanian pregnant women with anemia

Iron deficiency anemia is a major public health problem among pregnant women in developing countries. This study aimed to use a randomized controlled trial to evaluate the effectiveness of a health information package in Jordanian anemic pregnant women’s knowledge regarding anemia, compliance with iron supplementation, and hemoglobin level. Two hundred pregnant anemic women were recruited and randomly assigned into intervention or control group from April to July 2016. The intervention group received a video presentation of the Health Information Package Program (HIPP), narrated by a midwife, combined with PowerPoint slides to educate women about anemia in pregnancy. The participants in the control group received standard care in antenatal clinics, including iron supplementation. No significant differences were observed between the groups in age, gestational age, health problems, and total income. Only education and source of information differed significantly between the groups. Women in the intervention group had higher scores on the compliance checklist, knowledge, food selection ability, and hemoglobin level than women in the control group. The health information package program was effective. Policymakers should adopt a health information package program and apply it as a comprehensive national strategy for the prevention of anemia during pregnancy.     

Prevalence of health behaviours in pregnancy at service entry in a Queensland health service district

Objective: Limited prevalence data for unhealthy pregnancy health behaviours make it difficult to prioritise primary prevention efforts for maternal and infant health. This study's objective was to establish the prevalence of cigarette smoking, sufficient fruit and vegetable intake and sufficient physical activity among women accessing antenatal clinics in a Queensland (Australia) health service district.
Method: Cross-sectional self-reported smoking status, daily fruit and vegetable intake, weekly physical activity and a range of socio-demographic variables were obtained from women recruited at their initial antenatal clinic visit, over a three-month recruitment phase during 2007.
Results: Analyses were based on 262 pregnant women. The study sample was broadly representative of women giving birth in the district and state, with higher representation of women with low levels of education and high income. More than one quarter of women were smoking. Few women met the guidelines for sufficient fruit (9.2%), vegetables (2.7%) or physical activity (32.8%) during pregnancy.
Conclusions: There were low levels of adherence to health behaviour recommendations for pregnancy in this sample.
Implications: There is a clear need to develop and evaluate effective pregnancy behaviour interventions to improve primary prevention in maternal and infant health. Brief minimal contact interventions that can be delivered through primary care to create a greater primary prevention focus for maternal and infant health would be worth exploring.     

Maternal and child health in Yushu, Qinghai Province, China

Introduction

Surmang, Qinghai Province is a rural nomadic Tibetan region in western China recently devastated by the 2010 Yushu earthquake; little information is available on access and coverage of maternal and child health services.

Methods

A cross-sectional household survey was conducted in August 2004. 402 women of reproductive age (15-50) were interviewed regarding their pregnancy history, access to and utilization of health care, and infant and child health care practices.

Results

Women's access to education was low at 15% for any formal schooling; adult female literacy was <20%. One third of women received any antenatal care during their last pregnancy. Institutional delivery and skilled birth attendance were <1%, and there were no reported cesarean deliveries. Birth was commonly attended by a female relative, and 8% of women delivered alone. Use of unsterilized instrument to cut the umbilical cord was nearly universal (94%), while coverage for tetanus toxoid immunization was only 14%. Traditional Tibetan healers were frequently sought for problems during pregnancy (70%), the postpartum period (87%), and for childhood illnesses (74%). Western medicine (61%) was preferred over Tibetan medicine (9%) for preventive antenatal care. The average time to reach a health facility was 4.3 hours. Postpartum infectious morbidity appeared to be high, but only 3% of women with postpartum problems received western medical care. 64% of recently pregnant women reported that they were very worried about dying in childbirth. The community reported 3 maternal deaths and 103 live births in the 19 months prior to the survey.

Conclusions

While China is on track to achieve national Millennium Development Goal targets for maternal and child health, women and children in Surmang suffer from substantial health inequities in access to antenatal, skilled birth and postpartum care. Institutional delivery, skilled attendance and cesarean delivery are virtually inaccessible, and consequently maternal and infant morbidity and mortality are likely high. Urgent action is needed to improve access to maternal, neonatal and child health care in these marginalized populations. The reconstruction after the recent earthquake provides a unique opportunity to link this population with the health system.     

Evaluation of the impact of birth preparation courses on the health of the mother and the newborn

In 1995-96 a knowledge, attitude and practise (KAP) survey on care during pregnancy, delivery and in the post-natal period was carried out by the National Institute of Health in Italy. Of the 9004 women interviewed, 23% have attended antenatal classes (36% in hospitals, 51% in maternal and child health, MCH, clinics and 13% privately). Women attending these classes tend to be well-educated, primigravidae and resident in the North. Women who attend antenatal classes, especially at MCH clinics, have a lower risk of caesarean section (OR = 0.60), of bottle feeding while in hospital (OR = 0.45) and of receiving no information on contraception (OR = 0.31). Women who attend classes and are able to apply the technique learnt have a reduced risk of being dissatisfied with the experience of childbirth (OR = 0.72), whereas the others have an increased risk of dissatisfaction (OR = 1.87).     

母婴健康素养量表编制及考评

目的 编制母婴健康素养量表用以测量孕妇母婴健康素养,并对该量表的信度、效度和可行性进行评价.方法 参考《母婴健康素养——母婴健康素养55条》和相关文献构建量表框架并建立条目库,经条目筛选形成测试版量表,对207名孕妇进行实测后,检验量表信度、效度和可行性.结果 初步建立了包含74个条目的条目库,经条目筛选,最终形成了包含55个条目的母婴健康素养量表,分属基本知识和理念、健康生活方式与行为和基本技能3个维度.总量表和3个维度的Cronbach'sα系数分别为0.890,0.824,0.689和0.536;量表重测相关系数为0.897,分半相关系数为0.802;各条目与其所在的维度/方面相关性均较高;因子分析提取了7个公因子,解释65.99%的方差变异;孕妇大多能在8-15分钟内完成问卷.结论 母婴健康素养量表具有良好的信度、效度和可行性,但对各文化层次人群的适用情况有待于进一步研究.     

西藏农牧区妇女孕产期保健现状分析

目的 了解西藏自治区农牧区妇女孕产期保健现状.方法 采用横断面调查方法,分层随机抽样,入户访问了1512名3岁以下儿童的母亲.结果 妇女产前检查覆盖率为77.6%,平均产前检查次数为3.89次,5次以上产前检查率为26.3%,住院分娩率为40 4%,83.9%的妇女接受过孕期卫生保健宣传教育,产后访视的比例为66.2%.家庭有无副业收入、是否牧区、个人卫生状况、产前保健宣传教育、动员住院分娩、孕期保健知识等是影响是否进行产前检查的主要因素.结论 该地区妇女孕产期保健状况有显著改善,但目前产前检查次数仍然偏低,住院分娩率偏低,缺乏孕产期保健常识是影响孕产期保健利用的主要因素之一.建议加强健康教育,普及孕期卫生保健知识,促进产前保健和住院分娩.     

农民工孕妇产前保健影响因素

目的了解分析农民工孕妇产前保健情况、存在问题和影响因素,为进一步采取措施改善农民工孕妇产前保健提供信息。方法于2006年7月至2007年11月期间,对在本院产科住院的203名农民工产妇作问卷调查,对早孕检查方法、建立孕产妇联系手册、产前检查次数等产前保健状况进行了描述,并分析影响因素。结果农民工孕妇的产前保健还存在比较大的问题。调查对象中,有30．5％不在医院作早孕确定,有38．4％没有建立孕产妇联系卡,有77．3％没作产前保健或者不足3次。丈夫是否上海户籍、丈夫的经济收入及是否有准生证是影响产前保健的重要因素。结论农民工孕妇产前保健还存在较大问题,其影响因素也是多方面的,包括丈夫是否上海户籍、经济收入及是否有准生证。这些问题都迫切需要政府有专门的措施来解决。     

Maternal factors, obstetric history and smoking stage of change.

BACKGROUND: Maternal smoking is known to be associated with low educational status, low social class and younger age groups. The aim of this study was to determine if maternal smoking and stage of change relating to smoking is associated with other maternal variables such as intention to breastfeed and attend antenatal classes, having a planned pregnancy, previous obstetric history and child health problems. METHOD: A cross-sectional survey was carried out of all women who attended antenatal clinics at the Leicester Royal Infirmary NHS Trust over a two-week period. The data comprised 254 completed questionnaires. Results Intention to breastfeed was more common among non-smokers as shown by smoking status (p < 0.001) and smoking stage of change (p < 0.05). Having a planned pregnancy was more common among non-smokers as determined by smoking status (p < 0.001) and stage of change (p < 0.05). Intention to attend antenatal classes showed no significant relationship with smoking status but the majority of those planning to attend antenatal classes were in the action-maintenance stage (p< 0.05). Previous obstetric complications were not associated with either smoking status or stage of change. Smokers were more likely to have at least one child with asthma (p < 0.05) or respiratory infections (p < 0.001). Having at least one child with asthma or respiratory infections was more common among precontemplators (p < 0.05). CONCLUSION: Smoking stage of change should be assessed in antenatal care so that appropriate information can be offered to pregnant smokers. The development and evaluation of stage-specific smoking cessation materials should offer considerable benefits to maternal and infant health.     

北京市朝阳区825例流动孕产妇产前检查现状及影响因素分析

目的了解北京市朝阳区流动孕产妇产前检查的基本现状及相关影响因素,为制定流动孕产妇孕期保健服务的相关卫生政策提供参考依据。方法采用分层整群抽样,选取朝阳区流动人口相对密集的7个街道/乡镇随机抽取825例流动产妇(对象为1岁以下儿童母亲)进行回顾性问卷调查。结果流动产妇中认为妊娠期间需要进行产前检查的为93.0%,而实际孕期建立《母子健康档案》的只占35.5%;21.2%的流动产妇在私人诊所做过产前检查。在对医院服务的综合评价中最不满意的是就诊等候时间。结论私人诊所为流动孕产妇提供廉价和不健全的产前检查服务这一因素不容忽视。通过取缔非法行医诊所,改善医疗管理体制,制定合理的收费标准,以满足不同层次流动孕产妇的孕期保健需求;加大宣传力度是增强孕产妇主动寻求孕期保健服务的有效手段。     

上海市松江区《全覆盖孕产期系统保健管理》项目效果评估

目的:探讨《全覆盖孕产期系统保健管理》对孕产妇死亡、围产儿死亡、孕产妇系统管理的影响。方法:开展全社会孕情排摸提高早孕建册率、评估孕期妊娠风险加强重点孕妇管理、设立危重抢救中心提高抢救技能与设立抢救"绿色"通道积极应对危重抢救、政府经济支持设立外来孕产妇住院分娩点及免费产后访视、开展孕产期全程健康教育等方法。结果:评估项目前后(2008年、2011年)非本市孕产妇的系统管理率、早孕建册率、产前检查(产检)≥5次率、产后访视率、围产儿死亡率均有明显改变,经χ2检验,差异都具有统计学意义(P<0.05)。结论:项目对降低孕产妇死亡率、围产儿死亡率效果明显,对提高孕产妇系统管理率有一定的作用。