卢湾区社区高危孕妇发生情况和妊娠结局分析

目的了解社区高危孕妇的发生情况和妊娠结局，为有效开展高危孕妇早发现、早诊断、早干预提供依据。方法按照《上海市孕产妇系统保健管理办法》中“高危妊娠评分标准”，对2008-2009年上海市卢湾区全区4个社区卫生服务中心的3167名孕妇中671名（21．19％）高危孕妇，进行高危因素和妊娠结局的分析。结果外来人口的高危孕妇发生率（29．09％）明显高于上海户籍人口（19．61％），高危因素中以异常妊娠分娩史为主，其中异常妊娠分娩史发生率比较高，高危孕产妇的流产率、低体重儿发生率和早产率明显高于正常的孕产妇。结论在社区卫生服务中心和接产医院建立高危孕妇双向转诊制度，可以提高高危孕妇管理的整体性、连续性及有效性。加强婚前、孕前保健和流动人口的生殖保健指导，可以有效地降低高危孕妇的发生率，预防不良妊娠结局的发生。

Analysis on the High-risk Pregnant Women in the Community and Their Pregnancy Outcome

Objective This paper is aimed to learn an occurrence of the high-risk pregnant women in the community and their pregnancy outcome and to provide the basis for effectively carrying out the early detection, early diagnosis and early intervention for the high-risk pregnant women. Method According to the High-risk Pregnancy Grading from the Shanghai Municipal Regulation on Maternal Health-care, this study analyzes the high-risk elements and the pregnancy outcome of 671 high-risk ones among all 3167 pregnant women from the four Community Health Centers in Shanghai Luwan District from the year of 2008 to 2009. Results The high-risk rate of the floating population is distinctly higher than that of the locals. Among all the high-risk elements, the majority is the fixed factors which include the women＇s general health conditions and history of abnormal pregnancy and delivery, and the latter has a relatively higher incidence. Abortion rate of high-risk pregnant women, the incidence of low birth weight and preterm children were significantly higher than those of the normal pregnant women. Conclusion In the community health service center and the delivery hospital the high risk pregnant women two-way referral system established can improve the high risk pregnant women management integrity, continuity and effectiveness. Before wedding, pregnant care and floating population reproductive health guidance can effectively reduce the incidence of high risk pregnant women, and prevent the happening of the adverse pregnancy outcome.