孕前优生健康检查人群中不孕不育发生情况的5年随访研究

目的了解江苏地区孕前检查人群5年生育和不孕不育发生情况。方法采取分层整群抽样方法对江苏苏南、苏中、苏北的3个县7个乡镇在2013年前参加免费孕前优生健康检查的5086对夫妇进行5年跟踪随访。结果①5年内共完成3次随访,随访应答率为100%。孕前检查人群1年累积受孕率为88.68%,1年累积不孕率为11.32%;2年累积受孕率为90.47%,2年累积不孕率为11.97%;5年累积受孕率为96.88%,5年累积不孕率为11.98%。②孕前检查一般风险人群不孕率为11.16%,低风险人群不孕率为11.78%,高风险人群不孕率为14.50%,差异有统计学意义(Z=2.45,P<0.05)。③不孕症患者的5年就诊率为31.42%。孕前检查后第1年就诊的患者5年累积受孕率为53.93%,第2年就诊的患者5年累积受孕率为44.29%,第3~5年就诊的患者5年累积受孕率为18.18%,差异有统计学意义(Z=2.87,P<0.05)。④122对已知不孕原因的对象中,女方原因占58.20%,男方原因占11.48%,双方原因占4.92%,不明原因占25.41%,包括2例性染色体异常对象。结论应加强孕前检查人群中不孕症患者的早期管理,结合孕前检查风险评估结果加以指导,做到早诊断、早治疗。

A 5-year follow-up study of infertility in pre-pregnancy eugenics

Objective To investigate the incidence of 5-year fertility and infertility among pre-pregnant examination women in Jiangsu.Methods 5086 couples who took part in free pre-pregnancy physical examination in 7 townships of 3 counties in southern,central and northern Jiangsu Province by stratified cluster sampling were followed up for 5 years.Results①Three follow-up visits were completed in 5 years,and the response rate was 100%.The cumulative fertility rate was 88.68% and the cumulative infertility rate was 11.32% in one year;the cumulative fertility rate was 90.47% and the cumulative fertility rate was11.97% in two years;the cumulative fertility rate was 96.88% and the cumulative sterility rate was 11.98% in five years.②The infertility rate of general risk group,low risk group and high risk group was 11.16%,11.78% and 14.50% respectively,with statistical significance(Z=2.45,P<0.05).③The 5-year visiting rate of infertility patients was 31.42%.The 5-year cumulative fertility rate was 53.93%in the population who seek medical advice in first year after pre-pregnant examination,44.29% in the second year and 18.18% in the third to fifth year(Z=2.87,P<0.05).④Among 122 known causes of infertility,58.20% were female,11.48% were male,4.92% were bilateral,25.41% were unknown,including 2 cases of abnormal sex chromosome.Conclusion We should strengthen the early management of infertility patients in pre-pregnancy check-up population,and guide them with the results of risk assessment of pre-pregnancy check-up,so as to make early diagnosis and treatment.