中国南北方部分地区1994-2000年孕产妇系统保健状况及其变化

目的 了解中国南北方部分地区1994—2000年的孕产妇系统保健状况及其变化。方法 数据来自“中美预防出生缺陷和残疾合作项目”中13个县（市）的围产保健监测数据库。研究对象为19942000年在上述项目县（市）分娩了孕满20周单胎活产儿的368589名妇女。结果 从19942000年，南北方地区产前检查率一直高于99．0％，第一次产前检查时的平均孕周从1994年13．1周提前至2000年的10．7N，早孕检查率从65．5％升至79．4％，产前检查次数≥5次的比例从34．1％升至71．8％，住院分娩率从913％升至98．8％，家庭分娩率从5．6％降至0．6％，产后访视次数≥3次的比例从80．5％升至951％。除早孕检查率外，同期比较，北方地区的其他各率均低于南方地区，且北方地区的城乡差别大于南方地区。结论 中国南北方地区的孕产妇系统保健状况得到了极大的改善，但南北地区之间、北方城乡之间存在明显的差别。

The current status and the changing patterns of perinatal health care in some southern and northern areas of China, 1994 - 2000

Objective To understand the current status and its changing patterns of perinatal health care in some southern and northern areas of China from 1994 to 2000. Methods Data was collected in 13 counties/cities covered by Perinatal Health Care Surveillance System which was part of the Sino American cooperative project on neural tube defects prevention, established in 1992, The study population consisted of 368 589 women who delivered single live births of at least 20 gestational weeks from 1994 through 2000. Chi-square test was employed to test the difference on the proportions of women with prenatal checkup, women with early prenatal care onset, women with at least five prenatal visits, hospital delivery versus home delivery as well as the proportion of women with at least three postpartum visits. Two-way ANOVA was used to test the differences of mean of gestational weeks at first prenatal visit and the mean of prenatal visits between different year and areas. Results The proportion of women with prenatal checkup remained over 99.0% from 1994 through 2000.The mean of gestational weeks at first prenatal visit changed from 13, I weeks in 1994 to 10.7 weeks in 2000. The proportions of women with early prenatal care onset increased frorn 65.5% in 1994 to 79.4% in 2000 while women with at least five prenatal visit increasing from 34.1% to 71.8%, hospital delivery increasing from 91.3% to 98.8%, home delivery decreasing from 5.6 % to 0.6 % , women with at least three postpartum visits increasing from 80.5 % to 95.1% , Except for the proportion of women with early prenatal care onset ,other proportions in northern areas were lower than those in southern areas in the same year. Greater differences between urban and rural areas in northern areas were found than in southern areas. Conclusion The utilization of perinatal health care services was greatly improved in both southern and northern areas from 1994 to 2000. However, there were still obvious differences in the perinatal health care services between northern and southern areas as well as between urban and rural areas in northern China.