背景:孕前护理是检测未来父母潜在健康风险并提供健康行为教育以降低妇女及其后代发病率和死亡率的机会。上海市妇幼保健院建立了孕前保健,中国,包括健康检查,健康教育和咨询。这项研究调查了与使用孕前护理相关的因素,以及孕前保健对孕妇及其伴侣受孕前健康行为变化的作用。
方法:对上海市三家妇幼保健院的孕妇进行横断面研究。参与者被邀请填写一份关于受孕前保健和健康行为变化利用情况的自我管理问卷。
结果:在948名招募的孕妇中,不到一半(42.2%)的人报告说他们在本次怀孕前使用了孕前护理。意外怀孕,不了解孕前护理和已经进行过一般体检是不参加孕前护理的主要原因。有关孕前保健的两个主要信息来源是当地社区工作者和卫生专业人员。年轻女性和多段女性不太可能利用孕前护理。使用孕前保健的女性更有可能在受孕前服用叶酸补充剂[调整赔率(aOR)3.27,95%置信区间(CI)2.45-4.36,P<0.0001]。参加过孕前护理服务的孕妇伴侣在受孕前更有可能戒烟[aOR2.76,95CI1.48-5.17,P=0.002]和戒酒[aOR2.13,95CI1.03-4.39,P=0.041]。
结论:孕前保健的使用被证明与孕前健康行为的变化呈正相关,例如怀孕前服用叶酸补充剂的妇女,他们的男性伴侣在怀孕前停止吸烟和饮酒。需要进一步的研究来探索利用孕前护理服务的障碍并了解服务的质量。促进孕妇孕前保健的策略,特别是对年轻和多段女性来说,应进一步发展,以进一步提高社区一级服务的利用率。
BACKGROUND: Preconception care is an opportunity for detecting potential health risks in future parents and providing health behavior education to reduce morbidity and mortality for women and their offspring. Preconception care has been established in maternal and child health hospitals in Shanghai,
China, which consists of health checkups, health education and counseling. This study investigated factors associated with the utilization of preconception care, and the role of preconception care on health behavior changes before conception among pregnant women and their partners.
METHODS: A cross-sectional study was conducted among pregnant women at three maternal and child health hospitals in Shanghai. The participants were invited to complete a self-administered questionnaire on the utilization of preconception care and health behavioral changes before conception.
RESULTS: Of the 948 recruited pregnant women, less than half (42.2%) reported that they had utilized preconception care before the current pregnancy. Unplanned pregnancy, unawareness of preconception care and already having a general physical examination were the main reasons for not attending preconception care. The two main sources of information about preconception care were local community workers and health professionals. Younger women and the multipara were less likely to utilize preconception care. Women who utilized preconception care were more likely to take folic acid supplements before conception [Adjusted Odds Ration (aOR) 3.27, 95% Confidence Interval (CI) 2.45-4.36, P < 0.0001]. The partners of pregnant women who had attended preconception care services were more likely to stop smoking [aOR 2.76, 95%CI 1.48-5.17, P = 0.002] and to stop drinking [aOR 2.13, 95%CI 1.03-4.39, P = 0.041] before conception.
CONCLUSIONS: Utilization of preconception care was demonstrated to be positively associated with preconception health behavior changes such as women taking folic acid supplements before pregnancy, their male partner stopping smoking and drinking before conception. Future studies are needed to explore barriers to utilizing preconception care services and understand the quality of the services. Strategies of promoting preconception care to expectant couples, especially to young and multipara women, should be developed to further improve the utilization of the services at the community level.