摘要
目的了解陕西省延安市育龄妇女掌握出生缺陷和优生知识的水平、对此的态度和行为(KAP)以及对预防出生缺陷服务的相关需求及获取方式,从而为本市进一步提高出生缺陷服务质量、制定优生优育服务策略及出生缺陷干预措施的整体方案提供科学依据。方法采用分阶段随机抽样法,于2015年11月至2017年1月在延安市13个区县中随机抽取4个区县共471名18~45岁准备妊娠及妊娠期妇女进行访谈及问卷式调查。结果延安市育龄妇女出生缺陷知识总体掌握程度欠缺,平均得分仅(8.00±2.22)分(13分制),其中40.3%不及格,26.3%良好,对"预防出生缺陷的叶酸增补方案"、"围孕妇女的个体化营养素补充"知晓度最低,回答正确频度分别仅为26.9%、5.0%。经比较分析发现高年龄、城市、受教育程度的增加、高收入、有妊娠史的妇女对相关知识点得分普遍高于低年龄、郊区和农村、低文化程度、低收入、初次妊娠妇女。态度方面,76.6%的育龄妇女经计划生育部门开展的宣传途径来获取优生相关知识,大部分育龄妇女对"优生优育"方面的知识表现出相对积极的态度。行为方面,接受过或有意愿接受婚前医学检查、孕前优生检查及孕期常规产检者分别占63.1%、75.8%和90.0%。对其中339名受孕妇女进行妊娠期不良因素调查发现,孕早期经常长时间用电脑及看电视者(每天累计超过4小时)占47.5%,怀孕前3个月丈夫未戒烟、戒酒者达到近50.0%左右。0.4mg叶酸服用率达到87.9%,从开始服用叶酸到现在坚持每天服用者占67.6%,而从怀孕前三个月开始并坚持每天服用者仅占25.4%;受教育程度越高,叶酸服用率也越高(P=0.021,OR=0.646),而有妊娠史的妇女对叶酸进行正确的增补频率较无妊娠史妇女反而变低(P=0.001,OR=2.760)。结论延安市育龄妇女出生缺陷相关知识掌握不够,但态度积极,有较大提高空间;影响出生缺陷的不良因素发生频率较高,叶酸服用不规范,应根据相关影响因素认真开展多种渠道的健康教育宣传,以提高育龄妇女预防出生缺陷知识的知晓率,有效降低出生缺陷发生的风险。
Objective To investigate the knowledge,attitude and practice（KAP） of childbearing women on birth defects and their relative requests on and acquiring ways in birth defects prevention service in Yan＇an City of Shaanxi Province and to provide scientific basis for whole scheme of improving birth defects prevention service,making eugenic strategy and birth defects interventions. Methods With multi-stage random cluster sampling method,among 13 regions and counties in Yan＇an City,471 women in 4 regions and counties aged from 18 to 45 years,planning to conceive or being pregnant were selected for interview and questionnaire survey from November 2015 to January2017. Results General mastery of birth defects knowledge of childbearing women in Yan＇an was defective,and their average score was only 8. 00 ± 2. 22 on 13 point scale. A total of 40. 3% of the women failed and 26. 3% got good score. Lowest awareness rate was identified in folic acid supplementation for prevention of birth defects and individual nutrient supplement for pregnant women,and correct answer rate on above two questions was only 26. 9% and 5. 0%,respectively. Comparative analysis revealed that score on relevant knowledge of women with older age,in urban area,high education level,high income,and pregnancy history was higher than that of those with younger age,in suburbs and rural area,low education level,low income,and first pregnancy. Regarding attitude,76. 6% of women obtained eugenic knowledge through publicity channel by family planning department, and most women showed a positive attitude towards eugenic knowledge. Regarding behavior,proportion of women received or willing to receive premarital examination,pre-pregnancy examination,and prenatal examination was 63. 1%,75. 8% and 90. 0%,respectively. Survey of adverse factors in 339 pregnant women showed that47. 5% of women often used computer and TV for a long time（ accumulated more than 4 hours a day） during early pregnancy,and almost50. 0% women＇s husband did not quit smoking and alcohol in first 3 months of pregnancy. Proportion of women who took 0. 4mg folic acid reached 87. 9%. Number of women taking folic acid every day from beginning of pregnancy until present accounted for 67. 6%,but proportion of women who took folic acid in 3 months before pregnancy and took it everyday until present was only 25. 4%. Intake rate of folic acid increased with increase of education level of women（ P = 0. 021,OR = 0. 646）,but rate of correct folic acid supplementary of women with pregnancy history was lower than that of women without pregnancy history（ P = 0. 001,OR = 2. 760）. Conclusion Knowledge of birth defects of childbearing women in Yan＇an City is deficient,but their attitude is positive and space for improvement is large.Incidence of adverse factors of birth defects is high,and taking folic acid is not standardized. Various health education campaigns need to be carried out based on relative factors to improve awareness rate of birth defects prevention knowledge of childbearing women and effectively reduce the risk of birth defects.
作者
李文静
杨文方
曾令霞
慕丽红
李延生
李康
李旭东
胡骏
郝建东
Mei Chun Chung
LI Wen-jing YANG Wen-fang ZENG Ling-xia MU Li-hong LI Yan-sheng LI Kang LI Xu-dong HU Jun HAO Jian-dong Mei Chun Chung(First Affiliated Hospital of Xi＇ an Jiaotong University, Shaanxi Xi＇ an 710061, China School of Public Health, Xi＇ an Jiaotong University Health Science Center, Shaanxi Xi＇ an 710061, China Family Planning and Reproductive Health Service Center of Yan＇ an City, Shaanxi Yan＇an 716000, China Yah＇ an Health and Family Planning Bureau, Shaanxi Yan ＇ an 716000, China Department of Public Health and Community Medicine, Tufts University School of Medicine, Massachusetts Boston 02111, U. S. A)
出处
《中国妇幼健康研究》
2017年第7期797-801,共5页
Chinese Journal of Woman and Child Health Research
基金
陕西省社会发展科技攻关项目(2016SF-126)
延安市卫生和计划生育局资助项目(HX201640)
延安市计划生育生殖健康服务中心资助项目(HX201537)
关键词
出生缺陷
KAP
叶酸
影响因素
birth defects
KAP
folic acid
influencing factors
