中国五城市流动育龄妇女孕产期保健影响因素研究

摘要

目的 了解流动育龄妇女孕产期保健现状及影响因素,为改善其孕产期保健质量提供依据.方法 利用2005年北京、南京、厦门、深圳和重庆5个城市流动人口生殖健康抽样调查数据,描述分析流动育龄妇女孕产期保健分布情况,用logistic回归分析流动育龄妇女孕产期保健影响因素.结果 5 399份有效调查问卷中有4 037份来自经历妊娠的流动育龄妇女,其中参加过和未参加孕产期保健者分别占75.3％(3 041/4 037)和24.7％(996/4 037).初次产前检查时间与其受教育程度有关(P＜0.05).孕产期保健多因素logistic回归分析显示,孕产期保健在调查地区间存在差异(P＜0.05),＜30岁和30 ～ 39岁组参加孕产期保健的比例分别是≥40岁组的4.09倍(95％CI:3.11 ～ 5.39)和1.98倍(95％CI:1.61 ～ 2.43);高中及以上、初中文化程度的流动育龄妇女参加孕产期保健的比例分别是小学及以下者的5.47倍(95％CI:3.85 ～ 7.77)和2.86倍(95％CI:2.42～3.39);已婚流动育龄妇女参加孕产期保健比例是未婚流动妇女的2.36倍(95％CI:1.07～ 5.22);生育1胎和2胎者均比生育≥3胎的流动育龄妇女更可能参加孕产期保健,其OR值分别是3.36(95％CI:2.33～ 4.84)和1.61(95％CI:1.12 ～ 2.30);有婚育证明者参加孕产期保健比例是无婚育证明者的1.44倍(95％CI:1.21 ～ 1.71).结论 教育程度高、已婚、生育胎数少及有婚育证明对流动育龄妇女的孕产期保健具有保护作用.通过改善孕产期保健影响因素,提高外来流动人口孕产期保健服务的利用水平,有助于预防和降低不良生殖健康结局的发生风险.%Objective To understand the current status of prenatal health care(PHC) and its related factors for floating women of childbearing age,and to provide evidence for improving the quality of PHC at childbearing age.Methods With data from the reproductive health survey on floating population in five cities,Beijing,Nanjing,Xiamen,Shenzhen and Chongqing,in 2005,the distributions of PHC among floating women were described.Multivariate logistic regression was performed to investigate the factors related to the utilization of PHC.Results In 5 399 cases of valid questionnaires,4 037 floating women who had the history of pregnant,cases who had or did not have PHC services would account for 75.3％ (3 041/4 037) and 24.7％ (996/4 037),respectively.The initial time of using the PHC service was significantly associated with the level of their education (P＜ 0.05) received.Data from the multivariate logistic regression analysis in PHC showed that there were differences between regions (P＜0.05).Proportions of women receiving PHC among those under 30 years and 30-39 were 4.09-folds (95％ CI:3.11-5.39) and 1.98-folds (95％ CI:1.61-2.43),respectively,when compared with that of women over 40-year-old.The proportion of women having received PHC with education levels of senior high school and above or junior high school,were 5.47-folds (95％CI:3.85-7.77) and 2.86-folds (95％CI:2.42-3.39) respectively,compared to that of women with education level of primary school or below.The proportion of married women having PHC was 2.36-folds (95％CI:1.07-5.22) of those unmarried women.The proportions of having PHC of women with one parity and two parities or with family planning certificate were 3.36-fold (95％CI:2.33-4.84) and 1.61-fold (95％CI:1.12-2.30),1.44-folds (95％CI:1.21-1.71) respectively,when compared with those women with three parities or without the certificate.Conclusion Factors as having received higher education,being married,with less parities or having family planning certificate etc.showed protective effects on PHC for floating women of childbearing age.Based on PHC,education should be promoted among the floating women of childbearing age,which would contribute to the prevention and reduction of adverse outcomes related to reproductive health.