目的 了解北京市通州区流动人口孕产妇管理现状,发现薄弱环节,为提高流动人口的孕产妇保健工作水平提出相应的对策建议.方法 基于北京市通州区妇幼保健院的电子信息系统,构建通州区2013年1月—2017年12月期间分娩的单胎孕妇的回顾性队列,对纳入的59281例单胎孕妇按照户籍特征分三组包括户籍人口组、流动人口组和配偶户籍孕产妇流动组,对年龄采用方差分析进行比较,对其他社会人口学特征、既往史、妊娠情况和新生儿情况采用卡方检验进行比较.结果 本研究中户籍人口有25051例(占42.3％),配偶户籍孕产妇流动的有9017例(占15.2％),流动人口有25213例(占42.5％).户籍人口组和配偶户籍孕产妇流动组孕早期建立北京市母子健康档案、首次产检是在孕早期和产检次数＞8次和产后访视次数≥2次的比例均高于流动人口组,差异均有统计学意义(P＜0.001).流动人口组选择三级医院的比例低于其他两组,分娩方式为自然产比例高于其他两组,差异均有统计学意义(P＜0.001).三组孕妇的分娩孕周和新生儿出生体重的分布差异有统计学意义(P＜0.001、P=0.004).但三组孕妇的围产儿结局之间的差异无统计学意义(P＞0.05).结论 应加强北京市通州区流动人口孕产妇保健管理的各项工作,提高早孕建册率、规范产前检查和产后访视,切实改善孕产妇的保健质量,以促进母婴健康.%Objective To investigate the situation of maternal healthcare management in Tongzhou district of Beijing and to explore the weakness, hence to put forward management countermeasures to improve maternal health. Methods Medical information of the singleton pregnancies in Tongzhou District of Beijing, from January 1, 2013 to December 31, 2017, were collected through electronic medical records system to build the retrospective cohort. According to the characteristics of household registration, 59 281 women with singleton deliveries were divided into three groups: 1) registered population, 2) floating population and 3) floating pregnant woman whose spouse is registered population. Age was compared by analysis of variance, and other socio-demographic characteristics, previous medical history, pregnancy and neonatal status were compared by chi-square test. Results In this study, the registered population group was 25 051(42. 3％); the floating pregnant woman whose spouse is registered population group was 9 017 (15. 2％); and the floating population group was 25 213 (42. 5％). The rate of registration of maternal and child health records in Beijing, the first antenatal care conducted in the first trimester, antenatal care with at least eight visits and the postpartum care with at least 2 visits in the registered population group and the floating pregnant woman whose spouse is registered population group, which were higher than the floating population group, and the differences were statistically significant (P ＜ 0. 001). The proportion of the floating population group choosing tertiary hospitals was lower than that of the other two groups, and the proportion of natural childbirth was higher than that of the other two groups, and the difference was statistically significant(P ＜ 0. 001). The distribution of gestational age and neonatal birth weight among the three groups were statistically significant (P ＜ 0. 001 and P = 0. 004). However, there were no statistically significant differences among the three groups n terms of the rate of perinatal outcomes (P ＞ 0. 05). Conclusion Various prenatal healthcare management should be carried out to implement basic public health services, improve the rate of early pregnancy registration and standardize prenatal and postpartum visits, so as to improve the quality of maternal health care and promote maternal and child health aiming at floating population in Tongzhou District of Beijing.
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