顾红英 陆冬梅

摘 要 目的：分析鄔桥社区孕妇早孕建册情况，探索提高早孕建册率途径。方法：对2012年至2016年上海市奉贤区庄行镇邬桥社区建册的1 986名孕妇资料进行统计分析。结果：2012年至2016年外来流动孕妇早孕（妊娠<13周）建册率36.60%，远低于本市户籍孕妇的早孕建册率76.43%，差异有统计学意义（P<0.01）；五年的早孕建册率有逐年提升，差异有统计学意义（P<0.001）。69.9%的户籍孕妇和53.3%的非户籍孕产妇推迟建册的主要原因均为停经后直接到二、三级医院就诊确诊怀孕，并不知晓要到社区卫生服务中心建册。结论：提高早孕建册率的工作重点是在对非户籍孕妇的孕情及时掌握上，孕产妇的全覆盖管理和妇科门诊医生的积极指导可提高孕妇的建册率。构建社区卫生服务网络，建立公共服务型政务，是提高流动孕产妇建册的关键，孕妇自身和妇科门诊医生重视对孕妇的早孕建册关系重大。

关键词 孕产妇；早孕建册；现状

中图分类号：R715.3 文献标志码：A 文章编号：1006-1533（2018）16-0050-03

Analysis of building the booklets for the early pregnancy in a community in Shanghai

GU Hongying1， LU Dongmei2（Department of Prevention and Health Care of Zhelin Community Health Service Center of Fengxian District， Shanghai 201417， China； 2. Department of Gynecology and Obstetrics of Wuqiao Community Health Service Center of Zhuanghang Town of Fengxian District， Shanghai， 201402， China）

ABSTRACT Objective： To analyze building the booklets for the early pregnancy in Wuqiao Community to explore ways to improve the rate of building the booklets for the early pregnancy. Methods： The data of 1 986 pregnant women in Wuqiao Community of Zhuanghang Town were collected from 2012 to 2016 and statistically analyzed. Results： From 2012 to 2016， the rate of building the booklets for the early pregnancy in floating population（pregnancy<13 weeks） was 36.60%， which was far lower than that in the native population（76.43%）， and the difference was statistically significant（P<0.01）. From 2012 to 2016， the rate of building the booklets for the early pregnancy was increasing year by year and the five-year difference was statistically significant（P<0.001）. The main reasons for the delayed building the booklets were that the household registration（69.9%） and non-household pregnant women（53.3%） went straightly to the second and tertiary hospitals to confirm pregnancy after their menopause， and they did not know they should build the booklets in the community health service center. Conclusion： To increase the rate of building the booklets， the focus of the work is on the timely control of the pregnancy of non-household pregnant women. Full coverage management for pregnant women and initiative of gynecologists in the outpatient clinic can improve the rate of building the booklets of the pregnant women. Building community health service network and establishment of public service government affairs is the key to improve the rate of building the booklets of the pregnant women in floating population. The attention of pregnant women themselves and the gynecologist is of great importance of the building booklets for the early pregnancy.

KEY WORDS pregnant woman； building the booklets for the early pregnancy； present situation

早孕建册是指孕妇在怀孕13周内到户口所在地（流动人口到居住地）的社区卫生服务中心建立孕早产妇保健手册[1]。社区卫生服务中心是为孕产妇开展系统管理的第一道关口，在整个孕期保健中显得尤为重要。做好早孕保健的关键是做到“三早”，即早期发现，早期检查及早期建立《孕产妇健康手册》[2]。本文旨在分析社区孕妇早孕建册情况。

1 资料和方法

1.1 资料来源

收集2012年至2016年上海市奉贤区庄行镇邬桥社区孕产妇系统管理中的早孕建册登记表，共纳入孕妇1 986名，其中户籍孕妇437名占22.0%。非户籍孕妇1 549名，占78.0%。

1.2 方法

回顾性分析孕妇早孕建册情况，以孕期小于13周列入早孕建册范畴。按户籍、孕周、推迟建册原因等进行分析。

1.3 统计学方法

用SPSS 19.0软件进行统计分析，计数资料用百分率（%）表示，行χ2检验。P<0.05为差异有统计学意义。

2 结果

2.1 不同户籍孕妇早孕建册比较

在1 986名孕妇中，有901名孕妇早孕建册，早孕建册率为45.37%。户籍孕妇的早孕建册率为76.43%（334/437），非户籍孕早孕建册率为36.6%（567/1 549），差异有统计学意义（χ2= 45.77，P<0.01）。

2.2 2012年至2016年早孕建册比较

2012年至2016年的五年中早孕建册率有逐年提升，差异有统计学意义（χ2=153.19，P<0.001）

2.3 孕妇推迟建册原因分析

有1 085名孕妇参与推迟建册原因调查。……