李华才

摘要：目的 探讨免费孕前优生健康检查对降低出生缺陷发生的影响。方法 选取青龙满族自治县2011～2012年符合生育政策、计划怀孕的8000对农村夫妇，随机分为两组，即观察组（参加免费孕前优生健康检查）和对照组（未参加免费孕前优生健康检查）。对选取的两组夫妇分别建立档案，专人管理，怀孕后均严格跟踪，进行早孕随访，记录妊娠结局，对出生缺陷儿进行登记汇总，比较分析各项指标。结果 观察组共发现出生缺陷11例，对照组共发现出生缺陷44例，观察组出生缺陷发生率为27.5/万，对照组出生缺陷发生率为110.0/万，两组比较差异有统计学意义（P<0.05）。排在前四位的出生缺陷分别为神经管畸形、指（趾）畸形、唇腭裂、先天性心脏病。结论开展免费孕前优生健康检查，把预防措施落实在怀孕之前，实现预防关口的前移，能有效降低出生缺陷的发生风险，很有必要。

关键词：免费孕前优生健康检查;出生缺陷;影响分析

中图分类号：R722.1 文献标识码：A 文章编号：1674-4721（2013）11（a）-0156-02

[Abstract]Objective To study the influence of free pre-pregnancy checkups to reducing the occurrence of birth defects.Methods 8000 county couples who were accord with family planning policy and planning pregnancy from 2011 to 2012 in Qinglong Manchu Autonomous County were divided into observation group（taking part in free pre-pregnancy checkups）and control group（not taking part in free pre-pregnancy checkups）randomly.ALL these couples were given of establishing archives，special management，strict tracking，following up of early pregnancy，recording the results of gestation，recording and gathering birth defects，and the indexes were compared between the two groups.Results There were 11 and 44 cases of birth defects in the observation group and control group respectively.The incidence of birth defects in observation group was 27.5/10000 which was significantly different from it in control group（110.0/10000，P<0.05）.The first four diseases of birth defects were neural tube defects，polydactylism，cheilopalatognathus，congenital heart disease.Conclusion It is essential to launch free pre-pregnancy checkups，make precaution before pregnancy and make control and prevention more early for effectively reducing the risk of birth defects.

[Key words]Free pre-pregnancy checkups;Birth defect;Influence analysis

全國出生缺陷总发生率为（110/万）[1]，出生缺陷已经成为严重的社会问题，在围产儿死亡中出生缺陷占第一位[2-3]，存活下来的婴儿也给家庭和社会造成沉重的经济负担，尤其是孕妇本人的身心健康损害更大。为了降低出生缺陷率，本院充分利用作为国家免费孕前优生健康检查试点县的优势，对计划怀孕的农村夫妇通过参加免费孕前优生健康检进行干预，现将结果报道如下。

1 资料与方法

1.1 一般资料

选取青龙满族自治县2011～2012年符合生育政策、计划怀孕的8000对农村夫妇，随机分为两组，即观察组（参加免费孕前优生健康检查）和对照组（未参加免费孕前优生健康检查）。……