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目的:探索科学界定孕前优生健康检查和风险评估高风险人群的方法。方法:对河北省15个国家免费孕前优生健康检查项目县(市)的风险评估情况进行回顾性分析。结果:2010年7月～2012年3月共有249 470例接受检查,评估高风险人群数为31 140例(12.48%),高风险人群评估比例呈阶段性下降趋势。结果显示,环境风险中吸烟在男性人群所占比例最高(57.50%),既往及家族病史中糖尿病所占比例最高(1.47%),实验室检查项目异常主要为:ALT异常(12.98%)、乙肝五项(除HBsAb外)中1项以上阳性(12.06%)、Cr异常(10.96%);女性高风险人群中,体重超重或肥胖比例最高(34.75%),其次为TSH异常(18.11%)、ALT异常(16.41%)、乙肝五项(除HBsAb外)中1项以上阳性(11.36%)、年龄<18岁或>35岁(10.87%)、环境中接触猫狗等宠物(9.99%)、被动吸烟(6.77%)等。结论:规范和统一风险评估标准,对于提高孕前优生健康检查和风险评估水平具有重要意义。充分提高风险评估的针对性,探索出适合本地区的工作模式才能使项目顺利全面推进。
OBJECTIVE: To explore a method for scientifically defining the prenatal health check-up and risk assessment of high-risk populations. Methods: The risk assessment of free pre-pregnancy health checkup project counties (cities) in 15 countries in Hebei Province was retrospectively analyzed. Results: From July 2010 to March 2012, a total of 24 4707 patients were examined, 31 140 (12.48%) were evaluated for high-risk groups, and the proportion of high-risk groups showed a downward trend in stages. The results showed that smoking had the highest proportion of male population (57.50%) in the risk of the environment, the highest prevalence of diabetes (1.47%) in the past and familial history, abnormalities of the laboratory items were as follows: abnormal ALT (12.98%), hepatitis B (12.06%) and abnormal Cr (10.96%) in five (except HBsAb) patients; the highest prevalence of overweight or obesity (34.75%) among women at high risk, followed by abnormal TSH (18.11% (16.41%), one or more of hepatitis B (except HBsAb) positive (11.36%), age <18 years or 35 years (10.87%), pets in cats and dogs (9.99% Passive smoking (6.77%) and so on. Conclusion: To standardize and unify the risk assessment standards is of great significance for improving the prenatal health examination and risk assessment. Fully improve the pertinence of risk assessment and explore suitable working models in this region so that the project can be smoothly and comprehensively promoted.