目的对河北省早、中孕期妇女进行问卷调查,从地域、年龄、文化程度三个层面进行分析,评估其和孕育状态相关的环境因素指标,为加强孕前、孕期一级预防措施提供科学依据,从而进一步降低出生缺陷发生,提高出生人口素质。方法采用横断面研究设计,分别抽取城市和农村调查点各4个,选取门诊就诊的早、中孕期妇女,就受教育程度、生活习惯、孕产史、疾病史、用药史等环境因素进行问卷调查,并测定血红蛋白数值。结果城市妇女受教育程度高于农村妇女。不良生活习惯中以久坐、豢养宠物、熬夜、偏食所占比例较高。其中,豢养宠物、久坐、偏食、饮用浓茶/咖啡等城市显著高于农村,≤34岁年龄组孕妇的不良生活习惯所占比例显著高于≥35岁年龄组孕妇,但饮用浓茶/咖啡的习惯≥35岁年龄组孕妇明显高于≤34岁年龄组,初中及以下学历孕妇中豢养宠物、久坐的不良习惯显著高于其余两个学历组。≥35岁年龄组孕妇的不良孕产史发生率显著高于≤34岁年龄组。23. 22%的妊娠期妇女有服药史,其中保胎药和甲状腺素药物的服药史比例城市显著高于农村。≤34岁年龄组孕妇抗菌素的应用比例显著高于≥35岁年龄组,本科及以上学历孕妇服用保胎药物的比例显著高于其余两组。各种疾病史中便秘和痔疮的发生率最高,甲状腺疾病患病率城市显著高于农村,≥35岁年龄组孕妇的痔疮、口腔疾病、子宫肌瘤、乙肝、盆腔炎、糖尿病、便秘、肺结核等发生率均显著高于≤34岁年龄组孕妇。8. 71%的孕妇发生了贫血,其中,≥35岁年龄组孕妇贫血发生率显著高于≤34岁年龄组。结论地域、年龄和文化程度不同,妇女的生活和工作环境也不一样。因此,在环境因素构成上也存在差异,提示在加强出生缺陷一级预防措施中应结合地域、年龄、文化程度的不同各有侧重。

Objective To conduct a comprehensive survey of women in first and second trimester of pregnancy,analyze the geography,age and education levels. To evaluate the indexes of environmental factors related to pregnancy status,so as to provide scientific basis for strengthening primary preventive measures before and during pregnancy,and further reduce the occurrence of birth defects and improve the quality of the birth population. Methods A cross-sectional study was conducted and to extract four urban and four rural survey sites respectively. Women in the early and second trimester of pregnancy were selected to be investigated the education level,living habits,maternal history,disease history,drug history,etc. The blood hemoglobin were tested at the same time. Results Urban women had higher education levels than rural women. The proportion of sedentary,pets,late nights,and partial food in poor living habits is higher. Sedentary,keeping pets,staying up late and partial eating account for a higher proportion of the bad habits.The he proportions of keeping pets,partialeating,sedentary,drinking strong tea/coffee were significantly higher among women in urban areasthan in rural areas. The proportion of poor living habits of pregnant women in the ≤34 years old age group of was significantly higher than that in the ≥ 35 years old age group of However,the habit of drinking strong tea/coffee was significantly higher in the≥35 years old age group than in the ≤34 years old age group. Among the pregnant women with junior high school degree or below,the bad habits of keeping pet and sedentary were significantly higher than the other groups. The incidence of poor maternity history was significantly higher among pregnant women in the ≥ 35 years old age group than in the ≤ 34 years old age group. About 23. 22% of women during pregnancy had a history of taking drugs,among them,the medication history of drug taken to protect fetus and thyroxine drugs was significantly higher in urban areas than in rural areas. The proportion of antibiotics taken by pregnant women in the 34 years old age group of was significantly higher than that of the≥35 years old age group. The proportion of pregnant women with bachelor's degree or above taking the drug to protect fetus was significantly higher than that of the other two groups. The highest incidence is constipation and hemorrhoids in the history of diseases. Thyroid disease prevalence was significantly higher in urban than in rural areas. The incidences of hemorrhoids,oral diseases,uterine myoma,hepatitis B,pelvic inflammatory disease,diabetes,constipation,and tuberculosis in pregnant women in the ≥35 years old age group were significantly higher than those of pregnant women in the ≤ 34 years old age group. About 8. 71% of pregnant women experience anaemia,of which the prevalence of anaemia among pregnant women in the ≥35 years old age group was significantly higher than that in the ≤ 34 years old age group. Conclusion Women's living and working environments vary according to geographic location,age and level of education. So there are differences in the composition of environmental factors. It suggests us that different areas should be emphasized in primary prevention of birth defects according to different regions,ages,and education levels.