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有效的产前护理可降低低体重儿的发生率。

Effective prenatal care decreases the incidence of low birthweight.

作者信息

Hakala T H, Ylikorkala O

机构信息

I Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland.

出版信息

Am J Perinatol. 1989 Apr;6(2):222-5. doi: 10.1055/s-2007-999581.

Abstract

In Finland a nationwide free prenatal care system was mandated by law in 1944. At present, 99.9% of Finland's pregnant women use it. The primary aim is to provide advice and care to all women in local centers and to identify pregnant women exhibiting risk factors and refer them to specialized prenatal units located in 21 central hospital districts. This screening has succeeded well since the late 1970s, as judged by the low frequency of stillborn and low birthweight children born outside central hospitals. The rate of preterm birth has decreased by 1% during the latter half of the 1970s and is now 5.8%. This decrease occurred concomitantly with an overall decrease of 55% in the use of betamimetic drugs, which suggests that the use of betamimetic agents has had minor or no significant impact on the reduction of the incidence of prematurity. In order to improve the identification of mothers at high risk for preterm delivery, a mathematical model was constructed that included 13 risk factors. This model successfully identified a class made up of 22% of all women in whom 65% of preterm deliveries occurred, but 35% of mothers delivering prematurely still remained unidentified. Efficient screening of genital tract infections, relieving mothers of heavy work, and developing new oxytocin analogues may further reduce prematurity in the future.

摘要

1944年,芬兰依法规定建立全国免费产前护理系统。目前,芬兰99.9%的孕妇都使用该系统。其主要目的是在当地医疗中心为所有孕妇提供建议和护理,识别出有风险因素的孕妇,并将她们转诊至位于21个中心医院区的专业产前护理机构。自20世纪70年代末以来,这种筛查取得了很好的成效,从中心医院以外出生的死产儿和低体重儿的低发生率就可以判断出来。20世纪70年代后半期,早产率下降了1%,目前为5.8%。这一下降与β-拟交感神经药物使用量总体下降55%同时发生,这表明β-拟交感神经药物的使用对降低早产发生率影响较小或没有显著影响。为了更好地识别早产高危母亲,构建了一个包含13个风险因素的数学模型。该模型成功识别出了占所有孕妇22%的一个群体,其中65%的早产发生在这个群体中,但仍有35%的早产母亲未被识别出来。有效筛查生殖道感染、减轻母亲的繁重工作以及开发新的催产素类似物可能会在未来进一步降低早产率。

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