Ngo Thi-Thuy-Dung, Nguyen The-Dung, Goyens Philippe, Robert Annie
a Epidemiology Department of Faculty of Public Health, Pham Ngoc Thach University of Medicine , Ho Chi Minh City , Vietnam.
b Pôle Epide´miologie et Biostatistique, Institut de Recherche Expe´rimentale et Clinique, Faculte´ de Sante´ Publique, Universite´ catholique de Louvain , Brussels , Belgium.
Health Care Women Int. 2018 Apr;39(4):472-492. doi: 10.1080/07399332.2017.1400035. Epub 2017 Dec 14.
Researchers in Vietnam reported a high percentage of pregnant women attending ANC at least once, but an insufficient utilization of ANC services remains. The evidence demonstrating how the utilization of these services affect pregnancy outcome is not documented in Vietnam. We investigated the association between the misuse of ANC services and pregnancy outcome, and assessed other determinants associated with ANC services utilization. We conducted a prospective community-based study in Trang Bom district, Dong Nai, during 12 consecutive months. Data were collected using a structured questionnaire and medical records. Women were followed up to delivery. Misuse of ANC services, related factors and its association with adverse events were assessed using logistic regression. Out of 3301 pregnant women, 91% initiated an ANC visit within first trimester, 95% attended at least three ANC visits, but a low percentage of pregnant women underwent blood and urine tests at least once (20% and 39%, respectively). Factors significantly associated with a higher risk of adverse outcomes were lack of blood test and urine test, parity ≥ 3, ANC visits < 3, history of an adverse outcome, and having a clinical condition. Blood and urine tests were less frequently used by young women, women from ethnic minorities, women using only private facilities for ANC attendance, and women with a low number of ANC visits. Despite a high percentage of early entry into ANC and of at least three ANC visits, misuse of ANC services still exists and contributes to adverse outcomes. There is a need to increase the awareness of women on the benefits of ANC services by educating young women as well as women with several children. Health workers should be encouraged to propose suitable ANC services to pregnant women.
越南的研究人员报告称，很大比例的孕妇至少参加过一次产前检查，但产前检查服务的利用仍不充分。在越南，尚无证据表明这些服务的利用情况如何影响妊娠结局。我们调查了产前检查服务的不当使用与妊娠结局之间的关联，并评估了与产前检查服务利用相关的其他决定因素。我们在同奈省德和县进行了一项为期12个月的前瞻性社区研究。数据通过结构化问卷和病历收集。对妇女进行随访直至分娩。使用逻辑回归评估产前检查服务的不当使用、相关因素及其与不良事件的关联。在3301名孕妇中，91%在孕早期开始进行产前检查，95%至少参加过三次产前检查，但进行过至少一次血液和尿液检查的孕妇比例较低（分别为20%和39%）。与不良结局风险较高显著相关的因素包括未进行血液和尿液检查、胎次≥3、产前检查次数<3、有不良结局史以及患有临床疾病。年轻女性、少数民族女性、仅在私立机构进行产前检查的女性以及产前检查次数较少的女性较少进行血液和尿液检查。尽管早期进行产前检查和至少进行三次产前检查的比例较高，但产前检查服务的不当使用仍然存在，并导致不良结局。有必要通过对年轻女性以及多子女女性进行教育，提高女性对产前检查服务益处的认识。应鼓励卫生工作者为孕妇提供合适的产前检查服务。
