A Study Of Related Factors On Adverse Pregnancy Outcomes Among The Married Couples At Childbearing Age In Xiangyun County

Objectives:To explore the pre-pregnancy risk factors on adverse pregnancy outcomes among the married couples at childbearing age in Xiangyun, Dali, Yunnan, based on the "health ecological model". The study was explored the different pre-pregnancy factors about five aspects and dividing into upstream factors, middle factors and downstream factorsof the couples as follows:personal factors, the psychological and behaviors&life styles, living and working environment, situation during early pregnancy and prepregnancy physical check. Then discussed which factors would influence the pregnancy outcomes though different statistical methods. Finally, provide a basis for making interventional measures and realizing prepotency based on the results of our study and the upstream, middle and dwonstream related factors.Methods:In quantitative methods,1060married couples who delivered from0a.m. January1st2009to24p.m. December31th2010in hospital at childbearing age with pregnancy outcomes were selected randomly. Self-made questionnaires which include pre-pregnancy factors:personal factors, the psychological and behaviors&life styles, living and working environment, situation during early pregnancy and prepregnancy physical check were use to explored the relationship between these factors and adverse pregnancy outcomes. SPSS software was used to analyze all the explored factors with univariate and multivariate logistic regression analysis. Then the selected statistically significant differences factors would be to do the Principal Component Analysis and Logistic regression analysis. Meanwhile, in qualitative methods, we interviewed the leaders and staffs who working county family planning institutions and the married couples in Xiangyun, so that explored the breakthrough point and feasibility of improvement the process of Eugenic Health Promotion Project.Results:1. In the1060respandents, there were1057pregnancy outcomes in total be got, the effective rate was99.72%. There were990normal pregnancy outcomes and67adverse pregnancy outcomes; the positive rate was6.34%; the rate of pregnancy planning was females’912,86.29%, males’842,79.66%.2. The pre-pregnancy related factors about all variables were selected as independent variable, adverse pregnancy outcomes were selected as dependent variable. After univariate logistic regression analysis,21variables were selected (P<0.05) including5protecting factors (OR<1) and15risk factors (OR>1).They were age of wife less than20or more than34(OR=0.925).age of husband less than20or more than34(OR=0.930), abnormal urinalysis of wife (OR=0.897), abnormal urinalysis of husband (OR=0.642), abnormal blood analysis of husband (OR=0.662), education years of wife less than9years (OR=1.982), family history of congenital heart disease of husband (OR=1.102), family history of diabetes mellitus of husband (OR=1.104), family history of hearing impairment of husband (OR=1.101), history of anemia of wife (OR=2.220), history of fetal intrauterine of wife (OR=5.102), monotonous diet of wife (OR=5.108) monotonous diet of husband (OR=6.557), tensions with relatives and friends of wife (OR=14.868), wrong folic acid of wife (OR=1.187), progestation vaginal bleeding(OR=27.949), progestation stomachache(OR=7.738), progestation fever (OR=11.204), progestation passive smoking(OR=1.553), BMI of wife less than or more than the standard (OR=1.881), BMI of husband less than or more than the standard (OR=1.720) 3. The Principal Component Analysis was used,69.8%information of the21related factors could be explained by the7principal components before. The first principal component was education years of wife less than9years and wrong folic acid of wife.4. The multivariate logistic regression analysis was used, the results showed there were4variables in the regression equation (P<0.05), including the age of wife less than20or more than34(OR=0.902),BMI of wife less than or more than the standard (OR=1.116), progestation passive smoking (OR=4.618), progestation vaginal bleeding (OR=5.125)5. Among the21related factors, there were1factor assigned to the upstream,5factor assigned to the middle and15factor assigned to the downstream.Conclusions:The qualitative and quantitative research showed that, the related factors of married couples at childbearing age were related with adverse pregnancy outcomes at different levels. The greatest impact factocs were the education standard of wife and wrong folic acid of wife. The second impact factocs were pre-pregnancy physiological indexes of physical examination. The lowest impact factocs were mentality, life-style of the couples. They influenced each other between various factors.Suggestions:The measures should be taken as follows:developing tertiary prevention strategy of adverse pregnancy outcomes, combining with the upstream, middle and dwonstream level factors and the actual needs of married couples to improve Eugenic Health Promotion Project.The primary prevention was developing the pre-pregancy examination and prenatal examination and health education based; the second prevention was screening the adverse pregnancy outcomes as soon as possible; the third prevention was developing the neonatal screening.