| Objective To evaluate the implementation of the Preconception care (PCC) in Shanghai, and describe the experience of the child-bearing women who have participated in PCC, thus providing information for quality improvement of PCC in the future.Methods The investigation was implemented by both quantitative and qualitative studies. In the quantitative research:a retrospective and self-designed questionnaire survey was carried out from July to October in 2012 in three Level-3 first-class Obstetrics & Gynecology Hospitals in Shanghai. Pregnant women, who registered at Prenatal Clinic Department for the first time, were recruited after obtaining their informed consent. There were two different questionnaires to different women according to whether they had participated in PCC or not. While in the qualitative research:our team had semi-structured interviews with those open and talkative pregnant women according to the interviewing outline.Results In the quantitative research:7310 valid questionnaires were received. Among all the subjects in our study,95.3% of whom knew the concept of PCC, 50.0% knew the free preconception examination policy of Shanghai government. The planned pregnancy rate of child-bearing aged women in Shanghai was 82.3%, PCC rate 38%. Women of planned pregnancy (OR=8.64,95% CI:7.03-10.63, P<0.01), knowing the free policy of preconception examination (OR=1.55,95% CI:1.40-1.72, P<0.01), age (OR=1.10,95% CI:1.08～1.11, P<0.01), living in Shanghai≥1 years (OR=1.34,95% CI:1.20～1.50, P=0.01), annual income of family≥10,000 yuan (OR=1.31,95% CI:1.17～1.46, P<0.01) and master degree or more (OR=1.36,95% CI:1.09～1.69, P<0.01) were more intended to participate in the PCC. In the PCC group (i.e. all the subjects in this group had participated in Preconception Care), 12.2% of whom had been diagnosed with diseases,52.4% of which were cured or under the control before conception. The PCC group was better than the non-PCC group in the folic acid supplement, intake of trace elements, exercise-taking, alcohol consumption stopping, drug-quit and rubella vaccination before conception (P<0.01). But in the aspects of smoking cessation, avoiding the contacts with toxic substances and pets, there was no significant difference between the two groups (P>0.05). 86.0% of the PCC group were satisfied with the PCC service, but the satisfaction rate was different among different service agencies (P<0.01).While in the qualitative research:child-bearing women were informed of PCC information via many ways and social support system played an important role in affecting their participation of the PCC; the desire of good pregnancy outcomes was the main factor in the participation of the PCC; the interviewees gave positive evaluation on PCC; the service quality of different PCC institutions was satisfactory in the whole, but still needed further improvement.Conclusions The concept of PCC had been widely known among child-bearing aged women in Shanghai area, and the participation rate of PCC in Shanghai closed to the level of the developed countries. The effects of PCC were obvious and the overall satisfaction rate of PCC was high. To explore the effective preconception counseling and intervention means, thus promoting the unity of knowledge, attitude and practice of child-bearing aged women, is still the key point in the future. |
PDF Full Text Request