| ObjectiveRelying on the existing Guangxi Maternal and Child Information Management Development and Application Platform,through the selection and optimization of maternal and prenatal examination data collection indicators set,and optimizing information design and implementation technology of accurate tracking management function of maternal and prenatal examination information,to promote the improvement of standardization level of maternal and prenatal examination management,so as to achieve the goal of reducing adverse pregnancy outcomes.Method1.Based on the national and Guangxi maternity and prenatal examination business management norms,select the indicators suited to prenatal examination information management,focus on innovative research and increase the data indicators needed to achieve accurate tracking information management.2.The business service demands,data standard and system functionmodule optimization design of precise tracking and management of maternal production inspection informatization,researching the feasibility of information-based accurate identification,business process tracking management,information interaction between service objects and mobile terminals of service providers,data quality control and other aspects from the aspects of business service requirements,provides feasible system functions for the optimization and development of system function modules,develop demand analysis,provides technical personnel to complete the development and online application.3.Evaluation of the application effect of precise tracking.A third-class first-class maternal and child health hospital in Guangxi was selected as the research unit.Based on the interactive data of WeChat APP,a precise tracking management information interactive carrier,January 2018 as the time dividing point,The pregnant and lying-in women were divided into group 2017 and group 2018,and the application effect of accurate tracking was analyzed for the binding status,the times of prenatal examination and the standardized prenatal examination of maternal and child health manual WeChat APP.4.The influencing factors of delivery mode,postpartum hemorrhage and perinatal death were discussed respectively,and the adjustment variables of multivariate regression model were determined.To research group 2018,14744 cases of single pregnancy women were selected as the research objects,The mode of delivery,postpartum hemorrhage and perinatal death were taken as dependent variables;age,nationality,number of children,times of pregnancy,hepatitis B,scarred uterus,gestational hypertension,premature rupture of membranes,macrosomia and oligohydramnios were taken as independent variables.Univariate logistic regression was used to investigate the influencingfactors of different pregnancy outcomes,providing the basis for constructing multivariate regression model.5.Standard correlation analysis between prenatal examination and pregnancy outcome.Multivariate logistic regression analysis was used to take the number of prenatal examinations,standardized prenatal examination and whether the first prenatal examination was less than 13 weeks as independent variables,the delivery mode,postpartum hemorrhage,and perinatal death as dependent variables respectively.Accordingly,the covariates with statistical significance(P<0.05)in the univariate analysis were included in the multivariate regression model.Result1.The analysis results of precise tracking application results showed that in the year which the binding rate of WeChat increased significantly.the number of pregnant and lying-in women in the group 2018 was 4532,the rate of standardized prenatal examination was 30.75%,and the average number of prenatal examinations were 8.35.Compared with the WeChat binding rate,the number of prenatal examinations,standardized prenatal examination rate and Average number of prenatal examinations in group 2017 with lower binding rate of WeChat increased by 3242,23.18% and 2.15 times respectively.2.The number of prenatal examinations had no effect on the choice of cesarean section and natural delivery(P > 0.05).Compared with natural delivery of which the number of prenatal examinations not less than 5 times,the number of assisted delivery was 0.62 times more than that of natural delivery(OR = 0.62,95% CI: 0.46~0.82).The perinatal mortality risk was 0.06 times higher than that of < 5(OR = 0.06,95% CI: 0.05~0.08).3.Compared with natural delivery,cesarean section was 0.87 times morethan that with nonstandardized prenatal examination(OR = 0.87,95% CI:0.80~0.95).The risk of postpartum hemorrhage was 0.80 times higher in women with standardized prenatal examination than in women with nonstandardized prenatal examination(OR = 0.80,95% CI: 0.67~0.96).The risk of perinatal death among women with standardized nonstandardized is 0.06 times higher than that of women without standardized labor examination(OR = 0.06,95% CI:0.02~0.13).4.Whether the first prenatal examination was less than 13 weeks had no effect on the choice of delivery mode,the risk of postpartum hemorrhage and the risk of perinatal death(P>0.05).ConclusionBy optimizing the data acquisition indicators of maternal and prenatal examination information management,and using electronic maternal and child health manual WeChat APP as the carrier to achieve accurate tracking management of prenatal examination information,the information interaction between the object of prenatal examination service and the provider of prenatal examination service can be improved.The rate of standardized prenatal examination increases with the increase of information interaction,and the rate of standardized prenatal examination rate also promotes improvement of the related indexes of adverse pregnancy outcome.Standardized prenatal examination can reduce the risk of cesarean section,postpartum hemorrhage and perinatal death.Therefore,the implementation of accurate information tracking management in prenatal examination process can improve the number of standardized prenatal examination,the rate of standardized prenatal examination and the number of prenatal examinations,and has important practical application value for improving pregnancy outcomes. |
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