Analysis On The Occurrence And Outcome Of High-risk Pregnancy After The "Two Children" Policy

【Objective】To compare the occurrence and outcome of high-risk pregnancy before and after the " two children " policy,analyze the impact of the adjustment of fertility policy on the change of high-risk factors and pregnancy outcome,Clarify the management direction of high-risk pregnancy in the future,and reduce the occurrence of adverse pregnancy outcome.【Method】The data of pregnant and lying in women hospitalized in the obstetrics department of Huangdao District Maternal and child health care hospital from 2014 to2016 were analyzed retrospectively,observe the impact of the adjustment of fertility policy on the occurrence and outcome of high-risk pregnancy through the rate and percentage;specifically analyze the 3758 pregnant and lying in women in 2016,the first year after the "comprehensive two child" policy,and divide them into high-risk group and non high-risk group according to whether pregnancy is accompanied with high-risk factors.2263 in non high risk group and 1495 in high risk group were analyzed by Microsoft Excel,spss20.0,MATLAB and other software.By means of variance analysis,?2test and logistic regression analysis,the occurrence and termination of high-risk pregnancy were analyzed.【Result】Part OneWith the adjustment of fertility policy: 1.The incidence of high-risk pregnancy increased year by year.The incidence of high-risk pregnancy in 2016 was 39.78%,13.53% higher than that in 2015(26.25%)and 14.66% higher than that in 2014(25.12%).2.The composition and ranking of high-risk factors have not changed significantly.The top three are: adverse pregnancy and childbirth history(abortion ≥ 3 times),cicatricial uterus and old age,but the percentage of cicatricial uterus and old age is increasing year by year.3.The incidence of adverse pregnancy outcomes increased year by year,from21.74% in 2014 to 23.65% in 2015,and then to 27.94% in 2016.4.The rate of cesarean section increased year by year,from 41.83% in 2014 to 43.25% in 2015 and 46.34% in2016.Part TowThe occurrence and outcome of high-risk pregnancy in 2016: 1.The incidence was39.78%.In many high-risk factors,adverse pregnancy and childbirth history(abortion ≥3 times)is the most important high-risk factor,scar uterus is the second factor,the elderly ranked third.2.The detection rate of high-risk pregnancy was higher in urban population(P < 0.001,or = 2.214);the detection rate was higher in high-level population;the adverse pregnancy outcome in high-risk group was 37.98 percentage points higher than that in non high-risk group(P < 0.001).3.The cesarean section rate of high-risk pregnancy was62.6%,22.8% higher than that of non high-risk pregnancy(P < 0.001),the adverse pregnancy outcome rate was 71.43%,37.98% higher than that of non high-risk pregnancy(P < 0.001).【Conclusion】After the policy of "second birth" was released:1.The occurrence of high-risk pregnancy and adverse pregnancy outcomes increased.Therefore,we can start from the pre pregnancy eugenics examination,early detection,early evaluation and early intervention of high-risk people,which can effectively control the occurrence of adverse outcomes.2.The detection rate of people living in urban areas and with high education level is high.The management of pregnant and lying in women can be subdivided into villages,the importance of regular birth inspection can be publicized to households,and the coverage area of birth screening can be expanded.3."Scar uterus" and "old age" have been on the rise for several years.In this regard,it is necessary to give full play to the role of secondary midwifery institutions as a link between the preceding and the following,to assess the upper level accurately and grade,to refer the patient in time,and to monitor and guide the health dynamically.4.The rate of cesarean section is increasing year by year.High risk pregnancy is closely related to this result.Strict indication of cesarean section,improvement of midwifery technology,and development of Doula and painless delivery can reduce the rate of cesarean section.Hospitals,health administrative departments and pregnant women can cooperate with each other to control the progress of high-risk situation and reduce the adverse pregnancy outcome.