| Objective: This research adopts semi-structured in-depth interviews and combined case-control study,Retrospective analysis of Beta-Thalassemia Major(β-TM)situation and related children was born,Aimed at the prevention and control heavy Mediterranean anemia children born in western guangxi provides the theory basis for more effective prevention and control plan.Methods:(1)The first part:uses the qualitative method,selection of baise 2020 maternity and child care to terminate pregnancy fetal couple β-TM and continuation of pregnancy couple together,Using Colaizzi seven step analysis method to analyze data compilation,explore the beta TM children born and prevent invalid reasons.(2)The second part: Using case-control study,according to include and exclude standards,the period 2015～2020 was born in baise β-TM children with their parents in case group(n=60),during the same period in baise diagnosed and induced labor fetus couple β-TM in the control group(n=80).By issuing paper questionnaires and gui fuer system to collect the basic information of the research object(general demographic data,maternal history,thalassaemia screening and disease).Using SPSS25.0 data analysis,the general data of case group and control group do descriptive analysis,pregnancy outcomes as the dependent variable of β-TM.Results:(1)Qualitative research results precipitation four topics:(1)There are differences in disease cognition among individuals;(2)strong desire to give birth;(3)Poor compliance with prenatal diagnosis;(4)The intensity and level of intervention by health professionals varies.(2)Basic characteristics of the investigation subjects: A total of 60 β-TM children were included in the case group,including 80 induced labor couples,including 34 boys and 26 girls,with an average age of(4.51±1.57)years;the average age of fathers was(31.13±6.09)years;the average age of the mothers was(28.00±5.65)years old.In the control group,the average age of puerpera was(30.13±5.45)years,and the average age of husband was(31.91±5.97)years.Prenatal Diagnosis(PND)unit inspection on 14～25 w mid pregnancy;with an average gestational age of(22.80±3.79)weeks.(3)Before birth,β-TM children had poor parental awareness of thalassaemia and lack of disease awareness.(4)The results of univariate Logistic regression analysis showed that residence area,maternal age,educational level of both parents,birth rate,family history of thalassaemia and thalassaemia gene diagnosis were the influencing factors for the birth of β-TM children(P<0.05).(5)Multivariate Logistic regression analysis showed that the birth risk of β-TM children with parents living in rural areas was higher than that in urban areas(OR=0.091,95%CI:0.017-0.472).The birth risk of β-TM children with maternal age <24 years was higher than that with age ≥24 years(OR=0.137,95%CI: 0.024-0.786).Compared with mothers with primary education OR below,middle OR high school education(OR=0.063,95%CI:0.009-0.432)was a protective factor for the birth of β-TM children.In addition,birth(OR=0.144,95%CI: 0.028-0.735),family history of thalassemia(OR=0.130,95%CI:0.031-0.533),and thalassemia gene testing(OR=0.014,95%CI: 0.002-0.092)reduced the risk of birth of β-TM children.Conclusion:(1)Differences in cognition of disease,strong desire to have children,poor compliance with prenatal diagnosis,low intensity and level of intervention by health professionals can lead to the birth of a β-TM foetus.(2)The parents of β-TM children lack disease awareness before birth,and the compliance of prenatal diagnosis is poor.(3)The birth of β-TM fetus was influenced by many factors.Rural parents and maternal age <24 years were the risk factors for β-TM birth,while maternal education,childbirth,family history of thalassemia and thalassemia gene testing were the protective factors for β-TM birth.It is suggested that prenatal diagnosis and follow-up should be paid more attention to the pregnant women in remote areas,early pregnancy and childbirth,and those with low education level. |
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