【摘要】 目的了解江苏地区孕前检查人群5年生育和不孕不育发生情况。方法采取分层整群抽样方法对江苏苏南、苏中、苏北的3个县7个乡镇在2013年前参加免费孕前优生健康检查的5 086对夫妇进行5年跟踪随访。结果①5年内共完成3次随访,随访应答率为100%。孕前检查人群1年累积受孕率为88. 68%,1年累积不孕率为11. 32%; 2年累积受孕率为90. 47%,2年累积不孕率为11. 97%; 5年累积受孕率为96. 88%,5年累积不孕率为11. 98%。②孕前检查一般风险人群不孕率为11. 16%,低风险人群不孕率为11. 78%,高风险人群不孕率为14. 50%,差异有统计学意义(Z=2. 45,P <0. 05)。③不孕症患者的5年就诊率为31. 42%。孕前检查后第1年就诊的患者5年累积受孕率为53. 93%,第2年就诊的患者5年累积受孕率为44. 29%,第3～5年就诊的患者5年累积受孕率为18. 18%,差异有统计学意义(Z=2. 87,P <0. 05)。④122对已知不孕原因的对象中,女方原因占58. 20%,男方原因占11. 48%,双方原因占4. 92%,不明原因占25. 41%,包括2例性染色体异常对象。结论应加强孕前检查人群中不孕症患者的早期管理,结合孕前检查风险评估结果加以指导,做到早诊断、早治疗。更多还原

【Abstract】 Objective To investigate the incidence of 5-year fertility and infertility among pre-pregnant examination women in Jiangsu. Methods 5 086 couples who took part in free pre-pregnancy physical examination in 7 townships of 3 counties in southern,central and northern Jiangsu Province by stratified cluster sampling were followed up for 5 years. Results ① Three follow-up visits were completed in 5 years,and the response rate was 100 %. The cumulative fertility rate was 88. 68 % and the cumulative infertility rate was 11. 32 % in one year; the cumulative fertility rate was 90. 47 % and the cumulative fertility rate was11. 97 % in two years; the cumulative fertility rate was 96. 88 % and the cumulative sterility rate was 11. 98 % in five years. ② The infertility rate of general risk group,low risk group and high risk group was 11. 16 %,11. 78 % and 14. 50 % respectively,with statistical significance( Z = 2. 45,P < 0. 05) . ③ The 5-year visiting rate of infertility patients was 31. 42 %. The 5-year cumulative fertility rate was 53. 93 % in the population who seek medical advice in first year after pre-pregnant examination,44. 29 % in the second year and 18. 18 % in the third to fifth year( Z = 2. 87,P < 0. 05) . ④Among 122 known causes of infertility,58. 20 % were female,11. 48 % were male,4. 92 % were bilateral,25. 41 % were unknown,including 2 cases of abnormal sex chromosome. Conclusion We should strengthen the early management of infertility patients in pre-pregnancy check-up population,and guide them with the results of risk assessment of pre-pregnancy check-up,so as to make early diagnosis and treatment.更多还原