RESUMO
Objective:To assess the detection rates of preconception health risks among couples of reproductive age in China and analyze the differences between 2013 and 2019.Methods:In this cross-sectional study, the preconception health examination data of 9 153 916 couples of 20-49 years who participated in the National Free Preconception Health Examination Project in 2013 or 2019 were consecutively selected. The health risks involved eight aspects in women (genetic risk, reproductive risk, chronic disease risk, infectious risk, nutritional risk, behavioral risk, environmental risk and psychosocial risk) and seven aspects in men except for reproductive risks were assessed. The t test and χ2 test were used to compare the differences in demographic characteristics between the couples of reproductive age. The detection rates and 95% CI of each preconception health risk were calculated and the χ2 test was used to compare the differences in the detection rates of risk factors. Results:In 2019, the proportion of couples of reproductive age in China who were 35 years or older, had an education background of high school and above, workers, and held non-agricultural registered residence were all higher than those in 2013 (15.18% vs 6.22%, 52.12% vs 29.78%, 8.33% vs 7.17%, 12.39% vs 6.64%), while the proportion of farmers was significantly lower than that in 2013 (60.95% vs 76.87%) (all P<0.001). In 2013, the three health risks with the highest detection rate among Chinese women of reproductive age was nutritional risk (37.50%), infectious risk (16.95%) and psychosocial risk (11.62%), respectively; while in 2019, it was nutritional risk (38.07%), infectious risk (12.82%), and chronic disease risk (11.12%), respectively. The detection rate of nutritional risk in Chinese women of reproductive age in 2019 was significantly higher than that in 2013 (38.07% vs 37.50%), while the detection rates of infectious risk and psychosocial risk were both lower than those in 2013 (12.82% vs 16.95% and 7.37% vs 11.62%) (all P<0.001). In 2013, the top three risks detected in men of reproductive age was behavioral risk (44.87%), nutritional risk (36.81%) and psychosocial risk (13.43%), respectively; and in 2019, it was nutritional risk (45.47%), behavioral risk (38.76%) and psychosocial risk (9.18%), respectively. The detection rates of nutritional risk in men of reproductive age in 2019 was significantly higher than that in 2013 (45.47% vs 36.81%), while the detection rates of behavioral risk and psychosocial risk were both lower than those in 2013 (38.76% vs 44.87%, 9.18% vs 13.43%) (all P<0.001). Conclusions:The detection rate of nutritional risk in couples of reproductive age and genetic risk in men in 2019 in China are higher than those in 2013, and the exposure to the other preconception health risks is decreasing. The nutritional risk, infection risk, psychosocial risk and chronic disease risk are the main risk factors for women of reproductive age, while the nutritional risk, behavioral risk and psychosocial risk are the main risk factors for men.
RESUMO
Objective:To analyze the prevalence and risk factors of pre-pregnancy underweight, overweight and obesity among women aged 18~49 years in China in 2013 and 2019 and the changing trends during this period.Methods:Pre-pregnancy examination data were collected for 9 220 664 women of reproductive age who participated in the National Free Pre-pregnancy Health Examination Project in 2013 and 2019, to analyze the prevalence and changing trends of underweight, overweight and obesity. Data from China Population Census in 2010 were applied to calculate the age-standardized prevalence of underweight, overweight and obesity. Logistic regression model was used to analyze the risk factors.Results:The prevalence of underweight, overweight and obesity among women aged 18-49 years in China was 7.47%, 21.05% and 6.08%, respectively. Over the seven years from 2013 to 2019, the prevalence of underweight in women of reproductive age had decreased, and the prevalence of overweight and obesity had increased significantly. Younger age, higher education level and ethnic minorities were the risk factors of underweight, while advanced age, farmers, previous gravidity and previous parity were the risk factors of overweight and obesity. Vegetarian, smoking and passive smoking might increase the risk of underweight, overweight and obesity.Conclusion:Women of reproductive age in China are faced with the dual challenge of malnutrition and overnutrition and the weight management before pregnancy should be strengthened for women of reproductive age.