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研究生:戴汝妤
研究生(外文):Ju-yu Tai
論文名稱:低體重新生兒發生原因探討-台北市立婦幼綜合醫院個案研究
論文名稱(外文):Exploring the Causes of Low Birthweight Delivery- the Case Study of Taipei Municipal Women''s and Children''s Hospital
指導教授:邱冠斌邱冠斌引用關係
指導教授(外文):Kuanpin Philip Chiu
學位類別:碩士
校院名稱:中華大學
系所名稱:經營管理研究所
學門:商業及管理學門
學類:企業管理學類
論文種類:學術論文
論文出版年:2005
畢業學年度:93
語文別:中文
論文頁數:118
中文關鍵詞:低體重新生兒早產兒唐氏症篩檢政策建議
外文關鍵詞:Low BirthweightPrematureDown Syndrome ScreeningPolicy recommendation
相關次數:
  • 被引用被引用:9
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  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:2
低體重新生兒由於許多器官、功能或結構發展不完全,容易導致死亡、永久性的傷害以及併發症的產生,因此低體重新生兒的發生率直接或間接影響社會資源的分配。若低體重新生兒發生率高,所需醫療成本將大幅提高,相對犧牲其他資源適當的使用,未來的社會成本也相對提高。本研究嘗試找出隨目前社會環境改變而造成低體重新生兒發生之原因,並提出政策建議,以預防勝於治療為出發點,在婦女懷孕前給予足夠的教育,在懷孕後給予完善的醫療照顧。
本研究以邏輯斯迴歸(Logistic Regression Analysis)分析,在百分之九十五的信心水準下,發現懷孕母親年齡在20~24歲、25~29歲、30~34歲、35歲以上者生出低體重新生兒的機率皆比年齡在20歲以下的懷孕母親低,其發生率分別為0.118、0.112、0.084、0.063;懷孕期間增加體重小於10公斤的母親,生出低體重新生兒的機率較高,是體重增加10~14公斤者的1.794倍;母親唐氏症篩檢異常者,生出低體重新生兒的機率是篩檢正常者的2.454倍;懷孕期間曾住院安胎者,是不曾住院安胎者的2.589倍;曾經生過低體重新生兒者,是未曾生過低體重新生兒者的32.18倍;曾經生過早產兒者,是未曾生過早產兒者的3.21倍;新生女嬰較男嬰容易為低體重的發生率為1.803倍;新生兒為多胞胎較非多胞胎容易為低體重的發生率為14.553倍;本胎為早產兒較非早產兒容易為低體重的發生率為21.795倍。
本研究根據分析結果,提出以下政策建議:1、加強準父母相關之教育。2、以醫院為第一把守關卡,衛生所為協助輔導單位。3、強制規定婚前健康檢查。4、建議未來修法設立補助基金。5、彙整功能完善的單一法規服務。希望能藉由上述之建議,有效減少低體重新生兒的發生,並避免日後的資源浪費與社會負擔。
Many low birthweight newborns easily lead to death or permanent damage due to incomplete development of functions or structures of organs. Therefore, the prevalent rate of the low birthweight newborns affects the distribution of the social resources, both directly and indirectly. The higher the prevalent rate, the higher the medical costs as well as the social costs. It would also sacrifices some rescourses that could be used more properly. This case study of Taipei Municipal Women’s and Children’s Hospital examined numbers of possible causes of the low birthweight deliveries and proposed policy recommendations. This paper suggests that prevention is better than remedies. Women should be better-educated about conception, pregnancy, and birth before they become pregant, and be given sufficient medical care during and after pregnancy.
The result of logistic regression analysis in this study showed that, under the 95% confidence interval, the rate of low birthweight delivery for mothers with age between 20 to 24, 25 to 29, 30 to 34, or 35 and older, is statistically significantly lower than mothers under 20 years old. Compared with teenage mothers, the rates of low birthweight delivery are 0.118, 0.112, 0.084, and 0.063, respectively. It was also found that, mothers who gained less than 10 kilograms during their pregnancy are 1.794 times as likely as those mothers who gained 10-14 kilograms to have low birthweight newborns. Similarly, pregnant women with abnormal Down syndrome screening is 2.454 times as likely as those women with normal Down syndrome screening to deliver low birthweight babies.
The probability of low birthweight delivery for mothers who had been admitted for treatment of threaten abortion during pregnancy is 2.589 times as that for those who had not. Mothers who ever had low birthweight newborns are 32.180 times as likely to have low birthweight newborns as mothers who have not had. By the same token, mothers who had premature babies are 3.210 times as likely, as those who have not had, to deliver low birthweight babies. Baby girls are 80.3% more likely than baby boys to be low birthweight. The probability of low birthweight for newborns from multiple pregnancies is 14.553 times as that for those from single pregnancies. Premature newborns are 21.795 times as likely as their counterparts to be low birthweight.
Based on the findings this study provided the following policy recommendations: 1. The parents-to-be should be more educated about conception, pregnancy, and birth. 2. The regional hospitals should be the gatekeeper with the support of health stations. 3. Regulate the compulsory premarital health check-up for couples-to-be. 4. Establish the fund for low birthweight deliveries to lessen parents’ burden. 5. Set up a single service window for reference on laws and regulations related to low birthweight deliveries. It is hoped that effective policies can reduce the occurrence of low birthweight delivery in order to deminish the avoidable waste of resources as well as social burden.
第一章 緒論..................................................1
第一節 研究動機............................................1
第二節 研究目的............................................5
第三節 研究流程與章節安排..................................6
第二章 文獻探討..............................................7
第一節 低體重新生兒文獻探討................................7
第二節 名詞界定與介紹.....................................30
第三章 研究方法.............................................39
第一節 研究問題...........................................39
第二節 研究對象與方法.....................................40
第三節 研究資料變項操作性定義.............................44
第四節 研究架構...........................................49
第四章 研究分析............................................50
第一節 敘述統計(Descriptive Statistics)及
卡方檢定(Chi-Square Test)........................50
第二節 邏輯斯迴歸分析(Logistic Regression Analysis).....86
第五章 結論.................................................95
第一節 研究發現...........................................95
第二節 政策建議..........................................101
第三節 研究限制..........................................106
第四節 後續研究建議......................................108
參考書目....................................................109
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