新华视点：一升一降 出生缺陷与婚检的十年较量 Xinhua viewpoint:A liter a drop birth defects and check-ups ten years bout

　　婚检率直线下降，出生缺陷率逐年上升，这是我国取消强制婚检近10年来的两个不争事实。

Check-ups rate declines linearly,Birth defect rate is rising year by year,This is our country to cancel compulsory check-ups nearly 10 years of two known fact.

　　这“一升一降”之间是否有直接因果关系？出生缺陷第一道防线如何坚守？提高出生人口素质路在何方？在9月12日“中国预防出生缺陷日”到来之际，“新华视点”记者就这些问题采访了权威部门及有关专家。

this"A liter of a drop"Whether there is a direct causal relationship between?Birth defects the first line of defense how to stick to?Improve the quality of the population was born where road?On September 12,"China, prevention of birth defects"arrival,"Xinhua viewpoint"Reporter on these issues interviewed authorities and experts.

婚检率下降反弹乏力 出生缺陷上升势头不减 Check-ups rate decline rebound fatigue birth defects rising immortalization

　　2003年10月1日《婚姻登记条例》实施，“强制婚检”变为“自愿婚检”。“老百姓误以为取消婚检，全国婚检率陡降。”卫生部妇社司有关负责人说，2004年全国婚检率由80%降至2.67%，一些地方直接归“零”。

On October 1, 2003[The marriage registration regulations]implementation,"Compulsory check-ups"into"Voluntary check-ups"."Common people mistakenly assume that cancel check-ups,The national check-ups rate steep drop."The ministry of health women club company officials said,The 2004 national check-ups rate by 80% to 2.67%,Some places to directly"zero".

　　尽管一些地方推出免费婚检、“一站式”服务以及个别省份恢复强制婚检，直到2011年，全国平均婚检率仍只有41%。

Although some place with a free check-ups/"one-stop"Service and individual provinces reinstate compulsory check-ups,Until 2011,The national average check-ups rate is still only 41%.

　　同时，我国出生缺陷率则上升明显。全国妇幼卫生监测数据显示，2003年出生缺陷率为129.8／万，2006年是145.5／万，2011年则升为153.23／万。

At the same time,Our country was born defect rate rises obviously.The maternal and child health monitoring data shows,Born in 2003 defect rate was 129.8 per,In 2006 is 145.5 per,2011 years is promoted to 153.23 per.

　　取消强制婚检是出生缺陷率升高的“罪魁祸首”？北京大学生育健康研究所所长、卫生部生育健康重点实验室主任任爱国表示，目前没有研究数据支持这一结论，出生缺陷率走高，一方面是监测能力提高，发现增多，漏报减少；另外还有高龄产妇增多等多重因素。

Cancel the compulsory check-ups is birth defect rate increased"culprit"?Beijing university reproductive health institute director/The ministry of health reproductive health key laboratory director as patriotic said,There is no research data to support this conclusion,Birth defect rate go high,On the one hand is monitoring capability,Found that increasing,Omission of reduce;In addition to increased maternal age on the multiple factors.

　　“但婚检率下降不利于出生缺陷的预防毫无疑问。”任爱国说，婚检不仅仅是医学检查，还包括婚前健康教育、婚育咨询指导等，婚检率下降导致这些工作无法开展，出生缺陷一级预防明显被削弱。

"But check-ups rate decline against birth defects prevention without doubt."As patriotic said,Check-ups is not only a medical examination,Also includes premarital health education/Baby is a consulting guidance, etc,Check-ups rate drop caused these work can be carried out,Birth defects primary prevention obviously weakened.

　　孕妇叶酸缺乏可能导致以神经管畸形为主的多种出生缺陷增多。北大生育健康所的一项地区调查显示，《婚姻登记条例》实施前，80%以上的妇女从卫生保健机构获得叶酸知识，取消强制婚检后，这一比例不足30%，孕早期妇女对叶酸的知晓率和服用率均降低20%左右。任爱国说：“孕妇叶酸服用率的降低，神经管畸形及与叶酸缺乏相关的其他出生缺陷如唇腭裂、先心病等有可能不同程度升高。”针对这一状况，我国从2009年开始，为打算生育的农村户籍妇女免费提供叶酸增补剂。

Pregnant women with folic acid deficiency can lead to deformity of neural tube birth defects is increased.Peking University of reproductive health of a regional survey,[The marriage registration regulations]Prior to the implementation of the,More than 80% of women from health care institutions get folic acid knowledge,Cancel after compulsory check-ups,This proportion less than 30%,Early stages of pregnancy women of folic acid at the top of the kimono YongLv are reduced by 20% or so.As patriotic said:"Pregnant women to reduce the rate of taking folic acid,Neural tube malformation and lack of folic acid and other related birth defects such as cleft lip and palate/Such as congenital heart disease may have different degree rise."According to the situation,From 2009, China started,To intend to have rural household women provide free folic acid supplements increased.

　　调查还表明，取消强制婚检后，妇女怀孕前及孕早期服用禁用药物、接触放射线、饮酒等有各种妊娠危险因素的比例均较之前增长一倍，不良妊娠结局发生率也随之上升。

The survey also showed that,Cancel after compulsory check-ups,Pregnant women before and early pregnancy taking banned drugs/Contact radiation/Drinking, there are all kinds of risk factors, such as the proportion of pregnancy were previously doubled,Adverse pregnancy outcome with incidence rate rise.

意识淡泊免费婚检遇“冷” 防线退守孕检也难“热” Awareness indifferent in free check-ups"cold" Defence checks are hard to withdraw"heat"

　　为遏制婚检率急剧下降，2004年开始许多省市推出免费婚检。但这一政策并没有挽住“狂澜”，甚至在一些地区还遭到“冷遇”。如北京免费婚检后仍以7%居全国倒数第一。

In order to contain the check-ups rate fell sharply,2004 start many provinces and cities with a free check-ups.But the policy did not hold"Raging waves",Even in some areas were also"disesteem".Such as Beijing free check-ups still to 7% in the country the last one.

　　“免费婚检不能起到撬动婚前保健服务的杠杆作用，特别在城市。”卫生部妇社司有关负责人表示，心理学调研表明，基于人们害怕隐私暴露的心理，自愿进行婚前保健比例达到40%-60%就算理想。

"Free check-ups cannot have prise premarital care service leverage,Special in the city."The ministry of health women club company officials said,Psychological research shows that,Based on the people who are afraid of privacy exposed psychological,Voluntary premarital care to 40% - 60% even if ideal.

　　“婚检率低更多是意识问题。”北京市卫生局妇幼与精神卫生处处长吕璠说，由于婚前保健服务对象主要是青年人，他们往往对自身健康状况关注不够，容易忽视疾病；还有人怕自己某些疾病暴露后，会失去对方，因而逃避婚检。

"Check-ups rate is low is more consciousness."The municipal bureau of health maternity and child and mental health marshal LvFan said,Due to the premarital health care service object is mainly young people,They tend to oneself health condition is not enough attention,Easy to ignore disease;Others feared he some disease after exposure,Will lose each other,Therefore escape check-ups.

　　北京市卫生局的调查表明，认为婚前保健不是婚姻登记必要程序，没必要做的占86.77%；认为检查耽误时间、不方便的占27%；仅有13.75%的人认为会增加经济负担。

The municipal bureau of health survey,Think premarital care is not the marriage registration procedures necessary,No need to do 86.77%;Think check lose time/Don't convenient accounted for 27%;Only 13.75% of people think that will increase economic burden.

　　近年来，我国建立健全婚检、产前筛查及产前诊断、新生儿疾病筛查 “三道防线”。作为预防出生缺陷更直接、更有针对性的孕检，能否替代婚检成为第一道防线？对此，浙江大学医学院附属妇产科医院孕前咨询门诊专家韩秀君表示：“防线不能退守，目前我国孕前检查率还很低。就算是强制孕检，因为怀孕的随机性大，没有明确的关口和抓手，其相对强制婚检可操作性更弱，因此更难普及。”

In recent years,Our country establish check-ups/Prenatal screening and prenatal diagnosis/Neonatal illness screening "Three passes".As more directly to prevent birth defects/A more targeted checks,Can replace check-ups become the first line of defense?this,Zhejiang university medical college hospital outpatient experts consultation about what HanXiuJun said:"Defence cannot withdraw into their,At present our country pregnant examination rate is still very low.Even forced checks,Because of the randomness of pregnancy,No definite gates and gripper,The relative compulsory check-ups maneuverability even weaker,So more difficult to popularization."

　　海南省卫生厅妇社处处长吴桂珠说，孕检的目标很单一，就是为了生一个健康的宝宝。而婚检内容更丰富。“婚前保健除预防疾病和出生缺陷，更侧重使双方相互了解彼此的生殖健康状况，为和谐家庭生活及孕育健康后代打下基础。”

Hainan province women health club marshal WuGuiZhu said,Checks goal is single,Is to give birth to a healthy baby.And more enriched check-ups."Premarital care in addition to prevent disease and birth defects,More emphasis on make both parties mutual understanding of each other's reproductive health status,For the harmonious family life and raise healthy offspring to lay the foundation."

　　卫生部妇社司有关负责人表示，将出生缺陷和传染病预防关口前移至婚前保健是预防性传播疾病、减少遗传病延续的最重要措施。婚前保健应当包括孕前保健的内容，而孕前保健不能替代婚前保健。

The ministry of health women club company officials said,Will birth defects and infectious disease prevention passes forward to premarital care is preenting sexually transmitted diseases/Reduce the continuation of genetic disease the most important measures.Premarital care shall include the contents of pregnant care,And pregnant care cannot replace premarital care.

婚检没有“回头路” 提高出生人口素质路在何方 Check-ups no"back" Improve the quality of the population was born where road

　　近年来，恢复强制婚检呼声不断。对此，北京市卫生局妇幼处副处长郗淑艳说：“恢复强制婚检，这是走回头路，行不通。”

In recent years,Reinstate compulsory check-ups calls.this,The municipal bureau of health, deputy director of the maternity and child place XiShuYan said:"Reinstate compulsory check-ups,This is the closeness,Won't work."

　　面对居高不下的出生缺陷率，如何提高出生人口素质？调查显示，造成出生缺陷除环境因素外，90%左右与遗传有关。因此，受访的业内人士认为，婚检有必要恢复，但不是从行政上恢复强制婚检，而是用各种政策引导和鼓励人们自觉选择婚检，恢复人们的婚检意识。

In the face of high birth defect rate,How to improve the quality of the population was born?Investigation shows that,Cause birth defects in addition to the environmental factors,About 90% of that is linked to genetics.therefore,The surveyed the personage inside course of study thinks,Check-ups is necessary to restore,But not from administrative reinstate compulsory check-ups,But with the various policy guide and encourage people to consciously choose check-ups,Recovery of people's consciousness of check-ups.

　　“不管从家庭责任角度，还是社会责任角度来说，婚检都应该成为人们的一种自觉行为。”业内人士指出，一方面加大宣传力度，让老百姓认识到婚检的必要性；同时提高婚前保健服务质量，通过提供免费的、便利的、人性化的服务，使人们觉得婚检物有所值。

"No matter from the Angle of family responsibility,Or social responsibility point of view,Check-ups should become one kind of aware behavior."The personage inside course of study points out that,On the one hand the increased publicity,Let people realize the necessity of check-ups;At the same time improve the premarital health service quality,By providing free/convenient/Humanized service,Make people feel check-ups content is worth somewhat.

　　任爱国指出，随着人们性观念、婚姻观念及生育观念的变化，未婚先孕、婚前同居、婚前人工流产现象的增加以及婚后长时间不打算怀孕妇女的增多，婚检显然对保障这些人群以及生育第二胎的母婴健康存在不足。因此，为更有效预防出生缺陷，在加强婚检的同时，还应提倡孕前保健。

As patriotic pointed out that,As people sexual concept/Concept of marriage and birth the change of the idea,Premarital pregnancy/Premarital cohabitation/Premarital artificial abortion phenomenon and the increase of marriage for long periods of time without going to the increase of pregnant women,Check-ups to secure these apparently crowd and reproduction, a second litter of maternal and child health inadequacy.therefore,For more effectively prevent birth defects,At the same time in strengthening check-ups,Still should advocate pregnant care.

　　“预防出生缺陷三道防线都不能松。”卫生部妇社司有关负责人表示将会针对三个关键环节进一步加大投入，同时建议各级政府对婚前保健提供经费支持和政策保障，对目标人群实施婚检补助或免费政策。(记者周婷玉、王晖余、李亚红、黄深钢)

"Prevent birth defects three passes can loose."The ministry of health women club company officials say will be according to the three key links further increasing investment,Also recommended that governments at all levels to premarital care funding support and policy guarantee,To target population implement check-ups subsidies or free policy.(Reporter ZhouTingYu/WangHuiYu/LiYaGong/HuangShen steel)