目的:通过对示范地区β地中海贫血、新生儿溶血症干预效果的调查分析,探寻适宜贵州农村β地中海贫血、新生儿溶血症群体干预的措施和模式。方法:采用人群实验研究方法,在项目干预县建立示范区,依托贵州省计划生育技术服务网络,以β地中海贫血、新生儿溶血症为切入点,全面实施出生缺陷综合干预。通过对干预前后和地区间的比较评估干预效果。结果:干预后育龄夫妇出生缺陷干预知识、态度、行为均有明显改变,干预组各项得分值明显高于对照组。计生管理技术人员在知识得分和专业能力方面,与基线相比均显著提高,干预组明显高于对照组,差异有统计学意义(P<0.05,P<0.0001),干预组认为基本能胜任出生缺陷干预工作者占80.0%,对照组占41.2%。干预组经血型筛查发现659名高危对象,经干预在分娩的7 737名新生儿中无1例因新生儿溶血症死亡,对照组在分娩的6 903名新生儿中则有3人死亡;干预组筛查发现5对β地中海贫血高风险夫妇,经干预无重型β地中海贫血患儿出生。结论:健康教育能显著提高育龄群众预防出生缺陷知识和意识,是一种可以在农村广泛开展的低成本高效率的干预措施。引入的群体干预技术和措施需符合基层的实际情况才能被更好推广和接受。同时,必须加大对基层计生技术能力的建设和投入,以保证先进的方法在出生缺陷干预工作中得到更好应用和推广。 OBJECTIVE: To investigate the intervention effects of β-thalassemia and neonatal hemolytic disease in demonstration areas and to explore the appropriate interventions and modes of β-thalassemia and neonatal hemolytic disease in rural Guizhou. Methods: Based on population experimental research, a demonstration area was set up in the project intervention counties. Based on the family planning technical service network of Guizhou Province, β-thalassemia and hemolytic disease of newborns were taken as the starting point to comprehensively implement the comprehensive intervention of birth defects. The effectiveness of the intervention was evaluated by comparing pre- and post-interventions and between regions. Results: Knowledge, attitude and behavior of couples with child-bearing age after intervention were significantly different from each other, and scores in intervention group were significantly higher than those in control group. Family planning management technicians in knowledge score and professional ability, compared with the baseline were significantly increased, the intervention group was significantly higher than the control group, the difference was statistically significant (P <0.05, P <0.0001), the intervention group that basically be qualified to be born Defect intervention workers accounted for 80.0%, control group accounted for 41.2%. In the intervention group, 659 high-risk subjects were found by blood screening. None of the 7 737 newborn babies who were delivered died of neonatal hemolytic disease, while 3 of 6 903 newborn babies in the control group died. Intervention group screening found that 5 pairs of β-thalassemia high-risk couples, were infants born without severe β-thalassemia. Conclusion: Health education can significantly increase the knowledge and awareness of childbearing-age children in preventing birth defects. It is a low-cost and high-efficiency intervention widely available in rural areas. The introduction of group intervention techniques and measures should be in line with the actual situation of the grassroots level in order to be better promoted and accepted. At the same time, we must step up construction and investment in grassroots family planning and technical capabilities to ensure that advanced methods are better applied and promoted in interventions for birth defects.