The Pre-pregnancy Health Care Specialty was officially established in 2017. Targeted at preventing birth defects and improving population quality, and relying on maternal and child health programs, the specialty has built a three-level service network of hospital-subdistrict-community within the district. Inside the hospital, an integrated service system covering pre-pregnancy care, reproductive health and eugenic genetics has been set up. By continuously strengthening the collaboration mechanism of service networks at all levels, it has gradually formed a one-stop comprehensive fertility service model including pre-pregnancy physical examination, folic acid distribution and eugenic guidance.
To further elevate specialty development, our hospital cooperated with The Chinese University of Hong Kong to establish the first Maternal-Fetal Medicine Research Institute in western Shenzhen. It integrates multiple disciplines including prenatal diagnosis, biochemical screening, medical imaging, high-risk obstetrics and neonatology, carrying out cutting-edge basic and clinical research on the pathogenesis, prediction and intervention of maternal-fetal diseases. In 2018, the hospital laboratory passed ISO15189 accreditation, further guaranteeing the quality of pre-pregnancy testing and examination.
To fully leverage maternal and child health care as well as family planning technical service resources, four public health departments including the Family Planning Service Department have been established. This facilitates effective collaboration between the hospital and government authorities, and promotes substantive integration of pre-pregnancy health care and clinical work. Committed to delivering high-quality pre-pregnancy health services for about 5.1 million residents in Bao’an District, the hospital strives to build a one-stop featured pre-pregnancy health care specialty with wide coverage, high accessibility, multidisciplinary collaboration, cutting-edge technology, intelligent services and humanistic care.
Over the past three years, Bao’an District has allocated nearly 100 million yuan annually as special funds for maternal and child health care. The funds support multiple initiatives such as birth defect prevention and optimized family planning services, delivering equitable and accessible whole-life-cycle health care for women and children.
The Pre-pregnancy Health Care Specialty keeps optimizing health education, implementing people-benefiting projects and strengthening quality control management, endeavoring to build a one-stop featured pre-pregnancy health care specialty with wide coverage, high accessibility, multidisciplinary collaboration, cutting-edge technology, intelligent services and humanistic care.
1. Establishing a Three-level Service Network with Wide Coverage and High Accessibility
With strong support from the Bao’an District Government, Bao’an District Health Bureau and subdistrict offices, Bao’an District has built the city’s most extensive and accessible three-level service network of hospital-subdistrict-community. Our hospital and four subdistrict general hospitals have been designated as project implementation units.
The district maternal and child health hospital, subdistrict hospitals, subdistrict family planning centers and communities jointly form a full-chain service system covering publicity and mobilization, physical examination, consultation and guidance, diagnosis, treatment and referral, follow-up tracking, as well as qualification review and quality control.
The hospital actively popularizes pre-pregnancy health knowledge via its official WeChat public account. The influence of its popular science articles ranks among the top 20 nationwide among 377 tertiary maternal and child health hospitals. Subdistrict offices and social affairs departments conduct outreach into communities to raise public awareness of pre-pregnancy health care. Subdistrict family planning centers improve service quality by increasing professional staffing and strengthening work supervision. An internal referral and consultation system has been set up within the district and the specialty to classify individuals at high risk in pre-pregnancy assessment, providing timely referral, consultation and follow-up management services.
In 2021, the hospital provided free pre-pregnancy examinations for 7,939 couples, covering 7,939 families and 15,878 person-times, with a total project fund expenditure of 4.422 million yuan. A total of 7,939 risk assessment reports were completed and fully issued.
Among the screened cases, 5,399 families were classified as general-risk and 2,540 as high-risk. The high-risk group included: 198 couples positive for thalassemia, 25 preliminary syphilis screening positive cases, 416 cases with adverse pregnancy history, 12 women with Rh-negative blood type, 36 individuals with personal birth defects, 175 cases with genetic family history, 75 chlamydia infection cases, 420 cases of G6PD deficiency, and 1,183 advanced-age women. All high-risk families received face-to-face fertility consultation and professional guidance.
2. Constructing an Innovative Service Model of Multidisciplinary Linkage to Drive Overall Discipline Upgrading
Our hospital set up a Leading Group for Standardized Construction and Regulated Management of Maternal and Child Health Service Institutions, headed by the hospital president. It integrates professional businesses of multiple departments including Pre-pregnancy Eugenics Department, Reproductive Health Department, Prenatal Diagnosis Department, High-risk Obstetrics Department, Neonatology Department, Pre-pregnancy Health Care Department and Public Health Department. An innovative service model has been built featuring multidisciplinary linkage that drives the overall upgrading of the discipline cluster.
The Pre-pregnancy Eugenics Department adheres to the principle of one person or one family per consulting room for medical consultation. It optimizes workflows for ultrasound examination, blood collection and sample transportation, and regularly holds pre-pregnancy health lectures. These measures fully protect patient privacy, reduce waiting time and unnecessary movement, forming a mature one-stop service model.
The Prenatal Screening and Diagnosis Network Center has opened a green referral channel, enabling high-risk groups in the district to be referred to our hospital for further examination, greatly increasing the positive referral rate. Meanwhile, it actively develops fetal intrauterine treatment to improve maternal and fetal outcomes, offering a high-quality medical option for patients in Shenzhen and surrounding cities.
The Pre-pregnancy Health Care Department has formulated standard operating procedures for premarital and pre-pregnancy eugenic examinations, clarifying standardized workflows for pre-pregnancy health services. The Public Health Department pioneered the Bao’an Model for eliminating mother-to-child transmission, featuring testing before registration, high-risk E-clinic, in-laboratory vaccination and immune monitoring clinics. Bao’an District became a national pilot area for eliminating mother-to-child transmission in 2017, a Guangdong provincial pilot area for zero hepatitis B mother-to-child transmission in 2018, and passed the final national evaluation of the pilot program in 2020.
3. Providing Cutting-edge Pre-pregnancy Health Services and Conducting In-depth Scientific Research
The sub-specialty of Prenatal Diagnosis and Fetal Medicine actively carries out fetal intrauterine treatments, including rapid transabdominal amnioreduction, constant-temperature amnioinfusion, fetal fluid drainage, intracardiac potassium chloride fetal reduction, radiofrequency ablation fetal reduction, and fetoscopic occlusion of placental vascular anastomoses.
It conducts research and clinical application of multiple new technologies. The clinical application of low-pass whole-genome sequencing (low-pass WGS), non-invasive peripheral blood DNA testing and next-generation sequencing leads the international frontier, with key research achievements published in Genetics in Medicine.
Specialized clinics for recurrent miscarriage and preterm birth have been established in the Prenatal Diagnosis Department and Obstetrics Department. By applying chromosomal microarray analysis to explore genetic causes of miscarriage, it is found that 40% of aborted fetuses carry pathogenic variants: 8.8% trisomy 16, 14.4% trisomy 18, 17.6% trisomy 21, 18.9% sex chromosome abnormalities, and the rest are rare genomic variations. The findings identify the exact causes of miscarriage for couples and provide precise guidance for subsequent pregnancy.
4. Empowering with Smart Services to Elevate Specialty Construction
Centering on the development of the Pre-pregnancy Health Care Specialty, the hospital has built a regional maternal and child health project management platform featuring whole-life-cycle coverage and cross-institutional, cross-department collaboration, realizing information interconnection and sharing.
It took the lead in realizing fully paperless management of pre-pregnancy eugenic examination projects across the city, with functions including electronic file establishment, mobile terminal access to medical reports, and automatic data submission. Connected with mobile phones, self-service terminals and wearable devices, the platform delivers integrated one-stop pre-pregnancy eugenic services. The hospital is the nation’s first Smart Maternal and Child Digital Demonstration Hospital.
5. Promoting Humanistic Spirit to Deliver Warm Pre-pregnancy Health Services
First, centered on humanized services: patients’ average waiting time for test reports is reduced by 30%; average medicine collection time is shortened from 20 minutes to 3 minutes; average in-hospital stay time is cut by 100 minutes.
Second, humanized design is enhanced to enable patients to enjoy thoughtful care throughout the entire medical process. The hospital passed the national Baby-Friendly Hospital accreditation in 2015, won the honor of China’s Most Beautiful Hospital in 2019, and was awarded the title of Shenzhen Child-Friendly Hospital in 2020.