0～1岁儿童神经心理发育影响因素调查分析

目的:探讨0～1岁儿童神经心理发育影响因素。方法:选取我院2009年10月至2010年9月定期保健体检的560例0～1岁健康儿童采用《0～6岁小儿神经心理发育量表》进行神经心理发育情况测查,并采用单因素分析、多元线性回归分析其神经心理发育的影响因素。结果:孕周、母亲文化程度、主要抚养人及抚养人对早教知识的态度、母乳喂养方式、做抚触和婴儿被动操等都与儿童神经心理发育影响因素有关,P<0.05。其中孕周、母亲文化程度、主要抚养人及做抚触和婴儿被动操是独立影响因素。结论:母乳喂养,母亲作为主要抚养人且文化程度较高,做抚触和婴儿被动操等有利于婴儿早期的神经心理发育。     

孕期增重和婴儿喂养方式与儿童肥胖的相关性研究

目的探讨儿童肥胖与其母亲孕期增重和婴儿喂养方式之间的关系,为制定预防儿童肥胖相关公共卫生政策和措施提供参考依据。方法采用整群抽样调查的方法选取本院所在区域的4所幼儿园中的956名儿童及其家长作为研究对象进行问卷调查。内容包括儿童体质量、身高、母亲孕期情况、婴儿的喂养方式、家庭基本情况等。通过单因素分析和多因素Logistic回归分析母亲孕期增重、婴儿喂养方式和儿童肥胖之间的关系。结果本研究共发放956份调查问卷,成功收回的有效调查问卷948份,回收率99.16%。受访儿童中有10.02%(95/948)为肥胖。单因素分析显示,母亲孕期体质量增加大于15kg和婴儿6个月龄内纯母乳喂养是儿童肥胖的相关因素(P0.05)。多因素Logistic回归分析显示,母亲孕期体质量增加大于15kg是儿童肥胖的危险因素(P0.05),婴儿6个月龄内纯母乳喂养是儿童肥胖的保护因素(P0.05),其他因素与儿童肥胖无显著相关性(P0.05)。结论在制定预防儿童肥胖的相关公共卫生政策和措施的工作中,指导孕妇适当控制体质量增长,鼓励产妇采用纯母乳喂养是工作重点。     

0～4个月婴儿348例纯母乳喂养情况随访分析

０～４个月婴儿３４８例纯母乳喂养情况随访分析刘明月，王彩香我所于１９９４年６月开始，对全市２１个乡镇办事处０～４个月婴儿的母乳喂养情况进行随访，现将已总结的３４８例分析如下．一、资料及方法（一）资料来源：胶州市１９９４年６月在二级医院出生的婴儿及母亲...     

妊娠期尿路感染与智力缺陷和发育迟缓

为调查研究妊娠期尿路感染与婴儿智力缺陷、发育迟缓的关系 ,作者在 1995～ 1998年期间用队列方法研究了 410 90例妊娠妇女和婴儿的记录数据资料。结果 :与母亲无尿路感染的婴儿相比较 ,母亲患有尿路感染未用抗生素治疗的婴儿发生智力缺陷或发育延缓的相对危险性(ＲＲ)是 1 31,95 %可信限间隔 (ＣＩ)为 1 12 ,1 5 4。与母亲患有尿路感染用抗生素治疗的婴儿比较 ,母亲患有尿路感染未用抗生素治疗的婴儿发生智力缺陷或发育延缓的ＲＲ是 1 2 2 (95 %ＣＩ是 1 0 2 ,1 46 )。在调整种族和妊娠年龄因素后 ,妊娠头 3个月(1 46 ,95 %ＣＩ 1 0 7,1 99…     

普萘洛尔联合平阳霉素硬化治疗婴儿血管瘤疗效及瘤体发生部位和面积的危险因素分析

目的研究手术治疗和口服普耐洛尔联合平阳霉素硬化治疗3个月以内婴儿血管瘤的疗效对比,并分析瘤体发生部位和瘤体面积有关的影响因素。方法选取我院2018年4月至2018年10月就诊的所有婴儿血管瘤患儿40例,接受手术治疗和接受药物治疗(口服普萘洛尔+平阳霉素硬化)的患儿各20例。回顾性分析两组患儿接受不同治疗后的临床疗效和不良反应。对可能影响瘤体发生部分和面积的各种危险因素,如儿童出生体质量,母亲妊娠史、年龄、黄体酮使用史、维生素服用是否过量、是否早产、有无胎盘异常和妊娠期高血压,做多因素Logistic回归分析,获得独立危险因素。结果 (1)两组临床总有效率比较差异无统计学意义(P0.05)。(2)药物组大量出血(100 mL)和高热(38℃)方面发生不良反应数低于手术组,差异有统计学意义(P0.05)。(3)瘤体发生部位的危险因素分析:儿童出生体质量≤2 500 g和母亲孕期黄体酮使用史是血管瘤好发于头颈部的独立危险因素,低出生体重儿和母亲曾孕期使用黄体酮的患儿血管瘤发生于头颈部的概率分别是发生于四肢及其他部位概率的13.698倍和18.744倍。(4)瘤体面积的危险因素分析:母亲多次妊娠史是患儿血管瘤瘤体面积6 cm~2的独立危险因素,母亲有多次妊娠史的患儿发生血管瘤瘤体面积6 cm~2的概率是瘤体面积≤6 cm~2概率的17.896倍。结论口服普萘洛尔联合平阳霉素硬化治疗3个月以内婴儿血管瘤效果显著,且不良反应少,值得临床推广,同时早期要筛查患儿母亲的生育及孕期用药信息,对于孕期使用黄体酮,孕周37周及多次妊娠的孕妇给予及时的干预治疗,以避免婴儿血管瘤的发生发展。     

免疫阻断乙型肝炎病毒母婴传播多中心研究

目的 探讨孕产妇乙型肝炎表面抗原（HBsAg）阳性率及乙型肝炎病毒（HBV）母婴传播阻断的效果。方法 2008－2012年,通过多中心队列研究,对湖北省、山西省、广东省、新疆维吾尔自治区等地的孕产妇进行HBsAg筛查;对上述地区部分医院入院分娩的HBsAg阳性母亲及8～12个月龄婴儿进行随访观察,所有标本检测乙型肝炎血清标志物(HBsAg,HBsAb,HBeAg,HBeAb,HBcAb),部分标本检测HBV DNA。结果　筛查孕妇82214例,HBsAg阳性4924例,阳性率6.0%。随访HBsAg阳性母亲及8～12个月龄婴儿1371对,婴儿免疫阻断失败率3.1%（42/1371）,HBsAg及HBeAg双阳性母亲婴儿的免疫阻断失败率为8.2%。免疫阻断失败的婴儿其母亲均为HBeAg阳性且HBV DNA≥6 log10 copies/mL。HBeAg阳性母亲孕期注射乙型肝炎免疫球蛋白(hepatitis B immune globulin, HBIG)及未注射HBIG组,其婴儿免疫阻断失败率差异无统计学意义(8.8% vs. 8.1%, P=0.807)。结论　多中心调查显示目前孕产妇HBsAg阳性率6.0%,HBV母婴阻断失败率3.1%。HBsAg及HBeAg双阳性且HBV DNA≥6 log10 copies/mL 的孕妇应为母婴阻断的重点人群。孕妇孕期注射HBIG不能提高HBV母婴阻断效果。     

产科服务质量与产妇出院时母乳喂养率的关系

目的　了解产妇出院时母乳喂养情况及分析产科服务质量对产妇出院时母乳喂养率的影响 ,以提高产科质量 ,促进母乳喂养。　方法　于 2 0 0 0年 8月～ 10月用分层整群抽样的方法对北京、长春、呼和浩特、洛阳、西安、昆明及厦门七个城市进行横断面调查 ,对 112 3例 6～ 12个月婴儿的母亲进行接受产科服务情况、母乳喂养状况、母乳喂养知识和行为的问卷调查 ,使用 SPSS 10 .0软件进行计算机统计分析。　结果　出院时纯母乳喂养率平均为 5 2 % ,全母乳喂养率为 73% ;影响出院时母乳喂养率的因素有 :母亲的年龄、医疗费支付类型、剖宫产、孩子出生有无疾病、按需哺乳、住院期间见过奶瓶、住院时喂过奶粉和糖水、医务人员给母亲提供奶粉商电话、母亲掌握的母乳喂养知识等因素。　结论　产后出院时母乳喂养率较低 ,并与产科服务质量有一定关系 ,因此应加强产科服务质量 ,加强母乳喂养的健康教育 ,提高母乳喂养率。     

宫腔镜检查联合药物治疗早期子宫内膜癌的预后和妊娠结局影响因素分析

目的 探讨经宫腔镜手术联合药物治疗早期子宫内膜癌达完全缓解所需时间与临床特征的相关性,以及影响患者预后、妊娠结局的因素。方法 回顾性分析2010年1月至2022年10月于北京大学第三医院行宫腔镜手术+药物保守治疗的89例ⅠA期中-高分化子宫内膜癌患者的临床资料,分析保守治疗3个月后疗效的影响因素,并比较3个月后完全缓解（CR）和其他临床因素与妊娠成功、复发的相关性。结果 89例患者中,随访资料完整84例,中位随访时间为23个月。3个月达CR者64例（80.0%）,6个月达CR者83例（93.3%）。3个月CR与年龄呈正相关（P <0.05）,与血脂异常呈负相关（P <0.05）。其中66例患者有妊娠需求,妊娠率为42.4%(28/66),活产率为27.3%(18/66)。妊娠与年龄呈负相关,与辅助生殖助孕呈正相关（P <0.05）。3个月CR与妊娠无相关性（P> 0.05）。复发19例（22.6%, 19/84）,复发间隔时间为3～61个月,中位复发间隔时间为7个月,复发后继续保守治疗至6个月的患者均CR。Kaplan-Meier分析提示,子宫内膜厚度≥10 m...     

乙肝免疫球蛋白联合乙肝疫苗对阻断HBV母婴传播效果探析

目的：探讨乙肝免疫球蛋白和乙肝疫苗联合免疫对于阻断HBV母婴传播的效果。方法：选择2011年1月至2011年6月间于我州县级以上医院就诊的乙肝表面抗原（HBsAg）和e抗原（HBeAg）双阳性的乙肝孕母及其新生儿为研究对象，按免疫程序的不同分为A、B、c三组。A组母亲在分娩前三个月，每月均注射一次乙肝免疫球蛋白（HBIG），每次2001U，新生儿分别于0周和2周注射一次HBIG，每次200IU；B组新生儿分别于0周和2周注射一次HBIG，每次200IU；C纽孕母和新生儿均不注射HBIG。所有婴儿均按国家的免疫规划程序接种乙肝疫苗，即0、1、6月注射乙肝疫苗。观察并对比婴儿在6个月时乙肝五项结果。结果：三组婴儿在6个月时的乙肝表面抗体阳性率、保护性抗体产生率不同，A组婴儿的表抗阳性率低于其它两组，且保护性抗体产生率高于其他两组，差异有统计学意义（P〈0．05）。结论：乙肝免疫球蛋白和乙肝疫苗联合免疫方案对于阻断HBV的垂直传播有较好的效果。     

不能坚持母乳喂养的原因及预防措施

世界卫生组织和联合国儿童基金会大力推荐所有婴儿出生后 4～ 6个月必须给予母乳喂养 ,而后虽逐渐添加副食品 ,但仍要坚持母乳喂养直至两岁。但仍有不少母亲因各种原因未能坚持做好。其原因与以下因素有关 :1　母亲缺乏有关母乳喂养的相关知识。 1在妊娠期未能接受母乳喂养相关知识的学习 ,未能作好在婴儿出生初期以及成长期实施正确哺乳的思想准备。 2不了解母乳喂养的优点 ,不知如何实施哺乳。 3产后初期或产褥期受某些因素影响 ,部分产妇自觉无奶或奶量减少 ,就放弃哺乳或添加食品。泌乳是通过神经—激素的调节 ,即只有通过吸吮 ,刺激乳…     

Six-week postnatal depression predicts parenting stress profiles in mothers of preterm children

Objective

: This study examined the relationship between maternal postnatal depression (PND) at 6 weeks and first-year parenting stress for mothers of very preterm (gestation < 32 weeks) singleton children. Background: PND is reported as a strong predictor of parenting stress, but few studies examine the effectiveness of parenting interventions according to PND status. In the preterm population, the differential benefit mothers with PND experience from parenting interventions is also unclear. Methods: Validated questionnaires were used to collect information on both PND at 6 weeks and first-year parenting stress from 123 mothers of very preterm singleton children. Results: After adjusting for baseline birth and social risks, mothers who had PND at 6 weeks were more likely to experience parenting stress (OR 3.6, 95%CI 1.2, 12, p = 0.03) and have higher parental distress (OR 5.5, 95%CI 1.6, 18.0, p < 0.01) during the first postpartum year. Conclusion: When assessing the benefits of parenting interventions in reducing parenting stress, the effects of early PND in mothers of preterm infants should not be underestimated.     

Sub‐clinical levels of symptoms of attention‐deficit/hyperactivity disorder and self‐reported parental cognitions and behaviours in mothers of young infants

This study examined the relationship between sub‐clinical levels of maternal symptoms of attention‐deficit/hyperactivity disorder (ADHD) and parental cognitions and behaviours in a community sample of mothers of young infants. Given the numerous impairments experienced by adults with ADHD, it was hypothesised that mothers with more symptoms of ADHD would report cognitive and behavioural difficulties related to parenting. Ninety‐nine mothers of 6‐month‐old infants were recruited from immunisation clinics and completed questionnaires. Maternal symptoms of ADHD were positively correlated with other symptoms of psychological distress. In addition, mothers with higher levels of ADHD symptoms described themselves as having less parental impact and lower parenting satisfaction. They also reported more hostile‐reactive behaviours, but only for more difficult infants. ADHD symptoms were not related to social support and did not predict maternal self‐efficacy over and above co‐occurring symptoms of psychological distress. Findings suggest that even mothers who experience sub‐clinical levels of ADHD symptoms may be at risk for parenting cognitions and behaviours that could adversely affect their infant's development. Further studies of mothers who display clinical levels of ADHD symptoms are needed to replicate the current findings and to examine other dimensions of parenting in this potentially high‐risk population of mothers and their infants.     

The role of prenatal,obstetric, and post-partum factors in the parenting stress of mothers and fathers of 9-month old infants

Introduction: The aim of this paper was to examine the role of perinatal, obstetric and post partum factors on maternal and paternal stress. It will present the first examination of the role of prenatal, obstetric, post-partum, and demographic variables in parenting stress for mothers and fathers at 9 months.

Methods: Data from 6821 parental dyads of 9-month-old infants were extracted from the Growing Up in Ireland National Longitudinal Study of Children. Participants completed the Parental Stress Scale, the Dyadic Adjustment Scale, the Quality of Attachment Sub-scale from the Maternal and Paternal Postnatal Attachment Scales, and a single item health status question from the Short Form 12 Health Survey. Information on prenatal care, pregnancy complications, obstetric outcomes, infant health, and participant demographics were also collected. Separate hierarchical linear regressions were conducted for mothers and fathers

Results: Mothers reported higher levels of parenting stress than fathers (p?Discussion: A range of perinatal factors was associated with an increased risk of higher parenting stress at 9 months post-partum and the roles of these factors differ between mothers and fathers. These findings are important for predicting and reducing risk of parenting stress in both genders.     

HIV-INFECTED WOMEN AND INFANTS

The utilization of health care by HIV-seropositive pregnant women and their infants was studied in an indigent urban population. Ninety HIV-seropositive women delivered 99 HIV-exposed infants at the Johns Hopkins Hospital from August 1, 1988, to April 1, 1991. Repeat pregnancies occurred in 17 (18.9%) women during the study period. Completion of the primary immunization series by age nine months was the criteria for infant adherence to medical care. Of all infants, 72.9% achieved adequate immunization status by nine months. However, only 41 (45.6%) women reported ever seeking HIV-related health care. Factors associated with maternal adherence with HIV-related health care included HIV status of her infant, maternal drug use, and incarceration. Number of living children, maternal age, educational level, marital status, and repeat pregnancy were not associated with mothers seeking HIV-related health care. Despite low adherence to HIV-related health care in this sample of HIV-seropositive women, the majority of their infants did receive adequate immunizations, one proxy measure of adequate infant health care.     

HIV-infected women and infants: Social and health factors impeding utilization of health care

The utilization of health care by HIV-seropositive pregnant women and their infants was studied in an indigent urban population. Ninety HIV-seropositive women delivered 99 HIV-exposed infants at the Johns Hopkins Hospital from August 1, 1988, to April 1, 1991. Repeat pregnancies occurred in 17 (18.9%) women during the study period. Completion of the primary immunization series by age nine months was the criteria for infant adherence to medical care. Of all infants, 72.9% achieved adequate immunization status by nine months. However, only 41 (45.6%) women reported ever seeking HIV-related health care. Factors associated with maternal adherence with HIV-related health care included HIV status of her infant, maternal drug use, and incarceration. Number of living children, maternal age, educational level, marital status, and repeat pregnancy were not associated with mothers seeking HIV-related health care. Despite low adherence to HIV-related health care in this sample of HIV-seropositive women, the majority of their infants did receive adequate immunizations, one proxy measure of adequate infant health care.     

母源性抗乙型肝炎病毒表面抗原抗体对婴儿乙型肝炎疫苗接种的影响

目的 了解母源性抗乙型肝炎病毒表面抗原抗体(anti-hepatitis B surface antigen antibody,抗-HBs抗体)对婴儿乙型肝炎疫苗接种后抗体应答的影响.方法 2006年10月至2007年1月在南京大学医学院附属鼓楼医院产前检查并住院分娩的单胎足月妊娠妇女中,选择抗-HBs抗体阳性孕妇43例(阳性组)和阴性孕妇29例(阴性组),其足月儿出生时和出生后1个月分别接种乙型肝炎疫苗.定量检测孕妇分娩前、脐动脉血及婴儿1月龄和3.5月龄的抗-HBs抗体水平.结果 阳性组43例新生儿脐血抗-HBs抗体也为阳性,与母血清抗体水平的相关系数r=0.98(t=39.05,P<0.01);1月龄时,42例抗体仍阳性.阴性组29例新生儿脐血和1月龄时抗-HBs抗体均阴性.3.5月龄时,两组抗-HBs抗体阳性率均为100%,但阴性组平均抗-HBs抗体浓度高于阳性组[(466.9±86.7)mIU/ml和(151.2±23.1)mIU/ml,t=2.72,P=0.011].母源性抗-HBs抗体>1000 mIU/ml的5例婴儿中,3例在接种2次疫苗后没有产生主动抗体应答.结论 母源性抗-HBs抗体可抑制乙型肝炎疫苗前2次接种后的抗体应答.     

足月新生儿母源性抗-HBs及其亚型的特性

目的 分析了解足月新生儿母源性乙型肝炎表面抗体(抗-HBs)及其亚型的特性.方法 2006年12月至2007年02月在南京大学附属鼓楼医院住院分娩的单胎足月孕妇及其新生儿为研究对象,AxSYM全自动免疫分析仪定量检测63例抗-HBs阳性的单胎足月孕妇及其新生儿脐血婴儿和1月龄时的血清抗-HBs浓度,用固相酶联免疫法检测孕妇和脐血中抗-HBs 4种IgG亚型的含量,及其中和乙型肝炎患者血清中HBsAg的能力.结果 63例抗-HBs阳性孕妇分娩的新生儿脐血抗-HBs均为阳性,几何平均浓度为195.4 mIU/ml,明显高于孕妇平均水平141.6 mIU/ml(P<0.01).脐血抗-HBs浓度与母体水平高度相关(rs=0.976,P<0.01).无论是接种还是自然感染获得的抗-HBs,其4种IgG亚型均可通过胎盘,均以IgGl为主.1月龄婴儿抗-HBs平均浓度是脐血的64%,推测被动获得的抗-HBs衰减半衰期约41 d.脐血抗-HBs可中和乙型肝炎患者血清中HBsAg,其中和作用与抗-HBs浓度有关.结论 IgG型抗-HBs及其四种亚型均可通过胎盘,以IgG1为主.母源性抗-HBs可保护新生儿免受HBV感染.     

产妇和非麻疹婴幼儿麻疹病毒抗体IgG的检测及分析

摘要：目的　对健康产妇和非麻疹婴幼儿的麻疹IgG水平进行评估,以了解其对麻疹病毒的抵抗能力。方法　收集复旦大学附属妇产科医院健康产妇静脉血100份、新生儿（与产妇非配对,非麻疹患儿）血液52份、2～6月龄婴儿（非麻疹患儿）静脉血52份分别进行麻疹病毒抗体IgG检测。结果　受检的100例健康产妇中47例（占47%）达到保护性抗体水平,仅9例（占9.0%）麻疹抗体滴度可以在抵抗麻疹病毒侵袭的过程中起到比较明确的作用;受检的52例新生儿以及52例2～6月龄婴儿中分别有20例（占38.46%）和6例（占11.54%）达到保护性抗体水平,仅新生儿中5例（占9.61%）麻疹抗体滴度可以在抵抗麻疹病毒侵袭的过程中起到比较明确的作用。结论　上述人群麻疹保护性抗体水平均较低,产妇、新生儿麻疹抗体水平存在一定的相关性,2～6月龄婴儿麻疹抗体水平低于产妇以及新生儿。     

Emotional Responses of Mothers of Late‐Preterm and Term Infants

ObjectiveTo compare the emotional responses of mothers of late‐preterm infants (34 0/7 to 36 6/7 weeks gestation) with those of mothers of full‐term infants.DesignA mixed method comparative study.SettingA southeastern tertiary academic medical center postpartum unit.ParticipantsSixty mothers: 29 mothers of late‐preterm infants and 31 mothers of full‐term infants.MethodsMeasures of maternal emotional distress (four standardized measures of anxiety, postpartum depression, posttraumatic stress symptoms, and worry about infant health) and open‐ended semistructured maternal interviews were conducted in the hospital following birth and by phone at one month postpartum.ResultsMothers of late‐preterm infants experienced significantly greater emotional distress immediately following delivery, and their distress levels continued to be higher at one month postpartum on each of the standardized measures. Mothers of late‐preterm infants also discussed the altered trajectories in their birth and postpartum experiences and feeling unprepared for these unexpected events as a source of ongoing emotional distress.ConclusionMothers of late‐preterm infants have greater emotional distress than mothers of term infants for at least one month after delivery. Our findings suggest that it may not be a single event that leads to different distress levels in mothers of late‐preterm and full‐term infants but rather the interaction of multiple alterations in the labor and delivery process and the poorer‐than‐expected infant health outcomes. In the future, researchers need to examine how and when mothers’ emotional responses change over time and how their responses relate to parenting and infant health and development.