HBV-DNA阳性育龄妇女HBV血清标志物、前S1抗原的检测分析

目的：探讨HBV—DNA阳性育龄妇女病毒复制与HBV标志物及前S1抗原的关系。方法：对1643例慢性乙型肝炎育龄妇女采用荧光定量PCR法检测血清HBV—DNA，酶联免疫吸附法（ELISA）检测HBV标志物和前S1抗原。结果：HBV—DNA阳性育龄妇女432例。其中，HBsAg阴性者占19．44％，前S1抗原总阳性率55．09％，且随着HBV—DNA载量增加，前S1抗原阳性率也升高。结论：采用HBV—DNA、HBV标志物、前S1抗原联检，才能更准确提供育龄妇女HBV感染诊疗依据，有效控制HBV感染率。     

Bioavailability of oestradiol and oestriol administered orally to oophorectomized women

A bioavailability study was performed on ten oophorectomized women in a randomized cross-over design. The absorption of tablets containing 2 mg of micronized oestradiol and 1 mg of micronized oestriol (Estrofem®) was compared to the absorption of the same micronized hormones administered in an aqueous suspension. Serum concentration values of oestradiol, oestriol and oestrone were measured by radioimmunoassay. The data obtained were analyzed both by univariate and multivariate analyses, and neither the serum concentrations at the various sample times, the maximum concentrations, the times for the maximum concentrations, nor the areas under the serum concentration curves disclosed any significant differences between the tablet and suspension administrations at the 5% level. The serum concentration values achieved by giving 2 mg of oestradiol and 1 mg of oestriol were of the same magnitude or higher than those of the normal menstrual cycle.     

农村妇女就医选择行为的影响因素——基于2018年CFPS数据分析

目的 为引导农村妇女合理有序就医,本文基于计划行为理论框架探索其就医选择行为的影响因素。方法 运用2018年中国家庭追踪调查数据,采用二元Probit回归、Bootstrap抽样方法对农村妇女就医选择行为的影响因素进行研究。结果 农村妇女的就医选择行为受到其主观态度、结构性因素和知觉行为控制因素的正向影响（β = 0.403,0.388,0.096,P＜0.05）,医疗自付费用支出在农村妇女主观态度及其就医选择行为间起部分中介作用（β = 0.135,95%CI: 0.026～0.054）。 结论 农村妇女就医选择行为受到主观态度、结构性因素和知觉行为控制因素的影响,应加大健康教育宣传力度;合理统筹医联体医保政策;夯实农村基层首诊制度,推进基层医院家庭医生签约服务,提升农村基层医疗卫生服务利用效率,对农村妇女就医选择行为进行有针对性的干预。     

初次妊娠孕妇妊娠期缺铁性贫血及贫血程度的影响因素分析

目的探讨初次妊娠孕妇妊娠期缺铁性贫血及贫血程度的影响因素。方法回顾性分析2016年1月至2019年12月我院收治的980例初次妊娠孕妇的临床资料,依据是否出现缺铁性贫血分为对照组(未出现缺铁性贫血,800例)和观察组(出现缺铁性贫血,180例)。根据病情严重程度将观察组分为轻度组(血红蛋白100~109 g/L, 100例)、中度组(血红蛋白70~99g/L, 60例)和重度组(血红蛋白40~69 g/L, 20例),分析四组孕妇的临床特点,以及初次妊娠孕妇妊娠期缺铁性贫血与贫血程度的影响因素。结果两组的孕次、文化程度、家庭人均月收入水平比较差异无统计学意义(P>0.05)。轻度组、中度组、重度组年龄≥35岁、膳食铁摄入差、孕前保健<3次占比均高于对照组(P <0.05)。经Logistic多因素分析显示,年龄≥35岁、膳食铁摄入差、孕前保健<3次均为妊娠期缺铁性贫血发生的危险因素(OR>1, P <0.05)。结论高龄、膳食铁摄入差、孕前保健次数少是引发妊娠期缺铁性贫血的危险因素。     

Exploratory Efficacy of Calcium-Vitamin D Milk Fortification and Periodontal Therapy on Maternal Oral Health and Metabolic and Inflammatory Profile

In this 2 × 2 factorial, outcome-assessor blinded, feasibility randomised trial we explored the effect of a non-pharmaceutical multi-component intervention on periodontal health and metabolic and inflammatory profiles among pregnant women with periodontitis receiving prenatal care in a Brazilian public health centre. 69 pregnant women (gestational age ≤20 weeks, T0) were randomly allocated into four groups: (1) fortified sachet (vitamin D and calcium) and powdered milk plus periodontal therapy during pregnancy (early PT) (n = 17); (2) placebo sachet and powdered milk plus early PT (n = 15); (3) fortified sachet and powdered milk plus late PT (after delivery) (n = 19); (4) placebo sachet and powdered milk plus late PT (n = 18). Third trimester (T1) and 6–8 weeks postpartum (T2) exploratory outcomes included periodontal health (% sites with bleeding on probing (BOP)), glucose, insulin, C-Reactive Protein, serum calcium and vitamin D. The mean BOP was significantly reduced in the early PT groups, while BOP worsened in the late PT groups. No significant effect of fortification on BOP was observed. Changes in glucose levels and variation on birthweight did not differ among groups This feasibility trial provides preliminary evidence for estimating the minimum clinically important differences for selected maternal outcomes. A large-scale trial to evaluate the interventions’ clinical benefits and cost-effectiveness is warranted.     

Adherence to Mediterranean Diet and Selected Lifestyle Elements among Young Women with Type 1 Diabetes Mellitus from Northeast Poland: A Case-Control COVID-19 Survey

An appropriate balanced diet and dietary patterns are important at every stage of life, but in the case of young patients with type 1 diabetes mellitus (T1DM), it is especially crucial during the COVID-19 pandemic. The aim of the study was to assess health and nutritional behaviors, mainly adherence to the Mediterranean diet (MD), during the second wave of the COVID-19 pandemic in Poland among women with T1DM, and to compare them with a healthy population. This survey (based on a questionnaire) was conducted in December 2020 and included 219 young women, healthy (n = 106) and with T1DM (n = 113), from northeast Poland. Over 30% of the study group admitted that they did not engage in any physical activity. A large proportion declared that their screen time was 5–7 h a day (48% in control and 40% in T1DM group). High intakes of sweet-beverages, sweets and red meat, but also low intakes of olive oil, fish and nuts were observed. The vast majority of participants (60% vs. 71%) were moderately adherent to the Mediterranean Diet Adherence Screener (MEDAS). The study demonstrated that despite the similarity between the behaviors of healthy people and those with T1DM, negative health and nutritional practices, such as low physical activity, long screen time, medium and high levels of stress and inappropriate eating habits were observed.     

Evaluation of Serum Zinc Status of Pregnant Women in the China Adult Chronic Disease and Nutrition Surveillance (CACDNS) 2015

Objective: The purpose of this study was to evaluate serum zinc status of pregnant women in the China Adult Chronic Disease and Nutrition Surveillance (CACDNS) in 2015–2016. Methods: A total of 7147 apparently healthy pregnant women were randomly selected in 302 national monitoring sites. Information on age, race, residence region, education, pregnancy, and family income per annum was collected, and the concentration of serum zinc was determined. The evaluation of serum zinc status was further performed according to the recommendations by the International Zinc Nutrition Consultative Group (IZiNCG). Results: The median concentration of serum zinc was 858.9 μg/L with an interquartile range (IQR) of 712.9 μg/L and 1048.9 μg/L, while the overall prevalence of zinc deficiency was 3.5% with a 95% confidence interval (CI) of 3.0% and 3.9%. Serum zinc status of pregnant women changed greatly in the different categories, particular in pregnancy and family income per annum (p < 0.05), but no significant difference was observed in the prevalence of zinc deficiency (p > 0.05). Conclusions: The lower prevalence of zinc deficiency generally indicated a better zinc status for pregnant women in the CACDNS in 2015–2016. However, a well-designed evaluation system of zinc status for pregnant women should be continually optimized and improved by inducing more parameters such as biochemical, dietary, or functional indicators.     

What Are the Maternal Factors that Potentially Intervenes in the Nutritional Composition of Human Milk?

Background: To evaluate the potential factors associated with the nutritional composition of human milk of puerperal women. Methods: cross-sectional study, conducted between March 2016 and August 2017, with 107 women, selected in a Tertiary Health Care Tertiary Health Facility of the Unified Health System (SUS) in the Municipality of Rio de Janeiro. Data were collected two months after delivery. The dependent variable of the study was the nutritional composition of human milk. We divided the independent variables into hierarchical levels: distal (age, schooling, parity and pregestational nutritional status), intermediate (number of prenatal visits and gestational weight gain) and proximal (alcohol consumption, smoking, diabetes mellitus and hypertension). For data analysis, we applied the multiple linear regression, centered on the hierarchical model. Only the variables associated with the nutritional composition of breast milk remained in the final model at a 5% level of significance. Results: The nutritional composition of human milk yielded by women with pregestational overweight, smokers and hypertensive had higher amounts of lipids and energy. Conversely, women with gestational weight gain below the recommended had lower amounts of these components. Conclusion: The evaluation of factors associated with the nutritional composition of human milk is extremely important to assist post-partum care practices. In this study, we observed that lipid and energy contents were associated to pregestational nutritional status, gestational weight gain, smoking and hypertension.     

孕晚期静坐行为与抑郁和妊娠相关焦虑的关系

目的探究北京地区孕晚期妇女总静坐行为和不同类型静坐行为与抑郁和妊娠相关焦虑的关系。方法以中国孕产妇队列研究(CPWCS)·协和项目中的576例孕晚期妇女为研究对象。CPWCS项目自2018年5月起,在北京市通州区妇幼保健院采用方便抽样的方法纳入年龄≥16岁,孕5~12周的孕早期妇女,并进行基线调查。于研究对象孕晚期进行随访调查,采用孕期身体活动问卷(PPAQ)调查其静坐行为,分别采用爱丁堡产后抑郁量表(EPDS)和妊娠相关焦虑量表(PAQ)调查抑郁和妊娠相关焦虑状况。结果孕妇孕晚期抑郁检出率为25.0%,妊娠相关焦虑检出率为28.8%。Logistic回归显示,非工作时间高水平使用电脑或写东西、看电视或录像均与抑郁的发生风险相关(OR=1.72,95%CI:1.08~2.75;OR=1.90,95%CI:1.15~3.14);总静坐行为中等水平和高水平的孕妇相对于低水平的孕妇,妊娠相关焦虑的发生风险较高(OR=1.80,95%CI:1.14~2.84;OR=1.72,95%CI:1.07~2.75);非工作时间中等水平和高水平坐着看电视或录像与妊娠相关焦虑的发生风险相关(OR=2.69,95%CI:1.52~4.78;OR=2.82,95%CI:1.68~4.75),高水平坐着打电话、阅读和交谈与妊娠相关焦虑的发生相关(OR=2.37,95%CI:1.23~4.57)。结论孕晚期妇女静坐行为与抑郁及妊娠相关焦虑发生相关,减少非工作时间使用电脑或写东西、看电视或录像、打电话、阅读和交谈等静坐行为可能有助于孕妇预防和减轻抑郁及妊娠相关焦虑症状。     

晚孕期孕妇生殖道B族链球菌感染对母儿结局的影响

目的探讨晚孕期孕妇生殖道B族链球菌(GBS)感染的影响因素及其对母儿结局的影响。 方法选择2016年8月至2018年8月,在苏州高新区人民医院进行产前检查,并于35～37孕周时采取荧光定量PCR进行GBS DNA检测的1 149例晚孕期孕妇为研究对象。采用回顾性分析方法,将其分为研究组(n＝81,GBS DNA呈阳性)与对照组(n＝1 068,GBS DNA呈阴性)。对研究组GBS感染孕妇,采取产时抗菌药物预防(IAP)措施。收集2组受试者年龄、受教育程度、孕次、产次、流产史、分娩方式,分娩孕龄与人体质量指数(BMI)、血清维生素D含量,妊娠期糖尿病(GDM)、胎膜早破与产后出血发生情况,以及研究组新生儿出生后第4周GBS感染随访结果,并采用成组t检验、Mann-Whitney U检验、χ²检验等进行统计学比较。采用多因素非条件logistic回归分析,对晚孕期孕妇GBS感染影响因素进行分析。本研究遵循的程序符合2013年新修订的《世界医学协会赫尔辛基宣言》要求,并通过苏州高新区人民医院伦理委员会审批(审批文号：[2016]伦审批第001号)。 结果①2组孕妇中,初产妇与经产妇构成比、流产史、GDM发生率、血清维生素D含量比较,差异均无统计学意义(P>0.05),而2组孕妇年龄、受教育程度构成比与分娩时BMI分别比较,差异均有统计学意义(t＝-2.004、P＝0.045,χ²＝69.972、P<0.001,t＝7.054、P<0.001)。②晚孕期孕妇GBS感染影响因素的多因素非条件logistic回归分析结果显示,分娩时BMI≥25 kg/m²与受教育程度为高中及以下,均为晚孕期孕妇GBS感染的独立危险因素(OR＝2.901、6.137,95%CI：1.782～4.722、3.737～10.078,均为P<0.001)。③研究组孕妇产褥期感染、新生儿肺炎发生率分别为3.7%(3/81)与4.9%(4/81),分别显著高于对照组的0.8%(9/1 068)与1.0%(11/1 068),并且差异均有统计学意义(P＝0.047,χ²＝6.150、P＝0.013)。④研究组孕妇分娩的81例新生儿的出生后1周GBS阳性率为53.1 %(43/81),早发型GBS肺炎发生率为2.5%(2/81)。 结论分娩时孕妇BMI≥25 kg/m²与受教育程度为高中及以下,均为其GBS感染的独立危险因素。晚孕期孕妇GBS感染可导致其产褥期感染及新生儿肺炎发生率增高。