女性围产期抑郁动态观察及相关因素研究

目的:观察女性围产期抑郁情绪动态变化及探讨女性孕期压力水平、应对方式与围产期抑郁的相关性.方法:采用便利抽样法选取在合肥市某三甲医院门诊孕期检查的162例孕妇为调查对象,运用妊娠压力量表(PPS)、简易应对方式问卷(SCSQ)评估孕期压力水平和孕妇应对压力的方式,运用爱丁堡产后抑郁量表(EPDS)评估孕期、产后的抑郁情绪.结果:孕产妇孕期抑郁、产后抑郁的发生率分别为47.53％ (77/162)、48.77％ (79/162);纵向追踪发现,孕期77例抑郁女性中,在产后有24例女性(31.17％)转为非抑郁;孕期85例非抑郁女性中,在产后有26例女性(30.59％)转为抑郁.其次,妊娠晚期孕妇妊娠总体压力为轻度水平[中位数(M)=1.57].孕妇应对方式总分(1.57 ±0.03)分,积极应对方式评分为(1.93±0.04)分,消极应对方式评分为(1.03±0.03)分.与常模比较,其中,积极应对方式评分比常模评分高,差异有统计学意义(t=1.96,P＜0.01).孕妇孕期抑郁情绪与妊娠压力总分、各压力因子得分呈正相关,与应对方式总分、积极应对分值呈负相关.产妇产后抑郁情绪与妊娠压力总分、各压力因子得分呈正相关,与积极应对分值呈负相关.多元逐步回归分析显示,孕期抑郁情绪是产后抑郁的危险因素,家庭关系是产后抑郁情绪的保护因素.结论:在产前对孕妇做好心理健康水平的筛查和干预,对于产后抑郁的预防有着重要意义.     

流动已婚育龄妇女社会支持状况及影响因素调查

目的:了解流动已婚育龄妇女的社会支持的情况及其影响因素.方法:采用整群抽样方法随机抽取佛山市西樵镇一个社区的流动已婚育龄妇女进行面对面问卷调查.结果:在遇到急难情况时,流动已婚育龄妇女曾得到的经济支持和精神支持中来源于配偶的支持最多,分别为76.12％和78.65％;客观支持、主观支持、支持利用度得分和社会支持总分平均分分别为(9.19±3.09)、(26.54±4.06)、(7.59±2.21)和(43.61±6.71)分;Logistic回归分析显示和谁来打工影响客观支持得分,和丈夫、亲戚/同乡/朋友来打工的OR值分别为3.487和3.187;年龄影响主观支持得分,30岁～和40～49岁年龄组的OR值分别为2.484和2.340;职业以及和谁来打工影响社会支持总分,职业为干部/职员/专业技术人员以及和丈夫来打工的OR值分别为2.162和2.541.结论:西樵镇流动已婚育龄妇女的社会支持情况较好,但其社会支持主要来源于配偶,其他途径获取支持较少,提示相关部门和家庭外的其他社会组织应拓宽流动已婚育龄妇女获得支持的途径,并加大对她们的支持力度,特别是单独来工作、职业社会保障不完善和年龄较低的流动已婚育龄妇女.     

Twenty years trends and socio-demographic characteristics of HIV prevalence in women giving birth in Catalonia (Spain)

BackgroundStudies of the prevalence of HIV in sentinel populations are one of the key strategies to monitor the HIV epidemic. We describe HIV prevalence trends and identify differences across time in the sociodemographic characteristics of HIV-infected women giving birth in Catalonia.MethodsWe used dried blood specimens, residual to newborn screening, which have been collected in Catalonia every 2 months since 1994. The total number of samples obtained until 2009 and in 2013 represented half of yearly newborns. From 2010 to 2012, the total number of samples obtained represented a quarter of yearly newborns. We studied the prevalence by year and place of current residence (Barcelona-city, cities > 200,000 inhabitants and cities ≤ 200,000 inhabitants) and by the mother's birth country. A total of 624,912 infants were tested for HIV antibodies from January 1994 to December 2013.ResultsHIV prevalence trends among women giving birth in Catalonia decreased until 2007. Thereafter, there was a change to a steady trend until 2013. However, among foreign women giving birth and living in cities ≤ 200,000 inhabitants, the prevalence of HIV increased from 2007 to 2013.ConclusionTo ensure early identification and treatment of HIV-infected mothers, it is essential to maintain HIV surveillance programs and pre- and post-natal screening programs, both in Barcelona and in cities with 200,000 inhabitants or less, especially in immigrant women.     

五行健骨操对老年女性膝骨关节炎患者膝关节功能的影响

目的:观察五行健骨操对老年女性膝骨关节炎(KOA)患者膝关节功能的影响。方法:将72例老年女性膝骨关节炎患者随机分为治疗组(36例)和对照组(36例)。两组均接受健康宣教和口服硫酸氨基葡萄糖胶囊治疗,治疗组在上述治疗的基础上进行五行健骨操练习,观察周期为6个月。于治疗前后采用WOMAC指数评分评价患者的膝关节功能,采用视觉模拟量表(VAS)评分对患者的关节疼痛症状进行评估。结果:治疗后,两组患者的WOMAC指数评分均显著降低(P<0.05),且治疗组患者的评分低于对照组(P<0.05);两组患者的VAS评分均显著降低(P<0.05),而治疗组与对照组患者的评分比较,其差异无统计学意义(P>0.05)。结论:习练五行健骨操能够在一定程度上改善老年女性KOA患者的膝关节功能,减轻患者的疼痛症状。     

β－受体阻滞剂干预更年期妇女心电图变化的临床价值

目的：探讨β－受体阻滞剂干预更年期妇女心电图变化的临床价值。方法选取无器质性疾病但有心电图改变的更年期妇女62例,经患者知情同意按照数字表法随机分为治疗组31例,予以β－受体阻滞剂治疗3周;另31例为对照组,不给予任何治疗。观察治疗前后2组间及治疗组心电图指标（心率、心律、ST－T）的改变。结果（1）经β－受体阻滞剂治疗3周后,2组平均心率、心律、ST－T改变（除ST上斜外）比较差异均有统计学意义（P＜0．05）。（2）治疗组治疗前后比较,成对房早、ST上斜和T波倒置虽有改变,但差异无统计学意义（P＞0．05）;其余指标均有明显改变,差异有统计学意义（P＜0．05）。结论β－受体阻滞剂应用于心电图改变的更年期妇女有一定的临床价值。     

健脾和胃降逆止呕中药内服加穴位贴敷治疗妊娠恶阻脾胃虚弱证的临床研究

【目的】观察健脾和胃降逆止呕中药穴位贴敷治疗妊娠恶阻的临床疗效。【方法】将122例妊娠恶阻脾胃虚弱证患者随机分为观察组63例和对照组59例,对照组2例中途退出,最终纳入57例。对照组采用健脾和胃降逆止呕中药内服、静脉输液、饮食起居护理与情志调护,观察组在对照组治疗的基础上加用健脾和胃降逆止呕中药穴位贴敷。每日1次,4d为1个疗程,连续治疗2个疗程。观察2组妊娠恶阻临床症状的改善情况,比较2组临床疗效,并评价其安全性。【结果】（1）观察组总有效率为96.8%,显著优于对照组的71.9%（P＜0.01）;（2）观察组呕吐症状消失所需时间显著少于对照组（P＜0.01）;（3）治疗过程中,2组均无明显不良反应情况发生。【结论】健脾和胃降逆止呕中药穴位贴敷可显著提高妊娠恶阻的临床疗效,联合中药内服、静脉输液、饮食起居护理与情志调护可达最佳治疗效果。     

Caffeine intake in pregnancy: Relationship between internal intake and effect on birth weight

We used a physiologically based kinetic model to simulate caffeine blood concentration-time profiles in non-pregnant and pregnant women. The model predicted concentration-time profile was in good accordance with experimental values. With 200 mg, the safe dose per occasion in non-pregnant women, AUC and peak concentration in pregnant women were nearly twice that of non-pregnant women. In order to derive a safe dose for the pregnant women we estimated the dose in the pregnant women model taken at once which would not exceed AUC and peak concentration in the non-pregnant women of 200 mg as single dose. The resulting dose is 100 mg caffeine per occasion which we recommend as safe.The caffeine dose of 200 mg per day is declared as safe for pregnant women with respect to the foetus by EFSA based on results on reduced birth weight in epidemiological studies. We modelled AUC and peak concentration for different caffeine doses to investigate the relationship between internal caffeine exposure and risk measures of reduced birth weight from epidemiological studies. The graphical analysis revealed that the reduction in birth weight was related to AUC and peak concentration up to a dose of 250 mg caffeine.     

Association between the sense of coherence 13-item version scale score of pregnant women in the second trimester of pregnancy and threatened premature birth

Objectives

The purpose of this study is to determine whether the score of the sense of coherence 13-item version (SOC-13) scale in the second trimester of pregnancy is associated with threatened premature birth.

Methods

All the subjects gave their informed written consent before their participation in the study. A self-reported questionnaire survey was conducted on the pregnant women at approximately 18 weeks of pregnancy. The questionnaire consisted of items on demographic characteristics, perinatal abnormalities, stress perception scale (SPS), and SOC-13 scale. Approximately 30 weeks of pregnancy after the first survey, we surveyed whether any treatment had been provided for threatened premature birth during the course of the current pregnancy. The study period was from December 2007 to February 2010. One hundred and seventy-seven pregnant women participated in the study, but only the data from 151 pregnant women were analyzed.

Results

Forty-three (28.5 %) pregnant women had threatened premature birth and received some treatment. Logistic regression analysis was carried out with threatened premature birth as the dependent variable and age, childbirth history, smoking habit, history of miscarriage or premature birth in previous pregnancies, SPS score, and SOC-13 scale score as the independent variables. It was shown that SOC-13 scale score affected threatened premature birth (p < 0.001) and that a low SOC-13 scale score was associated with threatened premature birth.

Conclusions

This study suggests that the SOC-13 scale score in the second trimester of pregnancy could be of great value in clinical health care of pregnant women with a risk of threatened premature birth in the subsequent course of pregnancy.     

妊娠合并梅毒患者发生不良妊娠结局的影响因素分析

目的：探讨妊娠合并梅毒患者发生不良妊娠结局的影响因素。方法选取2011年7月—2014年2月柘城县妇幼保健院收治的妊娠合并梅毒患者100例,根据患者意愿分为治疗组（70例）和未治疗组（30例）。治疗组患者予以苄星青霉素治疗,未治疗组患者未予以任何驱梅治疗。观察两组患者妊娠梅毒阳性率、不良妊娠结局（异位妊娠、早产、死胎死产、自然流产等）发生率、不同分娩方式对新生儿结局的影响。结果治疗组患者妊娠梅毒阳性率低于未治疗组,不良妊娠结局发生率低于未治疗组,差异均有统计学意义（ P ＜0.05）。剖宫产新生儿的梅毒感染率低于阴道分娩,差异有统计学意义（P ＜0.05）。结论对于妊娠合并梅毒患者应开展孕早期梅毒筛查工作,及时进行规范的抗病毒治疗,并采用剖宫产,以降低妊娠梅毒阳性率及不良妊娠结局发生率,改善新生儿结局。