成都市某三甲医院孕妇孕期膳食习惯及行为调查

目的:调查成都市某三甲医院孕妇孕期膳食习惯及行为的变化情况。方法:以理性行为理论为基础,自行设计问卷对在成都市某三甲医院门诊就诊的600例孕妇进行调查。结果:孕妇普遍存在孕期膳食结构不合理,孕期营养知识缺乏的问题,不同年龄段孕前BMI之间差异有统计学意义(P=0.003);孕前、孕早期、孕中晚期在吸烟、喝酒、喝咖啡等方面差异具有统计学意义(P=0.000)。结论:孕妇孕期膳食行为及营养知识有待改善,应加强孕期膳食行为监督及营养知识健康教育指导。     

The Role of Vascular Addressins in Implantations Sites During Successful and Failing Mouse Pregnancies

Leukocytes are migratory cells. Highly specialized and regulated mechanisms exist to control their extravasation from the blood into tissues. Specificity for particular organs and tissues is provided by tissue-selective expression of vascular adhesion ligands and by tissue-selective chemoattractant factors. The successful coexistence of semiallogeneic cells at the maternal/fetal interface suggests that the pregnant uterus represents an environment in which leukocyte trafficking needs to be exquisitely regulated to establish a selected population of maternal leukocytes that support, modulate and regulate trophoblast invasion and local immunity. Especially during the critical period of initial placenta development in the mouse, there is an elegantly orchestrated progression of leukocyte homing events in the decidua basalis associated with the segregation of the major infiltrating leukocyte subsets into distinct decidual microenvironments. Switches of vascular addressins during the course of pregnancy parallel changes in the population of recruited leukocytes and transform the leukocyte-rich mid-term decidua basalis into the relatively leukocyte-poor phenotype at term. However, these mechanisms are sensitive to disruption. Consequently, it is relevant to understand how these mechanisms are modulated during abnormal pregnancy, where a dramatically altered decidual leukocyte composition may be involved in fetal loss.     

Estimating influenza disease burden among pregnant women: Application of self-control method

To evaluate influenza disease burden among pregnant women, an epidemiological study using the self-control method was conducted. Study subjects were 12,838 pregnant women who visited collaborating maternity hospitals and clinics in Osaka Prefecture, Japan, before the 2013/14 influenza season. As a study outcome, hospitalization due to respiratory illnesses between the 2010/11 and 2013/14 seasons was collected from each study subject through a baseline survey at the time of recruitment and a second survey after the 2013/14 season. The hospitalization rates during pregnancy and non-pregnancy periods was calculated separately. To compare the hospitalization rate during pregnancy with that during non-pregnancy within the same single study subject, Mantel-Haenzel rate ratios (RR_MH) were calculated.During the four seasons examined in this study, nine and 17 subjects were hospitalized due to respiratory illnesses during pregnancy and non-pregnancy periods, respectively. The hospitalization rate was 2.54 per 10,000 woman-months during pregnancy and 1.08 per 10,000 woman-months during non-pregnancy. The RR_MH for the hospitalization rate during pregnancy compared with that during non-pregnancy was 4.30 (95% confidence interval, 1.96–9.41).Our results suggest that during the influenza season, pregnant women have a higher risk than non-pregnant women for hospitalization due to respiratory illnesses. The self-control method appears to be an appropriate epidemiological method for evaluating the disease burden of influenza among pregnant women.     

绝经期女性激素水平与动脉粥样硬化的关系

目的研究绝经期女性激素水平与动脉粥样硬化(AS)的关系。方法纳入2018年1月-2019年4月于银川市中医医院心血管内科住院的接受冠脉造影的绝经女性142例为研究对象,均行性激素水平检测,包括雌二醇(E₂)、睾酮(T)、促卵泡生成素(FSH)、促黄体生成素(LH)水平及E₂/T值。所有患者均接受冠脉造影,根据冠脉造影检测结果分为AS组86例和非AS组56例,并对AS组造影结果进行评估,分为单支病变组32例、双支病变组28例及3支病变组26例,采用Gensini评分评估冠状动脉病变程度,比较AS组与非AS组性激素水平,观察单支病变组、双支病变组、3支病变组性激素水平,分析不同Gensini评分患者性激素水平,探讨性激素水平与AS患者Gensini评分的相关性。结果AS组E₂、E₂/T显著低于非AS组,T显著高于非AS组,差异均有统计学意义(P<0.05)。单支病变组E₂、E₂/T均显著高于双支病变组及3支病变组,双支病变组E₂/T显著高于3支病变组,差异均有统计学意义(P<0.05)。Gensini评分<20分组E₂、E₂/T均显著高于20~40分组及>40分组,20~40分组E₂、E₂/T均显著高于>40分组,差异均有统计学意义(P<0.05)。AS患者Gensini评分与E₂、E₂/T水平呈负相关(r=-0.196、-0.213,P=0.011、0.006)。结论绝经期女性激素水平与AS密切相关。     

Broader autism phenotype as a risk factor for postpartum depression: Hamamatsu Birth Cohort (HBC) Study

The broader autism phenotype (BAP), which refers to the expression of behavioral and cognitive propensities that are milder but qualitatively similar to those defining autism spectrum disorder, can play a crucial role in postpartum depression (PPD). We investigated whether pregnant women's BAP would increase the risk for PPD, using a representative birth cohort in Japan. Pregnant women were enrolled in the Hamamatsu Birth Cohort (HBC) Study during their mid-gestation (N = 841) and were followed up until 3 months after delivery. BAP was measured mainly during the 2nd trimester of the pregnancy by using the Broader Phenotype Autism Symptoms Scale. Participants scoring 9 points or higher on the Edinburgh Postnatal Depression Scale at least once during the first 3 months after childbirth were diagnosed with PPD. Among participants, 128 (15.2%) women were found to have PPD. Multiple logistic regression analyses showed that BAP were associated with PPD (OR = 1.19, 95% CI [1.07–1.31]), even after controlling for other potential confounders. In addition, the association was not moderated by history of depression and/or anxiety disorders, including concurrent depressive and anxiety symptoms during pregnancy. The findings suggest that pregnant women with BAP have an elevated risk for PPD.     

孕前超重/肥胖的妊娠期糖尿病孕妇血糖管理：基于静息能量消耗计算每日总能量消耗

目的探讨基于静息能量消耗(REE)计算每日总能量消耗(TEE)，对孕前超重/肥胖的妊娠期糖尿病(GDM)孕妇血糖管理意义。 方法选择2018年6月至2019年6月，于首都医科大学附属北京潞河医院产科"糖尿病一日门诊"就诊时，被诊断为孕前超重/肥胖的67例GDM孕妇为研究对象。按照其首次就诊时间的奇、偶周，将其分为研究组(n＝34，首次就诊时间为奇数周者)和对照组(n＝33，首次就诊时间为偶数周者)。采用成组t检验对2组孕妇年龄、孕次、孕期体重增加值、新生儿出生体重、空腹血糖、餐后2 h血糖等进行统计学分析。采用Mann-Whitney U检验对2组孕妇分娩孕龄、产次等进行统计学分析。采用χ²检验、Fisher确切概率法、连续性校正χ²检验对2组孕妇尿酮体阳性率、巨大儿发生率等进行统计学分析。本研究经首都医科大学附属北京潞河医院医学伦理委员审核批准(审批文号：2018-LHKY-027-02)，并与所有受试者签署知情同意书。 结果①2组GDM孕妇年龄、孕次、产次、分娩孕龄及孕前人体质量指数(BMI)构成比比较，差异均无统计学意义(P>0.05)。②研究组孕妇TEE为(1 532.6±301.9)kcal/d，显著低于对照组的(1 824.1±313.2) kcal/d，并且差异有统计学意义(t＝3.311、P＝0.002)；2组孕妇血糖达标情况构成比比较，差异亦有统计学意义(P＝0.040)。③研究组孕妇孕期体重增加值、糖化血红蛋白(HbA1c)水平和新生儿出生体重分别为(13.4±6.2)kg、(5.6±0.3)%和(3 287.5±577.1)g，明显低于对照组的(18.2±4.8)kg、(6.2±0.2)%和(3 632.8±490.6)g，并且差异均有统计学意义(t＝2.235、P＝0.031，t＝2.882、P＝0.047，t＝2.121、P＝0.039)。 结论基于REE估算的TEE，较通用系数法估算的TEE，更接近于孕前超重/肥胖GDM孕妇的实际能量需求。因此，基于REE估算的TEE更有利于对孕前超重/肥胖的GDM进行孕期血糖管理。     

同伴教育对初产妇分娩自我效能及分娩结局的影响

目的探究同伴教育对初产妇分娩自我效能感及分娩结局的影响。方法将2017年3-7月在该院产科建卡且孕28周的100名孕妇按照随机数字表法分为观察组和对照组,各50名,对照组实施传统孕产期健康教育,观察组在孕28周、32周、37周各进行与同伴教育相结合的孕产期健康教育一次。观察两组孕妇干预前及入院待产时自然分娩自我效能感水平、自然分娩率、产后出血及新生儿窒息发生率。结果观察组入院待产时自然分娩自我效能感水平提高、自然分娩率增加,与对照组比较,差异有统计学意义(χ^2=4.574,P<0.05);两组产后出血发生率比较,差异无统计学意义(P>0.05);两组均无新生儿窒息发生。结论同伴教育与孕产期健康教育相结合,可使孕妇在掌握自然分娩知识和技能的同时,自然分娩自我效能亦得以增强,达到促进和保护自然分娩。     

妊娠期、围生期带状疱疹25例临床分析

【摘要】 目的 探讨妊娠期、围生期带状疱疹的临床特征、治疗及预后。方法 收集2011年1月至2020年12月郑州大学第一附属医院住院治疗的妊娠期、围生期带状疱疹患者的临床资料，回顾分析临床特征、治疗及预后情况。结果 纳入25例，其中妊娠期22例（孕10 ~ 38周，孕早期1例、孕中期13例、孕晚期8例），产后1周内3例；年龄22 ~ 37岁，病程2 ~ 9 d。临床表现：皮疹位于头面部8例，胸背部5例，腰腹部7例，上肢1例，下肢3例，会阴1例，3例为播散性带状疱疹。皮疹形态均为红斑、丘疱疹、水疱，其中4例合并血疱，3例合并大疱，6例合并糜烂、渗出；5例发热，7例轻度、6例中度、11例重度疼痛。治疗：16例妊娠期、3例产后患者进行抗病毒治疗（口服或静脉滴注阿昔洛韦、单磷酸阿糖腺苷、膦甲酸钠氯化钠注射液），24例应用营养神经药物，1例妊娠期患者、3例产妇进行镇痛治疗，其他治疗包括抗感染、湿敷、红光照射等。预后：1例妊娠期患者早产，其余妊娠期患者均足月生产，新生儿无异常。3例妊娠期患者出现后遗症，1例为疼痛，2例为瘙痒。结论 本文25例妊娠期、围生期带状疱疹的治疗未观察到对胎儿、新生儿有明显影响。