Association between severe nausea and vomiting in pregnancy and lower rate of preterm births

Nausea and vomiting in pregnancy has been associated with some reduction in miscarriage in other studies. However the relationship between nausea and vomiting during pregnancy and preterm birth/low birthweight in newborns is inconsistent; therefore the objective of the study was to clarify this possible association. The population-based large control (without any defects) data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities was evaluated. Of 38,151 controls, 3869 (10.1%) had medically recorded and treated nausea and vomiting during pregnancy. The proportion of mothers who later delivered girls was higher in this group. Mothers with nausea and vomiting in pregnancy had a somewhat (0.3 week) longer gestational age and a lower proportion of preterm births (6.4% vs. 9.5%). This finding may be connected with the favourable hormonal milieu (larger placenta, higher level of chorionic gonadotrophin and oestrogens) of pregnant women with nausea and vomiting.     

少女妊娠与青春期性健康教育现状研究

[目的] 从少女妊娠的现象反映青春期性活跃人群存在的生殖健康问题及青春期性健康教育的现状.[方法] 采用随机整群抽样方法选取上海七家医院终止妊娠的≤19周岁的少女,采用现场匿名问卷的方式调查. [结果] 妊娠少女的平均年龄为(17.58±0.96)岁,有人工流产史者占19.1%,从来不使用避孕措施的占43.6%,有多个性伴侣者占22.5%.73.5%的从未接受过家庭性教育,48.7%很少、24.3%从来没有接受过学校性教育.家庭性教育和学校性教育的实施不会提早首次性行为的年龄(P>0.05).安全性行为/避孕教育可以促进性活跃少女人群避孕措施的使用(P<0.01). [结论] 必须在全国建立系统、科学、有效的青春期性健康教育体制,兼顾校内、校外和流动人口青少年,以保护他们的生殖健康.     

陕西省妇女既往生育史与末次妊娠早产的相关分析

目的 探讨陕西省单胎活产新生儿早产发生率及母亲既往生育史与其的相关性。方法 采用分层多阶段随机抽样方法,以问卷调查方式收集2010-2013年陕西省怀孕且其结局明确的育龄妇女生育史等相关信息。结果 共调查29 608名育龄妇女及其子女,活产单胎新生儿早产发生率为2.7%。logistic回归分析显示,早产史（OR=7.99,95%CI：5.59~11.43）、末次妊娠年龄≥35岁（OR=2.03,95%CI：1.59~2.59）、出生缺陷史（OR=1.54,95%CI：1.01~2.34）是发生早产的危险因素。妊娠间隔3~4年（与妊娠间隔≤2年者比,OR=0.74,95%CI：0.58~0.93）、妊娠间隔5~6年（与妊娠间隔≤2年者比,OR=0.66,95%CI：0.52~0.82）、妊娠间隔>6年（与妊娠间隔≤2年者比,OR=0.48,95%CI：0.37~0.61）、生产次数1次（与初产者比,OR=0.80,95%CI：0.67~0.95）、生产次数≥2次（与初产者比,OR=0.62,95%CI：0.39~0.97）是早产的保护因素。有序多分类logistic回归分析显示,影响孕周长短的主要因素是早产史、高龄妊娠（≥35岁）及妊娠间隔时间。结论 2010-2013年陕西省单胎活产新生儿早产发生率低于全国平均水平。有早产史、高龄妊娠（≥35岁）、出生缺陷史可能增加早产发生风险;妊娠间隔长、分娩次数多可能降低早产发生风险。     

甘肃汉族人群高血压家族史与高血压关联的研究

目的 了解甘肃省20~80岁汉族人群高血压患病现状,探讨高血压家族史（family history,FH）与高血压之间的关系。方法 本研究为横断面研究,采用多阶段分层整群抽样方法,选择甘肃省4个调查地区的汉族人群,进行面对面问卷调查、体格检查和血生化检测。结果 共调查4 247名20~80岁汉族常住居民,问卷应答率为97.4%,合格率为98.7%。其中男性有1 777人（41.8%）,女性有2 470人（58.2%）,高血压粗患病率为28.2%。多因素Logistic回归分析显示,有FH者患高血压的风险比无FH高（OR=3.36,95%CI：2.58~4.41,P<0.001）,当患病亲属从1代增加到2代和3代时,高血压的患病风险从2.33倍（OR=2.33,95%CI：1.77~3.09,P<0.001）增加到5.97倍（OR=5.97,95%CI：4.42~8.13,P<0.001）和14.64倍（OR=14.64,95%CI：8.30~26.27,P<0.001）。结论 有高血压FH的人群高血压患病率明显升高,且随着家族中患病亲属代数的增加,高血压的患病风险逐渐增加。有FH的人能形成一个易于识别的群体,对该群体的针对性干预能够使其受益,从而降低高血压的发病风险。     

Does family interaction prevent adolescent pregnancy?

This study uses data from the 1982 National Survey of Family Growth to ascertain whether family interaction can avert adolescent sexual activity, pregnancy, childbearing and parenthood. The results obtained from using logistic regression procedures indicate that the family may be effective in increasing adolescents' use of contraceptives and selection of abortion or adoption as alternatives to parenthood. Family interaction, however, was not associated with forestalling adolescent sexual activity or with providing for the well-being of the adolescent and her child and it is unlikely that a policy based solely on family interaction will be effective. Characteristics associated with effectiveness in preventing adolescent pregnancy included race, religion, residence, mother's education, the adolescent's age and family income.     

Association between documented family history of cancer and screening for breast and colorectal cancer

Background

Previous research on ascertainment of cancer family history and cancer screening has been conducted in urban settings.

Purpose

To examine whether documented family history of breast or colorectal cancer is associated with breast or colorectal cancer screening.

Methods

Medical record reviews were conducted on 3433 patients aged 55 and older from four primary care practices in two rural Oregon communities. Data collected included patient demographic and risk information, including any documentation of family history of breast or colorectal cancer, and receipt of screening for these cancers.

Results

A positive breast cancer family history was associated with an increased likelihood of being up-to-date for mammography screening (OR 2.09, 95% CI 1.45–3.00 relative to a recorded negative history). A positive family history for colorectal cancer was associated with an increased likelihood of being up-to-date with colorectal cancer screening according to U.S. Preventive Services Task Force low risk guidelines for males (OR 2.89, 95% CI 1.15–7.29) and females (OR 2.47, 95% CI 1.32–4.64) relative to a recorded negative family history. The absence of any recorded family cancer history was associated with a decreased likelihood of being up-to-date for mammography screening (OR 0.70, 95% CI 0.56–0.88 relative to recorded negative history) or for colorectal cancer screening (OR 0.75, 95% CI 0.60–0.96 in females, OR 0.68, 95% CI 0.53–0.88 in males relative to recorded negative history).

Conclusion

Further research is needed to determine if establishing routines to document family history of cancer would improve appropriate use of cancer screening.     

心血管病高危人群早发家族史与脑卒中的关联

目的  了解心血管病高危人群的脑卒中早发家族史对脑卒中患病风险的影响。 方法  基于2015年9月至2019年6月中国心血管病高危人群早期筛查与综合干预项目（China PEACE-MPP）江苏省22 552名心血管病高危人群数据,采用Logistic回归分析模型研究早发家族史对脑卒中患病的影响,并进一步进行早发家族史与高血压、糖尿病的交互作用分析。 结果  与无早发家族史人群相比,有脑卒中早发家族史的人群患脑卒中的风险较高,OR值为2.04（95% CI：1.70~2.44）;对于缺血性脑卒中的发病风险来说,男性亲属型、女性亲属型和双性亲属型皆比无早发家族史人群患病风险高,OR值分别为2.18（95% CI：1.68~2.84）、1.76（95% CI：1.3~2.37）和3.12（95% CI：1.80~5.42）;对于出血性脑卒中患病风险来说,只有女性亲属型人群与脑卒中无统计学意义。研究未发现早发家族史与高血压、糖尿病存在交互作用。 结论  有脑卒中早发家族史的心血管病高危人群发生脑卒中的风险较高,应当及早开展生活方式干预和疾病的治疗管理。     

家庭因素与青少年吸烟关系调查

目的探讨家庭环境与青少年吸烟的关系,为制定切实有效的干预措施提供依据。方法采取随机抽样的方法对武汉市11个区22所公立学校的6994名中学生进行吸烟行为与家庭环境的问卷调查,运用单因素χ2和多因素Logistic回归分析探讨两者之间的关系。结果11项家庭环境因素对青少年的吸烟行为均有影响,特别是家庭成员中兄弟姐妹吸烟、父母吸烟和青少年对父母的依从性是重要的影响因素。结论控制家庭的吸烟相关因素将有利于减少青少年的吸烟行为。     

The problem of teenage pregnancy

In this question and answer dialogue along with a case study, the psychosocial issues and medical aspects of teenage pregnancy are discussed. Suggestions for improving the situation included 1) developing a community based approach which utilizes school sex education integrated with parent, church, and community groups, 2) increasing teenage knowledge of contraception, and 3) providing counseling and medical and psychological health, education, and nutrition of the mother and father in order to reduce low birth weight babies and the school dropout rates. Advice to providers is to involved in supporting community based adolescent pregnancy and childbearing programs, and serving the needs of of teenagers by providing contraceptive information in confidence, and providing nonjudgmental information to parents and teenagers on sexuality, pregnancy and birth control. The cost of teenage childbearing is estimated at 16.6 billion for 1985, with the U.S. fertility rate, birth and abortion rates higher than Canada, France, the Netherlands, Great Britain and Sweden. Within 1 month of 1st initial intercourse, 20% result in teenage pregnancy. 50% will give birth to a second child. The health risk to the mother and child due to poor nutrition, toxemia conditions, while psychosocial effect is the cycle of failure and low self-esteem. For disadvantaged youth, a baby appears as a reachable achievement, and for those with an additional child, the goal of security and financial independence is less likely. Financial and emotional support from family or social services and family planning practices can lead to completion of H.S., limitation in family size, and independence. Of those receiving public assistance in 1969, 66% were independent, and only 12% receiving assistance between 1969 and 1974 were still receiving assistance. Teen fatherhood has not been adequately addressed, and findings suggest that parenting and contraceptive education, job training, support to stay in school are receptive ideas to fathers and also impact favorable on mothers and children.     

Second births among teenage mothers: program results and statistical methods

This paper uses survival analysis to examine three large-scale, multi-site, randomized, controlled programs that attempted to prevent or delay second births to teenagers. Statistically significant differences in the hypothesized direction were found between the intervention and the control groups in the Elmira and Memphis Home Visitation sites. No statistically significant differences in the hypothesized direction were found in the Teen Parent Welfare Demonstration overall or in any of its three sites or in all New Chance sites combined. Delaying second pregnancies among teenagers requires intensive efforts. Survival analysis is a more accurate and useful way of presenting program results than simple analysis of the proportion of women with a second birth.     

Primary prevention of adolescent pregnancy: Promoting family involvement through a school curriculum

In prevention work, practices are suggested by theories. Thus, the idea that family-centered prevention is beneficial already embodies a theoretical perspective about why certain approaches to prevention are more appropriate than others. Logic and research evidence both suggest that the family is an indispensable resource in the primary prevention of destructive sexual decisions by adolescents. This paper describes how one project draws upon the family to accomplish primary prevention. An Alternative National Curriculum (AANC) is currently being disseminated in selected public schools in three states, while promoting parent-teen involvement. This project is sponsored by the Office of Adolescent Pregnancy Programs (OAPP), Department of Health and Human Services, which has a legislative mandate under Title XX of the Public Health Service Act to sponsor family-centered demonstration projects that help prevent premarital teen sexual relations and pregnancy. A specific theoretical view of human nature, family life, and societal well-being has been drawn upon to produce AANC. It focuses on ethical and responsible behavior, the importance of family linkages, and how quality family living across generations can be achieved.Terrance D. Olson and Christopher M. Wallace are with the Department of Family Sciences, Brigham Young University, Provo, Utah 84602. Brent C. Miller is with the Department of Family and Human Development, Utah State University, Logan, Utah 84322.     

Association between family history of cancer and breast cancer defined by estrogen and progesterone receptor status

There are recent data to suggest that risk factors for breast cancer may differ according to whether the tumor expresses detectable levels of the estrogen receptor (ER) and progesterone receptor (PR). While a family history of breast cancer is one of the most consistent predictors of the disease, we recently reported a modest inverse association with ER+PR− tumors. However, the definition of a family history of cancer did not consider second-degree relatives or cancer sites that may be etiologically related. The current report presents additional data analysis from the Iowa Women's Health Study, a prospective population-based cohort study conducted among 41,837 postmenopausal women. At baseline in 1986, respondents provided information on family history of cancers of the breast, ovaries, or uterus/endometrium in their mothers, sisters, daughters, maternal and paternal grandmothers, and maternal and paternal aunts. Data on family history of prostate cancer in fathers and brothers and age at onset of breast cancer in mothers and sisters were collected in 1992. Cohort members were followed for cancer incidence through the statewide tumor registry. After 7 years and more than 235,000 person-years of follow-up, 939 incident cases of breast cancer were identified. Information was obtained from the tumor registry on ER (+/−) and PR (+/−) status for 610 cases (65.0%). A family history of breast cancer in first-degree relatives was associated with increased risk (relative risk [RR] = 1.4; 95% confidence interval [CI]: 1.1–1.6) for all receptor-defined subtypes of breast cancer except ER+PR− tumors (RR = 0.7; 95% CI: 0.3–1.4). These results were unchanged when data on second-degree relatives were included. When the onset of breast cancer in relatives occurred at or before the age of 45 years, increased risks were evident only for ER−PR+ and ER−PR− tumors (RR = 2.3 and 3.3, respectively). Conversely, when relatives were affected with breast cancer after the age of 45 years, increased risks were most apparent for ER+PR+ and ER−PR+ tumors (RR = 1.3 and 3.2, respectively). A family history of prostate cancer in first-degree relatives was associated with a 1.2-fold increased risk of breast cancer (95% CI: 0.98–1.50), largely a reflection of the association with ER−PR− tumors (RR = 1.5; 95% CI: 0.8–3.0). The small numbers of cases in some categories and the corresponding wide CIs preclude definitive conclusions, but these data are at least suggestive that joint stratification of breast tumors on ER and PR status may be useful in partitioning breast cancer families into more homogeneous subsets. © 1996 Wiley-Liss, Inc.     

Association of parental characteristics with adverse outcomes of adolescent pregnancy

BACKGROUND: It is well-known that pregnancy in adolescence has an increased risk of adverse reproductive outcomes. It remains unclear whether this association is due mainly to the unfavourable sociodemographic status or due solely to biological immaturity of pregnant adolescents. OBJECTIVE: The purpose of this study was to determine the association of parental sociodemographic characteristics with the adverse outcomes of adolescent pregnancy. METHOD: Data from certificates of live births in Taichung County, Taiwan in 1994 of 7994 singleton, first-born babies whose mothers were 15-34 years of age were analysed. The relative risk of having adverse pregnancy outcomes for adolescent subgroups was obtained as compared with that among mothers 20-34 years of age with the same characteristics. The adjusted relative risk of having adverse pregnancy outcomes for each covariate was calculated by a multiple logistic regression analysis. RESULTS: Of 7994 babies born to mothers of 15-34 years of age, 8.3% were born to adolescent mothers. In all age groups, the younger adolescent mothers (15-17 years of age) had the highest percentage of both infants with low birth weight (10.6%) and preterm births (7.1 %). Younger adolescent mothers in almost all sociodemographic categories had higher risks of having both low-birth-weight and preterm births than those of older adolescent mothers. Multiple logistic regression analysis showed that a younger maternal age is the only significant risk factor for having infants with low birth weight (adjusted RR = 2.5, 95% Cl 1.8-4.5 and adjusted RR = 1.7, 95% Cl 1.2-2.6 for younger and older adolescent mothers, respectively) or preterm birth (adjusted RR = 1.9, 95% Cl 1.1- 3.4 and adjusted RR = 1.5, 95% Cl 1.0-2.3 for younger and older adolescent mothers, respectively). CONCLUSIONS: Adolescent pregnancy carries an increased risk of having low-birth-weight and preterm births, and a younger maternal age is causally implicated.      

童年期不良经历与青少年抑郁关系队列研究的Meta分析

总结童年期不良经历与青少年抑郁之间现有的队列研究证据,为预防青少年抑郁提供证据.方法 通过检索万方、维普、中国知网、中国生物医学文献数据库、PubMed和Web of Science自建库到2019年2月间发表的有关童年期不良经历与青少年抑郁相关性的队列研究的中英文文献.中文检索词包括童年期不良经历、虐待、忽视、欺凌、家庭功能不全、家庭暴力、逆境、不良经历、不良事件、创伤、抑郁、前瞻性、队列、纵向、随访;英文检索词包括adverse childhood experiences,ACE,abuse,maltreat,mistreat,neglect,bully,bullying,family dysfunction,family violence,adversities,trauma,victimization,victim,adverse events,adverse experiences,longitudinal,follow-up,prospective,cohort,depression,depressive.对筛选得到的符合纳入标准的文献用Stata 11.0软件进行Meta分析.结果 纳入文献12篇(11篇英文,1篇中文).结果 显示,童年期不良经历与青少年抑郁呈正相关(OR=1.75,95%CI=1.43~2.15),其中忽视对青少年抑郁的影响最大(OR=2.42,95%CI=1.31 ~4.46),而虐待对青少年抑郁的影响最小(OR=1.77,95%CI=1.25~2.52).欺凌的OR值为2.09(95%CI=1.38~3.16),男生(OR=3.77,95%CI=2.31 ~6.15)大于女生(OR=1.44,95%CI=1.04~2.01).漏斗图和Egger检验提示,纳入文献存在发表偏倚,敏感性分析显示Meta分析结果较为稳健.结论 童年期不良经历与青少年抑郁呈正相关,忽视对青少年抑郁的影响最大,虐待对青少年抑郁的影响最小.     

Teenage conceptions, abortions, and births in England, 1994–2003, and the national teenage pregnancy strategy

Teenage conceptions, abortions, and births in England, 1994–2003, and the national teenage pregnancy strategy . Wilkinson P. , French R. , Kane R. , Lachowycz K. , Stephenson J. , Grundy C. , Jacklin P. , Kingori P. , Stevens M. & Wellings K. ( 2006 ) The Lancet , 368 , 1879 – 1886 .     

妇女孕前贫血与孕期贫血间关系的研究

我国妇女妊娠期贫血患病率在20%以上~[1-4],2003年在南方经济发达地区婚前医学检查妇女的贫血患病率仍在25%以上~[5].而农村地区有78.9%～84.1%的妇女在登记结婚后一年内受孕~[6],在北方和经济欠发达地区这一比例可能更高,因此有些妊娠贫血可能是孕前期(孕前)贫血的延续和发展.本研究分析妇女婚前医学检查时血红蛋白(Hb)浓度(g/L)和贫血患病情况与其在孕期Hb浓度和贫血患病率间的关系,明确防治孕前贫血对降低妊娠贫血患病率的作用.     

青少年网络成瘾与自杀行为的相关关系

目的 了解网络成瘾与青少年自杀行为的相关关系,如果存在相关关系,并考察能否被抑郁以及冲动相关行为部分或全部解释.方法 合肥市3507名使用网络的中学生完成问卷调查.内容包括Young网络成瘾诊断量表,自杀行为、抑郁量表,冲动相关的行为以及不良经历等调查表.采用层次logistic回归模型在调整混杂因素的基础上,分析网络成瘾与青少年自杀行为的相关关系及抑郁和冲动相关行为在上述相关关系中的作用.结果 3507名学生有182名(5.2%)被诊断为网络成瘾;过去一年有自杀意念、计划和未遂的学生比例分别为27.4%、9.5%和2.6%.网络成瘾与自杀意念、计划和未遂的关联指标OR值分别为1.79(95%CI:1.32～2.44)、2.32(95%CI:1.57～3.42)和2.08(95%CI:1.03～4.22),调整人口学和不良经历变量后,网络成瘾与自杀未遂的关联无统计学意义.抑郁和冲动相关行为分别引入以网络成瘾为自变量的方程,网络成瘾与自杀意念和计划的关联出现不同程度的下降;相反,若将网络成瘾引入以抑郁或(和)冲动相关行为自变量的方程,抑郁或(和)冲动相关行为与自杀意念和计划的关联未见明显变化.结论 网络成瘾与自杀意念、自杀计划存在关联,且该关联的路径可能由抑郁和冲动相关行为介导.     

青少年社会资本与健康行为间的相关性

探讨中国西南地区青少年社会资本与其健康行为间的关系,为推进学校健康促进工作提供参考.方法 在重庆市主城区及周边区县学校,根据年级及学校地理位置,采用分层随机抽样,共抽10所学校1 885名学生,采用“社会资本量表”和“健康行为量表”收集资料,并对获得的数据运用探索性及典型相关分析方法进行处理.结果 青少年的社会资本越多,则越能养成良好的健康行为(第1典型相关系数R=0.78,P<0.05),表现为家庭氛围越好、亲子关系越好、手足互动越好、亲友互动越好、社区参与越多、代间沟通越多、亲师关系越好、同伴关系越好、师生关系越好、社团参与越多的青少年,其健康行为越好(负荷量分别为-0.705,-0.687,-0.567,-0.705,-0.536,-0.521,-0.542,-0.711,-0.612,-0.688);社区参与越多、亲师关系越好、同伴关系越差、社团参与越多的青少年(负荷量分别为0.475,0.411,-0.504,0.426),则越能落实营养行为、健康责任行为及运动行为(第2典型相关系数R=0.45,P<0.05);家庭氛围越好、亲子关系越好、同伴关系越差、社团参与越少(负荷量分别为0.547,0.431,-0.415,-0.362),则越能履行营养行为(第3典型相关系数R=0.31,P<0.05).结论 青少年的社会资本与健康行为密切相关,家庭内、外社会资本及学校社会资本对其健康行为养成具有正向效应.