嘉兴市1993-2000年过期妊娠发生状况及相关社会因素

目的 了解浙江省嘉兴市1993-2000年过期妊娠发生状况及相关社会因素.方法 研究对象为嘉兴市在1993-2000年间分娩单胎活产的16 033名妇女.运用X2检验比较各组率的差别,运用两分类多元logistic回归模型分析过期妊娠的影响因素.结果 从1993-2000年过期妊娠发生率分别是8.7%、10.6%、9.4%、7.4%、4.3%、2.6%、3.3%、4.0%.婚(孕)前接受卫生服务的妇女过期妊娠发生率(5.6%)低于产前接受卫生服务的妇女(7.8%);接受县级及以上卫生服务的妇女过期妊娠发生率(4.3%)低于接受乡级及以下卫生服务的妇女(8.5%);小学文化程度的妇女过期妊娠发生率(11.5%)高于初中(6.8%)、高中(3.8%)、大学(2.9%);职业为农民的妇女过期妊娠发生率(9.5%)高于农村工人(8.90)、城市工人(4.3%)、其他职业(4.2%).接受卫生服务时期、接受卫生服务级别、受教育程度、职业均是过期妊娠的影响因素.结论 嘉兴市1993-2000年过期妊娠发生率有逐年下降的趋势.卫生服务时期、卫生服务级别、受教育程度、职业与过期妊娠有关.     

广东省农村育龄妇女产前保健服务研究

目的了解广东省农村育龄妇女产前保健服务利用现状,探讨妇女产前保健的影响因素。方法利用广东省第三次卫生服务调查数据,研究分析调查时15～49岁农村育龄妇女回顾在1998年1月1日-2003年10月20日最后一次活产时的产前保健服务利用情况。结果全省农村育龄妇女产前检查率85.65%,高于全国农村水平;平均产前检查次数5.14次;产前检查次数≥5次的占48.88%;平均初检孕周13.67周;早孕检查率49.50%,低于全国农村水平。多因素Logistic回归分析发现,影响产前保健利用及时性的主要因素有:文化程度、居住地区、职业和活产次;影响产前保健利用足够性的主要因素有:文化程度、居住地区、经济状况、职业、活产次和家庭离最近医疗点的距离。结论广东省农村育龄妇女产前保健覆盖率扩大,产前检查次数及产前检查次数符合率提高,但早孕检查率下降,早孕检查不受重视;全省不同地区间农村妇女的产前保健服务利用不均衡,非珠三角农村妇女产前保健利用明显不足。建议采取相应措施,提高农村育龄妇女文化程度,加强计划生育管理,提高广东省农村育龄妇女孕产期保健服务利用水平。     

江苏、浙江省4县(市)早产儿体重分布状况及相关社会因素

目的 了解早产儿体重分布状况及早产相关社会因素.方法 研究对象为1995-2000年江苏、浙江省4县(市)分娩孕满28～41周的单胎活产儿的97 537名妇女.采用X2检验比较各组率的差别,应用单因素方差分析比较两组第一次产前检查孕周及产前检查总次数的差异.运用两分类多元logistic回归分析早产的影响因素.结果 4县(市)≥t35岁妇女早产发生率(8.8%)高于＜24岁(5.6%)、25～29岁(4.6%)和30～34岁组(4.5%).身高＜149 cm的妇女早产发生率(6.8%)高于身高≥150 cm的妇女(5.0%).孕早、中期BMI≥28.0及BMI 24.0～28.0妇女的早产发生率(均为5.5%)高于BMI 18.5～24.0(5.0%)、BMI＜18.5的妇女(4.6%).初次怀孕妇女的早产发生率(6.0%)高于孕次≥4次(5.7%)、2次(4.3%)和3次的妇女(4.0%).产次≥2次妇女的早产发生率(9.3%)高于待产妇女(5.2%)和产1次的妇女(4.5%).孕早期没有接受早孕检查的妇女早产发生率(6.1%)高于进行早孕检查妇女(4.7%).早产妇女的产前检查总次数(8.53次)也低于足月产妇女(10.97次).产前检查次数＜4次妇女的早产发生率(18.9%)明显高于产前检查次数≥5次妇女(4.9%).生育年龄大、身材矮、体重指数大、初孕、多产次、孕早期检查少、产前检查次数少是过期妊娠的影响因素.结论 生育年龄大、身材矮、BMI大、初孕、多产次、孕早期检查少、产前检查次数少等与早产有关.     

2092例住院终止妊娠孕妇口腔保健意识及行为调查

目的:了解妊娠妇女口腔保健意识及行为,为完善门诊孕妇的口腔保健内容提供依据。方法:对2 092例妊娠妇女入院时进行问卷调查。结果:孕前半年内进行口腔检查保健的孕妇共452例,占21.6%,其中高学历、高收入人群明显高于低学历、低收入人群。1 554例孕妇孕期进行口腔健康状况检查,其中早孕孕妇占17.9%,中孕孕妇占53.7%,晚孕孕妇占28.4%,高学历、高收入孕妇早孕检查率明显高于其他组。孕期出现刷牙出血、对冷热不适、牙疼等孕妇有1 381例(66.0%),其中孕前半年进行口腔保健的孕妇发生率为22.8%(103/452),明显低于孕前半年未进行口腔保健的孕妇。1 677例孕妇孕期接受了口腔保健知识,其中58.2%(976/1 677)的知识主要来源于医务人员。结论:孕前半年及孕早期进行口腔健康保健意义更明显,高学历、高收入人群更注重孕期口腔健康。     

云南省农村育龄妇女出生缺陷预防服务利用状况调查

目的:了解云南省农村育龄妇女出生缺陷预防服务利用情况。方法:自制调查问卷由统一培训的调查员逐个入户对2538名育龄妇女进行调查,共回收有效问卷2500份。结果:51.7%的妇女服用过叶酸,其中有41.0%在妊娠前服用。36.5%的妇女接受了孕前咨询;24.8%的妇女做过孕前健康检查,69.4%接受过产前检查,孕12周以前检查者有32.3%,孕中期为49.5%;有75.6%的妇女做过孕期B超检查,其中孕早期检查者为17.9%,孕中期为39.4%;仅有7.57%的妇女接受过产前唐氏综合征筛查,住院分娩率为66.5%。结论:云南省农村育龄妇女出生缺陷预防服务的利用率不高,所利用的服务仅限于一些基本的常规检查项目,大部分育龄妇女在妊娠后才开始接受一些出生缺陷预防措施。     

南京地区流动孕产妇产前保健利用状况及其影响因素

目的:了解影响流动人口孕产妇产前保健服务利用现状及其影响因素,为今后制定相关卫生工作政策提供参考依据。方法:分层随机抽取409例流动产妇进行问卷调查,调查内容包括社会人口学特征、孕产史、孕早期检查及产前检查次数等情况。结果:调查结果显示,流动人口中孕产妇初次产前检查平均孕周为(21.1±9.1)周,早期检查率仅为24.9%,平均产前检查次数为(6.2±3.6)次,≥5次的产前检查率为56.2%。影响产前保健利用及时性的主要有月人均收入及是否经产;影响产前保健利用足够程度的因素主要有婚姻、文化程度、配偶有无工作、月人均收入及是否经产。结论:流动孕产妇产前保健利用率低,产前保健利用的主要影响因素为婚姻、文化程度、丈夫有无工作、是否经产及经济因素。     

孕早期环境因素对儿童先天性心脏病的影响

目的:探讨孕早期环境因素对儿童先天性心脏病(CHD)的影响。方法:收集2011年6月~2013年12月在深圳市妇幼保健院出生的汉族CHD患儿100例作为病例组,按照配对(1∶1)病例对照研究选取同期同医院同民族体检正常的儿童100例作为对照组,通过问卷调查及多因素Logistic回归分析方法,分析CHD可能的危险因素。结果:病例组患儿CHD的主要类型有室间隔缺损51例(51.0%)、房间隔缺损32例(32.0%)、动脉导管未关闭12例(12.0%)、其他5例(5.0%)。应用卡方检验筛选其中孕前6个月慢性病史、严重早孕反应、孕早期感冒、孕妇职业危险因素接触史、孕妇异常生育史、孕妇流产史、孕早期服药史、母亲被动吸烟、丈夫职业危险因素接触史、丈夫饮酒史、孕前补充维生素和补充微量元素等因素,两组间差异具有统计学意义(P<0.05);多因素Logistic回归分析发现,孕前补充维生素和微量元素与CHD发生呈现负相关关系;孕前6个月慢性病史、孕妇职业危险因素接触史、孕早期感冒、孕妇异常生育史、母亲被动吸烟和丈夫职业危险因素接触史与CHD发生呈现正相关关系。结论:儿童发生CHD与父母双方的某些习惯或者孕前的某些状况都有关系,应加强父母双方怀孕的整个过程的健康教育,保健服务以及减少对危险因素接触,从而减少和预防CHD的发生。     

经济欠发达地区农村妇女孕产期保健的现状及其影响因素分析

目的了解经济欠发达地区农村妇女孕产期保健利用的现状,探讨其影响因素。方法采用问卷方法调查在医院分娩的1159名产妇。结果平均产前检查次数为4.54±2.87,产妇产前检查覆盖率为90.5%,5次以上产前检查率为52.5%,早孕检查率为45.7%,剖宫产率为9.1%。有无孕管卡是产前检查覆盖率、5次以上产前检查率、早孕检查率和剖宫产率的主要影响因素。产前检查覆盖率的影响因素还有丈夫文化程度。剖宫产率的影响因素还包括产妇职业、已有孩子数、怀孕次数。结论该地区农村妇女孕产期保健利用不足、产前检查次数偏低、初检孕周偏晚、5次产前检查率偏低。有无孕管卡是影响孕产期保健利用的主要影响因素之一。建议加强孕产妇系统保健管理。     

非所在地户籍妇女产前保健服务利用现况研究

目的 了解非所在地户籍妇女产前保健服务利用现状,并分析其影响因素,为进一步完善非所在地户籍人口孕产妇管理提供信息.方法 选取2006年7月至2007年6月间单月在上海某二级综合医院分娩的所有非所在地户籍产妇共475例,进行问卷调查及病史资料收集,包括一般情况、孕产史情况、产前保健利用情况.结果 475例研究对象产前检查覆盖率为96.2%,早孕初查率为38.3%,5次产检率36.6%,建册率为46.9%.多因素分析结果显示,初产妇的早孕初查率高于经产妇(OR=2.059,P=0.008);初产妇的5次产检率高于经产妇(OR=3.032,P=0.000),年龄25～29岁的产妇5次产检率低于年龄＜25岁者(OR=0.275,P=0.006),家庭年收入≥50 000元的产妇5次产检率高于家庭年收入＜20 000元者(OR=3.998,P=0.001),丈夫职业为非体力劳动的产妇5次产检率高于丈夫职业为体力劳动者(OR=1.841,P=0.026).结论 非所在地户籍产妇产前保健服务利用不足,其妊娠后初次产前检查的时间较晚,次数也较少.产前保健服务利用的主要影响因素为产妇年龄、家庭年收入、是否经产以及丈夫职业.     

孕妇血清碱性磷酸酶和碱性磷酸酶胎盘型同工酶在妊娠中的变化及意义

目的 观察孕妇血清碱性磷酸酶(ALP)及碱性磷酸酶胎盘型同工酶(PALP)在妊娠中的变化规律.方法 采用Olympus AU-400全自动生化分析仪,对435例不同孕期的孕妇(早孕组、中孕组、晚孕组,每组各145例)、145例健康未孕妇女(对照组)及76例妊娠高血压综合征孕妇(妊高征组)的血清ALP和PALP进行检测.结果 早孕组ALP[(42.1 4±13.1)U/L]明显低于对照组[(65.1± 20.0)U/L](P<0.05);中孕组ALP[(66.5 4±21.2)U/L]与对照组比较差异无统计学意义;晚孕组ALP[(166.3±65.5)U/L]和妊高征组ALP[(256.5±45.7)U/L]明显高于对照组(P<0.05).早孕组和中孕组PALP较对照组增加不明显,晚孕组PALP[(96.44±52.2)U/L]和妊高征组PALP[(89.44±44.6)U/L]均较对照组(O)明显升高(P<0.05).进入晚孕期ALP和PALP水平随孕周增加而逐渐升高,呈直线关系.结论 正常妊娠在早孕期ALP轻度降低,中孕期时无显著变化,晚孕期和伴有妊娠高血压综合征时显著升高;PALP在早孕期和中孕期无明显变化,晚孕期和伴有妊娠高血压综合征时显著升高.进入晚孕期AIJP和PALP随孕周增加而逐渐升高,其是无创性判断胎盘功能的一个良好指标.     

Unintended pregnancy among the urban poor

This article seeks to determine the proportion of pregnancies that are unintended among poor women in New York City, compare the New York City rate to national data, and examine factors associated with unintended pregnancy in this population. Pregnancy testing data collected between June 1, 1998, and June 1, 2001, from field sites operated by the Office of Family Health, New York City Department of Health and Mental Hygiene were analyzed. Pregnancy planning (intended vs. unintended) was examined by age group, race/ethnicity, marital status, frequency of contraceptive use, number of previous pregnancies, drug and alcohol use, and smoking. Odds ratios were calculated to determine if pregnancies were more likely to be unintended among women with certain characteristics. Logistic regression was used to examine independent risk factors for unintended pregnancy. Of the 20,518 women who had a pregnancy test during the study period, 9,406 (45.8%) were pregnant. Of the pregnancies, 82% were unintended. Marital status was the strongest predictor of unintended pregnancy, increasing the risk 2.5-fold for unmarried women. Adolescents and those who drank alcohol were also at increased risk of unintended pregnancy. The extremely high percentage of pregnancies that were unintended among the study population suggests that national unintended pregnancy rates are not representative of what occurs among low-income women in an urban setting. Unintended pregnancy interventions should be tailored for the urban poor and target unmarried, young women.     

Nausea and vomiting in late pregnancy

Nausea and vomiting in late pregnancy is a little-studied phenomenon. In this study of 116 midwestern women, 32% of the women had nausea and vomiting after 20 weeks gestation. The purpose of this study was to examine demographic, anthropometric, maternal health factors, and pregnancy outcomes in women who had late nausea and vomiting in pregnancy (NVP) and those that did not. Women who experienced late NVP had significantly higher parity, were older, gained less weight in pregnancy, and slept fewer hours per night than women who did not experience late NVP. By being aware of prenatal factors that may affect nausea and vomiting in late pregnancy, health care providers will be better able to maximize the quality of life for these women.     

The risk of being ‘too honest’: drug use,stigma and pregnancy

In this article, I examine the ways in which risk is constructed and managed by those involved in the pregnancy and childbirth of women who use drugs, including the women themselves. I discuss how constructions of risk influence maternal care outcomes and the understanding of choice, often in the form of stigmatisation. In this article, I draw on data from a qualitative research study that I conducted in 2011 in a western Canada city in which I interviewed 13 pregnant and parenting women who had used drugs during their pregnancy. In this article, I show how the everyday risk construction of pregnancy, labour and delivery is compounded significantly by drug use and the stigmatisation associated with this perceived risk-taking behaviour. The participants in the study often internalised this understanding of risk and this manifested itself in delays in accessing maternal health and social care services. The women in the study had different understandings of risk and these were structured by the women’s own understanding of general risk factors during their pregnancy, as well as their experiences of the constructions of risk and risk management by health and social care professionals. While structural life chances can constrain women’s feelings of self-efficacy, services that promote clients’ ability to make choices can facilitate reduced stigmatisation and facilitate the development of more compassionate and autonomous approaches to risk management.     

Nausea and Vomiting in Late Pregnancy

Nausea and vomiting in late pregnancy is a little-studied phenomenon. In this study of 116 midwestern women, 32% of the women had nausea and vomiting after 20 weeks gestation. The purpose of this study was to examine demographic, anthropometric, maternal health factors, and pregnancy outcomes in women who had late nausea and vomiting in pregnancy (NVP) and those that did not. Women who experienced late NVP had significantly higher parity, were older, gained less weight in pregnancy, and slept fewer hours per night than women who did not experience late NVP. By being aware of prenatal factors that may affect nausea and vomiting in late pregnancy, health care providers will be better able to maximize the quality of life for these women.     

The Effects of Father Involvement during Pregnancy on Receipt of Prenatal Care and Maternal Smoking

Objectives To examine whether women whose partners are involved in their pregnancy are more likely to receive early prenatal care and reduce cigarette consumption over the course of the pregnancy. This study also examines sociodemographic predictors of father involvement during pregnancy. Methods Data on 5,404 women and their partners from the first wave of the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) were used to examine the association between father involvement during pregnancy and maternal behaviors during pregnancy. Multivariate linear and logistic regression analyses were used and data were weighted to account for the complex survey design of the ECLS-B. Results Women whose partners were involved in their pregnancy were 1.5 times more likely to receive prenatal care in the first trimester and, among those who smoked at conception, to reduce their cigarette consumption 36% more than women whose partners were not involved in the pregnancy (p = .09). Fathers with less than a high school education were significantly less likely to be involved in their partner’s pregnancy, while first-time fathers and fathers who reported wanting the pregnancy were significantly more likely to be involved. Conclusions The positive benefits of father involvement often reported in the literature on child health and development can be extended into the prenatal period. Father involvement is an important, but understudied, predictor of maternal behaviors during the prenatal period, and improving father involvement may have important consequences for the health of his partner, her pregnancy, and their child.     

Alcohol consumption after the recognition of pregnancy and correlated factors among indigenous pregnant women in Taiwan

To examine the rates and factors associated with alcohol consumption after the recognition of pregnancy among indigenous pregnant women, as well as the rates and factors associated with continuing alcohol consumption after the recognition of pregnancy among indigenous pregnant women who drank alcohol before the recognition of pregnancy in 10 hospitals in southern and eastern Taiwan. A total of 806 indigenous women who had just given birth in 10 hospitals in southern and eastern Taiwan were recruited. They were interviewed to collect their substance use information, demographic characteristics, psychological health status, history of physical abuse, and pregnancy history. The rates of alcohol consumption after the recognition of pregnancy in all indigenous pregnant women and the rates of continuing alcohol consumption after the recognition of pregnancy among those who drank alcohol before the recognition of pregnancy were calculated. The factors relating to alcohol consumption and continuing alcohol consumption after the recognition of pregnancy were examined using logistic regression analyses. The results of this study found that 26.6% of indigenous pregnant women drank alcohol at any stage after the recognition of pregnancy, and 52.5% of indigenous pregnant women who drank alcohol before the recognition of pregnancy persisted in drinking alcohol after the recognition of pregnancy. Multiple parities, smoking or chewing betel quid after the recognition of pregnancy, and a higher frequency of drinking alcohol before the recognition of pregnancy were significantly associated with alcohol consumption and continuing alcohol consumption after the recognition of pregnancy. Meanwhile, being single or divorced, and intimate partner violence after the recognition of pregnancy were significantly associated with alcohol consumption after the recognition of pregnancy. High prevalence rates of alcohol consumption and continuing alcohol consumption after the recognition of pregnancy were found among indigenous pregnant women in Taiwan. Early detection of alcohol consumption and effective intervention for alcohol consumption during pregnancy are needed.     

Internet networks as a source of social support for women with mobility disabilities during pregnancy

BackgroundSocial support during pregnancy is important for the health of mother and baby, yet little is known about social support available to women with disabilities during pregnancy. Internet social networks are one emerging source of social support, and social networks may help connect mothers with similar disabilities.ObjectiveTo examine the perceptions of women with mobility impairments about social support received during pregnancy from three sources: women with similar disabilities and previous pregnancy known in-person, women with similar disabilities and previous pregnancy met via online social networks, and healthcare providers.MethodsFor this cross-sectional study, an online survey of women with mobility impairments examining emotional and informational social support during pregnancy was distributed through email lists, social media and snowball recruitment. Wilcoxon signed-rank tests were conducted to examine differences in social support received by source.ResultsResponses from 63 eligible women were received. The majority of participants (n = 32, 51%) were connected both in-person and online to women with similar disabilities who had been pregnant, but 15 women (24%) were not connected to any women with similar disabilities who had been pregnant. Scores for informational social support from women met online were significantly higher than from women known in-person (p < .01) and from healthcare providers (p < .01). Scores for emotional social support from women met online were significantly higher than from women known in-person (p < .05).ConclusionsInterventions promoting online connections may help leverage an underutilized source of social support for women with mobility impairments seeking social support during pregnancy.     

妇女孕前和孕期维生素D水平及影响因素

  目的   了解上海市嘉定区妇女孕前、孕中期和孕晚期体内维生素D(Vitamin D, VD)水平的现状, 探讨孕中期和孕晚期VD水平的影响因素。   方法   选取2016年9月至2018年12月在上海市嘉定区妇幼保健院参加孕前检查并随访到分娩的94名妇女为研究对象, 采用化学发光法检测孕前、中期和晚期血清中的VD水平, 共检测282份血清。   结果   94名妇女的孕前、孕中期和晚期的VD缺乏率分别为:40.4%、57.4%和48.9%。混合线性模型结果显示, 近1年内有过染发/烫发的妇女孕期血清VD水平较低(P < 0.05), 孕期经常喝牛奶和吃深海鱼的妇女在孕期VD水平较高(P < 0.05)。   结论   上海嘉定区妇女孕前和孕期VD缺乏普遍, 应该重视在孕前和孕期VD的补充。     

Predictors of Smoking Cessation in Pregnancy and Maintenance Postpartum in Low-Income Women

Objective: To describe factors associated with smoking status of low-income women during pregnancy and postpartum. Methods: Data from a randomized clinical trial were used to conduct separate analyses on 327 women who smoked at baseline (time at enrollment) and for whom smoking status was available at delivery, and on 109 women who reported not smoking at delivery (quit spontaneously or after study enrollment) and for whom smoking status was available at 6-months postpartum. Salivary cotinine was used to assess the accuracy of self-reported smoking status for the sample as a whole. Data were collected between May 1997 and November 2000. Results: 18% of the 327 baseline smokers stopped smoking before delivery. Cessation was less likely in older women, those reporting Medicaid coverage (vs. commercial or no insurance), who were at a later week of pregnancy at baseline, were more addicted, had a husband/partner who smoked, and did not receive the study intervention. 37% of the 109 women who reported not smoking at delivery maintained abstinence at 6-months postpartum. Factors associated with abstinence were later week of pregnancy at baseline and quitting spontaneously with pregnancy, while women who lived with a smoker were less likely to report abstinence. Spontaneous quitters were less likely to relapse by 6 months postpartum than women who quit smoking later in pregnancy. Conclusions: Partner participation in smoking cessation programs for pregnant and postpartum women merits exploration. Lower relapse rates among spontaneous quitters indicate a need to foster an environment that encourages quitting at pregnancy.