Trends and predictors of folic acid awareness and periconceptional use in pregnant women

OBJECTIVE: The purpose of this study was to describe recent trends in folic acid awareness and use in the periconceptional period among pregnant women in relation to maternal sociodemographic and other relevant factors. STUDY DESIGN: From 1988 to 2002, 16,555 women from the Slone Epidemiology Center Birth Defects Study were interviewed about medication use before and during pregnancy (which included multivitamins and folic acid), about whether they were aware of any vitamins that might decrease the risk of birth defects, and about sociodemographic and medical factors. RESULTS: Awareness of folic acid benefits increased from 0 in 1988 to 50% in 1996 and thereafter. The use of folic acid in the periconceptional period increased from 15% in 1988 to 40% in the last few years. Maternal education was a strong independent predictor of both awareness and use as were ethnicity, whether the pregnancy was wanted, family income, and whether a health care provider was consulted before planning. CONCLUSION: Promoting the use of folic acid supplements, particularly among these disadvantaged groups, is essential to further decrease the prevalence of neural tube defects.     

Abortion attitudes of pregnant women in prenatal care

OBJECTIVE: This study was undertaken to describe abortion attitudes in a diverse cohort of pregnant women enrolled in prenatal care. STUDY DESIGN: A cross-sectional interview study of 1082 demographically diverse gravid women enrolled in prenatal care at less than 20 weeks' gestation was performed. RESULTS: Most participants (92%) supported abortion availability. Half (50%) who were willing to consider an abortion would do so only in the first trimester. Among the gravid women willing to consider an abortion in the first or second trimester, 84% would do so after rape/incest or if their life was endangered and 76% would if their fetus had Down syndrome. Gravid women considering abortion were more likely to be white, older, have had a previous abortion, and to express distrust in the health care system. Women who would not consider abortion were more likely to be multiparous, married/living with partner, and to express greater faith and fatalism about their pregnancy outcome. CONCLUSION: Although most pregnant women enrolled in prenatal care support abortion availability, about half would only consider a first-trimester procedure. These findings underscore the need for early prenatal genetic counseling, screening, and testing.     

Level of happiness and its determining factors in pregnant women: a cross-sectional study

Objective: This study aimed to estimate the prevalence of happiness and screen its determinant factors in pregnant Iranian women. Background: The psychological health status of a mother during pregnancy has a huge impact on clinical outcomes of pregnancy. Recent studies have demonstrated associations between mothers’ level of happiness and pregnancy outcomes such as low birth weight and intrauterine growth restriction. However, the data on determinant factors of maternal happiness are limited. Methods: Healthy pregnant women referring to a prenatal clinic in Tehran between 2013 and 2014 were recruited. We used the Persian version of the standard Oxford Happiness Questionnaire to assess level of happiness. In addition, personal, marital, pregnancy-related and psychological data were collected. Univariable and multivariable logistic analyses were conducted to investigate the determinant factors of happiness. Results: Two hundred pregnant women completed the questionnaire. One hundred and thirty women (68.5%) were categorised as happy. At a screening P value level of 0.2, univariable analysis selected maternal age (odds ratio [OR] = 8.3, P = 0.03), smoking (OR = 4.8, P = 0.01), level of education (OR = 1.78, P = 0.07), use of antidepressants (OR = 1.78, P = 0.17), and order of child (OR = 1.6, P = 0.18) for the multivariable model. The final multivariable logistic model demonstrated that maternal age (OR = 7.7, P = 0.01 for mothers aged 21–25; OR = 7.2, P = 0.01 for mothers aged 26–30; OR = 5.4, P = 0.03 for mothers aged 31–35; and OR=6.6, P = 0.05 for mothers aged 36–40 vs. mothers aged 20 or below) and smoking (OR = 5.4, P = 0.01 for mothers who had never smoked vs. mothers who had given up smoking) were independent correlates of happiness. Conclusion: Our observations suggest probable associations of maternal age and smoking with level of happiness in pregnancy. Further prospective longitudinal studies could investigate the causality inference of these associations.     

Awareness of the benefits of folic acid and prevalence of the use of folic acid supplements to prevent neural tube defects among Thai women

Objective To determine the level of knowledge about the usefulness of periconceptional folic acid supplementation among pregnant women. Materials and methods An anonymous questionnaire was completed by selected subjects to assess folic acid awareness. The questionnaire was administered to pregnant women who were seeking antenatal care at King Chulalongkorn Memorial Hospital May to December 2005. The questions covered their knowledge and use of folic acid supplements, pregnancy intention, and demographic and socioeconomic characteristics. Results Out of 401 women surveyed, 76.1% of them reported that they had heard of folate. Of these, only 24.4% of the total subjects knew that folate was something important. Overall, 9.7% of the total women took folic acid during periconceptional period. The most common information sources on folate were the media. Logistic regression analysis showed that education of mother was the strongest predictor of having taken folic acid during the correct period. Conclusion Although some pregnant women are aware of the need to take folic acid, the actual impact of the present recommendations is almost negligible. Information to specifically inform patients about the need to take folic acid to prevent neural tube defects by medias and healthcare personnel seem to improve the final intake of folic acid during the protective period.     

妊娠期亚临床甲状腺功能减退孕妇叶酸利用能力与血清同型半胱氨酸、维生素B12的相关性分析

目的 探究妊娠期亚临床甲状腺功能减退(妊娠期亚甲减)孕妇叶酸(FA)利用能力与血清同型半胱氨酸(Hcy)、维生素B₁₂的相关性。方法 选取100例妊娠期亚甲减孕妇为研究组;另选同期100例甲状腺功能正常孕妇为对照组。检测两组孕妇FA、Hcy、维生素B₁₂以及甲状腺功能,并分析其相关性。结果 两组FA利用能力比较,差异具有统计学意义(P<0.05)。研究组血清Hcy水平高于对照组,维生素B₁₂水平低于对照组,差异具有统计学意义(P<0.05)。两组游离三碘甲状腺原氨酸(FT₃)、游离四碘甲状腺原氨酸(FT₄)水平比较,差异无统计学意义(P>0.05),研究组促甲状腺激素(TSH)水平高于对照组,差异具有统计学意义(P<0.05)。FA利用能力与Hcy呈负相关(r=-0.454),与维生素B₁₂呈正相关(r=0.219);Hcy与维生素B₁₂、FT₃、FT₄呈负相关(r=...     

孕妇血铅水平测定及对妊娠结局的影响

目的 探讨北京城区孕妇的血铅水平及其与妊娠并发症、新生儿体格发育及神经行为发育的关系。方法 采用石墨炉原子吸收法测定1151例不同孕周孕妇静脉血及434例新生儿脐带血铅水平,同时观察孕妇妊娠及分娩期有无合并症、并发症;并于新生儿出生后24h内测量其体格发育情况(包括体重、身长、头围、胸围、腹围);采用儿童神经行为发育量表,对出生后42d的215例婴儿进行神经行为发育评分。结果 整个孕期血铅中位数为43．4μg／L,孕早期为44．5μg／L,孕中期为37．4μg／L,孕晚期为45．1μg／L。脐血铅中位数为26．4μg／L。孕妇血铅水平与妊娠并发症无明显相关性,但孕妇血铅水平与其血红蛋白水平呈正相关。另外,孕妇血铅水平及脐血铅水平与新生儿体格发育指标及神经行为发育评分,无明显相关性。结论 北京城区孕妇血铅水平对各种孕期并发症及新生儿的体格发育、神经行为发育无明显影响。     

A comparison of the dietary and total intake of micronutrients in a group of pregnant Greek women with the Dietary Reference Intakes

OBJECTIVE: We compared the dietary and total (diet and supplement) intake of micronutrients with the Dietary Reference Intakes (DRIs) from the USA in a population of pregnant Greek women. METHODS: Two hundred pregnant women participated in a nutritional survey, 98 in the second trimester and 102 in the third trimester in a random sampling. To examine dietary intake we used two questionnaires, the nutritional questionnaire for pregnant women from the California Department of Health Services, and a semi-quantitative questionnaire (Walter Willet) with modifications for use in Greece. Dietary intake analysis was performed using the Diet Analysis Plus software, Version 3, ESHA Research. Statistical analysis was performed with Minitab for Windows, Release 12. A simple complementary questionnaire concerning demographic and socio-economic features was also completed. RESULTS: The average total intake of vitamins A, B(1), B(2), B(3), B(6), B(12) and C, calcium and phosphorus was higher than the respective DRIs. Folic acid and iron intake exceed the highest values specified for pregnancy. Vitamin E and zinc was lower than the DRIs, while vitamin D, magnesium and thiamin did not differ. CONCLUSIONS: The results of our study suggest that in a Greek population, sufficient micronutrients appear to be received in adequate amount from diet, except for folic acid and iron, which also had to be taken in the form of nutritional supplements.     

正常孕妇体重增加的监测模式

目的确定正常孕妇孕期体重增加的模式,为孕期保健提供参考。方法收集１９９５年１月１日至１９９５年１２月３１日１５６２例孕产妇的资料,并对无妊娠合并症及新生儿出生体重在２５００～３９９９ｇ的１１０５９例次产前检查资料进行分析。结果产妇平均年龄２６．４９±３．０２岁;平均身高１５８．６９±４．８５ｃｍ。根据孕前体质指数（ＢＭＩ）可将孕妇分为低ＢＭＩ（＜１６．７５）、正常ＢＭＩ（１６．７５～２３．７１）及高ＢＭＩ（＞２３．７１）３类。各类孕妇的ＢＭＩ随孕周增加而递增,尤以正常ＢＭＩ孕妇最为明显;３类孕妇孕期ＢＭＩ增加分别为８．０７、５．３７、３．８２。结论ＢＭＩ较单纯体重增加更能反映孕妇体重改变的情况     

妊娠梅毒192例临床分析

目的探讨妊娠梅毒患者的临床特点和影响妊娠结局的因素。方法192例经血清学检查确诊为梅毒的孕妇,根据妊娠期是否行全疗程抗梅毒治疗,分为治疗组(93例)及未治疗组(99例)。比较两组孕妇的妊娠结局、围产儿预后及新生儿先天梅毒的发生情况。同时根据母血清快速血浆反应素环状卡片试验(RPR)滴度高低,将192例梅毒孕妇分为≤1∶8组与≥1∶16组,观察血清滴度与妊娠结局的关系。结果(1)妊娠结局治疗组足月分娩率为936%(87/93),未治疗组仅为283%(28/99)。两组比较,差异有极显著性(P<001)。治疗组早产及死胎发生率分别为54%(5/93)和11%(1/93),明显低于未治疗组的283%(28/99)和323%(32/99),且治疗组无死产及流产发生。两组比较,差异有极显著性(P<0005)。治疗组分娩正常新生儿者占630%(58/92),未治疗组仅占232%(13/56)。治疗组窒息儿、低体重儿、先天梅毒患儿发生率及新生儿死亡率明显低于未治疗组,两组比较,差异有极显著性(P<001)。(2)RPR滴度≤1∶8组114例,≥1∶16组72例。≤1∶8组足月儿占781%(89/114),明显高于≥1∶16组的361%(26/72)。≤1∶8组早产儿、先天梅毒患儿、新生儿及围产儿死亡率,分别为53%(6/114)、219%(25/114)、26%(3/114)和193%(22/114),明显低于≥1∶16组的375%(27/72)、722%(52/72)、181%(13/7     

农村妇女孕期体重对妊娠结局的影响

目的:探讨农村妇女孕期体重与妊娠结局的关系,为农村孕妇的体重管理提供理论依据。方法:收集2014年2月至2015年2月禹城市人民医院产一科住院分娩的单胎妊娠农村初产妇896例,按孕前体重指数(BMI)分为孕前消瘦组(≤18.5kg/m~2)、孕前体重正常组(18.5kg/m~2BMI24kg/m~2)、超重组(24kg/m2≤BMI28kg/m~2)、肥胖组(≥28kg/m~2);按孕期体重增长分为体重增长适宜组及体重增长过度组。分析各组孕妇妊娠结局及并发症的发生情况。结果:孕前超重组与孕前体重正常组比较,孕期体重增长过度组与孕期体重增长适宜组比较,均显著增加妊娠期高血压疾病、妊娠期糖尿病、剖宫产、产后出血、巨大儿的风险,差异有统计学意义(P0.05)。结论:孕前超重与孕期体重增长过度是导致农村孕妇不良妊娠结局的危险因素,应加强孕妇的体重管理,降低妊娠不良结局发生。     

妊娠合并恶性肿瘤14例临床分析

目的探讨妊娠合并恶性肿瘤患者的临床特点及母儿结局。 方法收集2009年10月至2015年12月就诊于广州医科大学附属第三医院妇产科的14例妊娠合并恶性肿瘤患者的临床资料,对患者的临床特点、孕期治疗、妊娠结局及预后进行分析。 结果14例妊娠合并恶性肿瘤患者的肿瘤类型分别为血液系统恶性肿瘤(8例)、乳腺癌(4例)和宫颈癌(2例)。足月分娩者有5例,早产6例,1例早期人工流产,1例中孕期引产,1例孕期死亡。共分娩新生儿11例,2例乳腺癌患者于孕期接受抗癌治疗,2例新生儿为足月儿;10例患者孕期选择期待治疗,9例患者的新生儿存活,包括3例足月儿和6例早产儿。 结论妊娠合并恶性肿瘤可导致严重的不良妊娠结局,根据病情孕期应进行合理的抗癌治疗可改善患者结局。     

正常妊娠和妊高征孕妇血浆D—二聚体含量的变化

目的：观察比较正常妊娠和妊高征妇女血浆D－二聚体含量变化。方法：采用ELISA双抗体夹心法,检测正常妊娠和妊高征孕妇各30例及非妊娠妇女20例的血浆DD含量变化。结果：正常妊娠和妊高征两组血浆DD含量均高于非孕妇女（均P＜0．01）,妊高征组高于正常妊娠组（P＜0．01）;在妊高征组中轻、中、重度患者血浆DD含量随病情加重逐渐升高并有显著性意义（P＜0．01）。结论：正常妊娠孕妇血浆DD水平升高,妊高征患者尤为明显,动态检测孕妇血浆中DD含量变化,对妊高征的早期诊断与防治有重要意义。