Systematic Review of Interventions for Reproductive Life Planning

Objective

To systematically review the literature on interventions for reproductive life planning (RLP).

加强孕前保健,改善母儿结局

正孕前保健是通过评估和改善计划妊娠夫妇的健康状况,减少或消除导致出生缺陷等不良妊娠结局的风险因素,预防出生缺陷的发生,提高出生人口素质的重要措施。通过孕前优生指导配合规范化的孕前保健和检查,能够及早防治妊娠合并症及并发症,评估孕妇及胎儿的安危,改善母儿结局。     

Preconception care of women with diabetes: The unrevealed obstacles

In spite of the widely accepted knowledge that elevated blood glucose levels in early pregnancy are associated with a significantly increased risk of birth defects in infants of women with established diabetes, the majority of diabetic women do not plan their pregnancies and enter pregnancy with inadequate blood glucose control. This article reviews the current research on circumstances and factors associated with unplanned diabetic pregnancies and offers recommendations to encourage effective pregnancy planning and preconception care among women with diabetes.     

Insulin pump therapy for pregnancy: a primer

Current knowledge and advances in insulin formulations, insulin pump technology, and blood glucose monitoring techniques have improved practitioners’ ability to achieve diabetic people’s blood glucose targets. Practitioners and pregnant women should bear in mind that important differences exist in glucose metabolism during pregnancy and require a different approach from non-pregnant people to avoid pregnant women’s experience being adversely affected. Insulin pump therapy, if used skillfully by practitioners and their pregnant patients, can be especially beneficial for some diabetic women during their pregnancies. Women’s healthcare practitioners should endeavor to be familiar with this therapy, even if they are not experts in its full complexity.     

The Reproductive Life Plan as a Strategy to Decrease Poor Birth Outcomes

The purpose of this article is to discuss the importance of implementing a life course perspective model that includes a reproductive life plan to improve health outcomes, especially in populations at risk for adverse outcomes. A reproductive life plan is a comprehensive strategy that can be incorporated into nursing practice at all levels to improve birth outcomes. Health care providers, especially nurses, should incorporate reproductive life planning into their daily encounters with patients.     

Tailored Intervention for Smoking Reduction and Cessation for Young and Socially Disadvantaged Women During Pregnancy

Rates of smoking during pregnancy remain high in Canada, and cessation rates are low among women who are younger than 24 years and who are socially disadvantaged, that is, have few social and economic resources because of poverty, violence, or mental health issues. On the basis of findings from literature reviews and consultation with policy makers, we developed and operationalized four approaches that can be used by health care providers to tailor interventions for tobacco use in pregnancy. These four approaches are woman centered, trauma informed, harm reducing, and equitable. Public health initiatives that address smoking in young and socially disadvantaged women could be more sharply focused by shifting to such tailored approaches that are grounded in social justice aims, span pre- and postpregnancy periods, and can be used to address women’s social contexts and concerns.     

糖尿病史女性孕前管理

有糖尿病史的女性,如果孕前血糖没有得到良好的控制,妊娠后其母儿合并症和并发症发生率明显升高。重视糖尿病史女性的孕前咨询、孕前监测和评估并进行孕前干预是获得良好妊娠结局的关键。文章结合国内外指南,详细阐述糖尿病史女性的孕前管理方案,为临床工作提供参考。     

Pregnancy Planning and Diabetes: A Qualitative Exploration of Women's Attitudes Toward Preconception Care

Introduction: Seeking preconception care is recognized as an important health behavior for women with preexisting diabetes. Yet many women with diabetes do not seek care or advice until after they are pregnant, and many enter pregnancy with suboptimal glycemic control. This study explored the attitudes about pregnancy and preconception care seeking in a group of nonpregnant women with type 1 diabetes mellitus. Methods: In‐depth semistructured interviews were completed with 14 nonpregnant women with type 1 diabetes. Results: Analysis of the interview data revealed 4 main themes: 1) the emotional complexity of childbearing decisions, 2) preferences for information related to pregnancy, 3) the importance of being known by your health professional, and 4) frustrations with the medical model of care. Discussion: These findings raise questions about how preconception care should be provided to women with diabetes and highlight the pivotal importance of supportive, familiar relationships between health professionals and women with diabetes in the provision of individualized care and advice. By improving the quality of relationships and communication between health care providers and patients, we will be better able to provide care and advice that is perceived as relevant to the individual, whatever her stage of family planning.     

辅助生殖技术(ART)助孕获得多胎妊娠行减胎术后妊娠结局观察

目的:探讨辅助生殖技术(ART)获得的多胎妊娠孕早期行经阴道减胎术的有效性和安全性。方法:以经ART助孕获得多胎妊娠行经阴道减胎术的患者123例为减胎组,根据减胎后保留的胎儿数分为双胎组(A组,n=90)和单胎组(B组,n=33)。另以同期经ART助孕获得单胎妊娠(C组,n=36)和双胎妊娠(D组,n=57)的患者为对照组。回顾性分析患者的妊娠结局及妊娠期并发症发生情况。结果:减胎组的减胎成功率为100.0%,妊娠成功率为91.9%。A组胎膜早破发生率、早产发生率、新生儿低出生体质量发生率、新生儿重症监护室(NICU)入住率均高于B组(P<0.05)。结论:多胎妊娠孕早期行经阴道减胎术安全、有效、可行。多胎妊娠实施减胎术中减为单胎更为安全。