Social Justice as a Wider Lens of Support for Childbearing Women

The ecological model is used as a framework for applying social justice concepts to the care of childbearing women and families. In this model, the environment of childbearing women has 3 distinct levels: macrosystem, mesosystem, and microsystem. Two scenarios are described and examples of nursing actions to promote social justice at each level are provided. This article demonstrates how maternal/infant nursing practice can be expanded to promote health equities, social justice, and support.     

Identifying Health Disparities and Social Inequities Affecting Childbearing Women and Infants

This article presents health disparities and social inequities that may underlie adverse outcomes for childbearing women and infants in the United States. It also presents Internet-accessible databases that nurses can use to assess maternal and infant health disparities at a national or state level. Such assessments are basic to planning programs to address gaps in health care and advocating for practice and policy changes to improve the health care of childbearing women and infants.     

围生期孕妇生殖道B族链球菌耐药性变迁及血清型分布研究

目的：了解西安地区孕产妇生殖道B族链球菌（group B Streptococcus,GBS）的血清型分布特征及GBS对常规抗菌药物的耐药谱,为临床预防与治疗提供依据。方法：收集2015年1月—2017年12月在西北妇女儿童医院产科接受产前GBS筛查的孕晚期孕妇阴道拭子培养出的GBS共498株。采用多重聚合酶链反应（PCR）方法测定GBS血清型,并进行药物敏感性试验和表型筛查试验。结果：所有GBS分离株均对青霉素、头孢曲松、万古霉素、利奈唑胺敏感。GBS对红霉素、克林霉素及左氧氟沙星耐药率分别为76.7%、73.5%和58.0%,且红霉素的耐药率呈逐年上升趋势。表型为结构型耐药（cMLSB）的GBS菌株占红霉素耐药菌株的首位（88.2%）,而诱导型耐药（iMLSB）和M型耐药菌株仅占耐药株的5.5%和6.3%。最常见的血清型为Ⅲ型,其次为Ⅰa 型、Ⅴ型、Ⅰb 型、Ⅱ型和Ⅵ型。结论：①西安地区孕产妇生殖道GBS定植率与我国其他地区相似或略低;②血清型Ⅲ占主要地位;③红霉素、克林霉素、左氧氟沙星耐药率高于其他地区,且红霉素耐药率呈逐年上升趋势。     

Barriers to Optimal Social Support in the Postpartum Period

ObjectiveTo examine the specific barriers to mothers’ realization of social support during the first‐year postpartum.DesignA qualitative approach in which social support data were analyzed thematically.SettingAn urban medical center in Pittsburgh, Pennsylvania.ParticipantsThirty‐one women who had given birth in the year prior to study enrollment were recruited through posted flyers at multiple community sites.MethodsData were collected during three focus groups. The data that related to social support were extracted from a larger qualitative data set and analyzed separately for prominent social support inhibitors.ResultsMajor themes that emerged were availability of trustworthy child care, cost of child care, demands of infant care, changing priorities, a transient population, and availability of family.ConclusionsEmergent barriers to social support such as the demands of infant care and changing priorities are likely challenges for women regardless of socioeconomic status. However, the volume of text related to availability (proximity) of family, availability of trustworthy child care, and the consequences of a transient lifestyle may be attributed to the composition of the study sample.     

绝经过渡期妇女睡眠质量与血清雌二醇、5-羟色胺的相关性研究

目的:探讨绝经过渡期妇女睡眠质量与血清雌二醇(E2)、5-羟色胺(5-HT)的相关性.方法:采用匹兹堡睡眠质量指数问卷(PSQI)对吉林大学第二医院妇女保健门诊40～55周岁的绝经过渡期妇女进行睡眠质量的评价;采用病例对照方法,应用放免法和荧光法对绝经过渡期妇女睡眠质量差组(Ⅰ组)、绝经过渡期妇女睡眠质量正常组(Ⅱ组)和生育年龄正常对照组(Ⅲ组)妇女各30例进行血清E2、5-HT水平的测定.结果:Ⅰ组的血清E2水平和5-HT水平低于Ⅱ组和Ⅲ组,且差异有显著性(P＜0.05);绝经过渡期组血清5-HT与E2水平呈正相关性(r=0.025,P＜0.01).结论:绝经过渡期妇女睡眠质量差的发生与血清E2及5一HT水平降低有关.     

育龄妇女ToRCH感染及与异常妊娠关系的研究

目的研究育龄妇女ToRCH系列感染及其与异常妊娠结局的关系.方法采用间接ELISA对250例育龄妇女作4种ToRCH病原体抗体检测,部分IgM(或IgG)阳性病例并作PCR检测.对其中21例异常妊娠结局的胚胎组织块作了PCR检测和对10例异常新生儿作了血清学诊断.结果250例育龄妇女ToX、RubV、CMV、HSVIgM阳性率分别为8.0%、12.8%、6.8%和8.4%,并发现同一病例有两种或两种以上病原体同时感染的情况,PCR结果与之基本一致.21例与ToRCH感染有关异常妊娠结局(流产、早产、死胎、先天缺陷)孕妇均有ToRCH中的一种、2种或2种以上病原体感染,从死胎脑组织块、人工流产混合物的PCR结果与之吻合.10例新生儿脑炎血清与对应母亲血清抗体检测表明,垂直传播率ToX与CMV分别为50%和40%.结论ToRCH系列感染与异常妊娠结局的关系十分密切.     

Prevention of Obesity and Diabetes in Childbearing Women

Obesity and diabetes have become pandemic in the United States, with more than one‐third of the US population obese and 8.3% of the population affected by diabetes. Efforts to prevent type 2 diabetes focus primarily on healthy eating and physical activity. In particular, women from at‐risk racial and ethnic groups and those who have experienced gestational diabetes are at high risk for developing type 2 diabetes. Achieving a healthy weight prior to conception, staying within weight gain guidelines during pregnancy, and losing accumulated pregnancy weight postpartum are key prevention factors. Maintaining a healthy weight in the long‐term is a challenge. Behavioral psychology and coaching techniques are presented in this article that can be useful in sustaining behaviors that promote a healthy weight.     

50例妊娠合并糖尿病孕妇的妊娠期管理分析

目的 :探讨妊娠合并糖尿病孕妇的妊娠期管理方法。方法 :将 5 0例妊娠合并糖尿病孕妇与 4 8例正常孕妇比较。结果 :5 0例妊娠期糖尿病孕妇中有 38例 ( 76 % )经饮食疗法后血糖控制效果良好 ,另 12例需饮食疗法加胰岛素治疗方能将血糖控制在正常范围内。经临床治疗后 ,5 0例妊娠合并糖尿病的孕妇 ,除早产发病率高于非糖尿病组孕妇外(P <0 0 5 ) ,妊高征、感染、产后出血、羊水过多、羊水过少、胎儿窘迫、巨大儿、胎儿生长受限 (FGR)、新生儿窒息、新生儿高胆红素血症等发病率与非糖尿病组孕妇无区别。结论 :加强妊娠合并糖尿病孕妇的妊娠期管理 ,用饮食疗法或胰岛素治疗控制血糖 ,适时终止妊娠 ,可有效降低母婴并发症的发生     

Cultural Aspects of Pain in Childbearing Women

As the American population increases in ethnic diversity, nurses must prepare to care for women from various cultures. The American Nurses Association has stated that a knowledge of cultural diversity is vital at all levels of nursing. Culture is known to affect the patient's perception of pain and the nurse's inference of pain in the patient. Pain is expected in childbirth, and nurses should learn how culture influences individual women in their expression of pain. Because each woman is unique, nurses must combine information about culture with clinical assessment of the patient to provide culturally sensitive care.     

子(癎)前期患者蛋白尿程度与围生儿结局的研究

目的:探讨子癎前期患者蛋白尿程度对其围生儿结局的影响。方法:对287例住院分娩的子癎前期患者根据蛋白尿程度进行分组,分别回顾性研究其围生儿结局,比较不同程度蛋白尿患者围生儿结局的差异。结果:随患者蛋白尿的加重,分娩孕周提前,新生儿出生体重明显下降;剖宫产分娩和治疗性引产数升高,而自然分娩数减少;低体重儿发生率、围生儿死亡率、医源性早产率、收住NICU率均明显升高,但新生儿窒息发生率差异无显著性。将所有病例根据分娩孕周分为两组,≥32周分娩者其围生儿结局在不同程度蛋白尿患者各组之间差异显著,而32周之前分娩者其围生儿结局在不同程度蛋白尿之间差异无显著性。结论:随蛋白尿加重,围生儿结局恶化,但较早的早产儿中,孕龄过小是造成围生儿不良结局的另一不利因素,因而终止妊娠应适时。     

Understanding and Meeting the Needs of Women in the Postpartum Period: The Perinatal Maternal Health Promotion Model

A new model for the care of women in the postpartum focuses on the development of life skills that promote complete well‐being. The year following childbirth is a time of significant transition for women. In addition to the physiologic changes associated with the postpartum period, a woman undergoes marked psychosocial changes as she transitions into a motherhood role, reestablishes relationships, and works to meet the physical and emotional needs of her infant and other family members. It is a time when women are vulnerable to health problems directly related to childbirth and to compromised self‐care, which can manifest in the development or reestablishment of unhealthy behaviors such as smoking and a sedentary lifestyle. In addition to long‐term implications for women, compromised maternal health in the postpartum period is associated with suboptimal health and developmental outcomes for infants. Maternal health experts have called for a change in how care is provided for women in the postpartum period. This article presents the rationale for a health promotion approach to meeting the needs of women in the postpartum period and introduces the Perinatal Maternal Health Promotion Model. This conceptual framework is built around a definition of maternal well‐being that asserts that health goes beyond merely the absence of medical complications. In the model, the core elements of a healthy postpartum are identified and include not only physical recovery but also the ability to meet individual needs and successfully transition into motherhood. These goals can best be achieved by helping women develop or strengthen 4 key individual health‐promoting skills: the ability to mobilize social support, self‐efficacy, positive coping strategies, and realistic expectations. While the model focuses on the woman, the health promotion approach takes into account that maternal health in this critical period affects and is affected by her family, social network, and community. Clinical implications of the model are addressed, including specific health promotion strategies that clinicians can readily incorporate into antepartum and postpartum care.