Prenatal and postnatal period presents the highest prevalence of mental disorders in women's lives and depression is the most frequent one,affecting approximately one in every five mothers.The aggravating factor h...Prenatal and postnatal period presents the highest prevalence of mental disorders in women's lives and depression is the most frequent one,affecting approximately one in every five mothers.The aggravating factor here is that during this period psychiatric symptoms affect not only women's health and well-being but may also interfere in the infant's intra and extra-uterine development.Although the causes of the relationship between maternal mental disorders and possible risks to a child's health and development remain unknown,it is suspected that these risks may be related to the use of psychotropic drugs during pregnancy,to substance abuse and the mother's lifestyle.Moreover,after delivery,maternal mental disorders may also impair the ties of affection(bonding) with the newborn and the ma-ternal capacity of caring in the post-partum period thus increasing the risk for infant infection and malnutrition,impaired child growth that is expressed in low weight and height for age,and even behavioral problems and vulnerability to presenting mental disorders in adulthood.Generally speaking,research on this theme can be divided into the type of mental disorder analyzed: studies that research minor mental disorders during pregnancy such as depression and anxiety find an association between these maternal disorders and obstetric complications such as prematurity and low birth weight,whereas studies that evaluate severe maternal mental disorders such as schizophrenia and bipolar disorder have found not only an association with general obstetric complications as well as with congenital malformations and perinatal mortality.Therefore,the success of infant growth care programs also depends on the mother's mental well being.Such findings have led to the need for new public policies in the field of maternal-infant care geared toward the population of mothers.However,more research is necessary so as to confirm the association between all factors with greater scientific rigor.展开更多
Background: The last Moroccan population and family health survey (EPSF 2011) was carried out between November 2010 and March 2011. The final report and the whole database are not yet accessible while a preliminary re...Background: The last Moroccan population and family health survey (EPSF 2011) was carried out between November 2010 and March 2011. The final report and the whole database are not yet accessible while a preliminary report was released early March 2012. The information given so far does not allow for a complete evaluation of the present health situation in Morocco. However, a partial equity analysis can be devoted to the comparison of health indicators in terms of gender and urban-rural gaps. Method: 1) Questionnaires: a household questionnaire dealt with household characteristics, general health, housing condition and anthropometric data for children less than six years of age. A second questionnaire was devoted specifically to ever married women and dealt with their resources, marriage, reproductive health, family planning, AIDS/SIDA, healthcare and nutrition. 2) Data collection: data were collected through the national survey using a three-stage stratified sampling design to select 640 clusters covering the 16 Moroccan regions. A total of 15,577 households were randomly drawn, providing a sample of 75,061 individuals (51.1% females and 48.9% males) for investigation. 3) Analysis: in this short report, we relied only on partial data released by the Ministry of Health in a preliminary report. We used absolute differences and relative ratios to study the evolution of gender and urban-rural gaps on the basis of socioeconomic indicators. Results and Discussion: The Moroccan population seems to be in the last phase of its demographic transition. The total fertility rate decreased from 5.6 children per woman in 1980 to 2.5 in 2011. The mean age of first marriage went from 24 years for men and 17.5 years for women in 1960 to 31.5 years and 26.3 in 2011 for men and women respectively. The age structure is showing a trend of ageing population. Generally, health indicators related to reproductive and women’s health improved noticeably and consequently, maternal and infant mortality also decreased. However, while these achievements are praiseworthy as national averages, they remain insufficient in terms of equitable healthcare and access to health services since there is still a long way to go in order to reduce the huge gender gaps and rural-urban disparities. Conclusion: In this short report, we showed that, as averages, health indicators improved noticeably during the last decade but gender inequality and urban-rural disparities are still challenging health decision makers. Moroccan health decision makers are urged to adopt an equitable health strategy, starting by giving access to data for analysis, monitoring and evaluation.展开更多
Background: Infant health inequalities responsible for high infant sicknesses and deaths in our setting could depend to a large extend on maternal inequalities like socioeconomic class (SEC), age and human immunodefic...Background: Infant health inequalities responsible for high infant sicknesses and deaths in our setting could depend to a large extend on maternal inequalities like socioeconomic class (SEC), age and human immunodeficiency virus (HIV). Objective: To look at maternal inequalities (SEC, Age and HIV), to predict well-being of neonates during infancy. Methods: Subjects were selected using systematic random sampling. Maternal education, occupation, age and HIV status were obtained using a questionnaire;their SEC was derived using the Oyedeji’s model. Gestational age (GA) of the neonates was estimated from their mother’s last menstrual period, obstetric ultrasound scan reports or the Dubowitz criteria;and birthweight (BW) was determined using the basinet weighing scale, which has a sensitivity of 50 grams. Results: Ninety mother-neonatal pairs were enrolled, 47 (52.2%) neonates were males and 43 (47.8%) females. Most of the neonates were term 66 (73.3%) and of normal BW 75 (83.4%). A significant association existed between maternal variables and the likely hood of the subjects being less healthy during infancy (χ2 = 126.528, p < 0.005). Maternal age had a negative correlation coefficient with GA (r = -0.200) and BW (r = -0.115) and comparison of MA, GA and BW was significant (F = 2662.92, p < 0.0001). Conclusion: The combine effects of maternal SEC, Age and HIV have predicted less healthy neonates during infancy. Neonates in the present work are more prone to sicknesses and ill-health during infancy.展开更多
Background: Adequate and quality Maternal and Child Health (MNCH) care is considered essential in reduction of maternal and child mortality. More than half of the global maternal deaths (66%) are in sub-Saharan Africa...Background: Adequate and quality Maternal and Child Health (MNCH) care is considered essential in reduction of maternal and child mortality. More than half of the global maternal deaths (66%) are in sub-Saharan Africa with infant mortality of 51/1000 live births in the WHO Africa region [1]. There is potential to improve access and utilization of health services through investing in Primary Health Care (PHC) digital innovations [2] especially in underserved settings [3]. In the last quarter of the year 2021 after lifting of the COVID-19 restrictions, Tekeleza project, aims to integrate digital health innovations into MNCH care within PHC settings in Kenya. The project team undertook a baseline survey in three rural counties (Kisii, Kajiado and Migori) characterized with low social-economic status to identify opportunities to leverage on the use of evidence-based digital innovations to reverse the adverse trends in Maternal and Child Health. Methods: A cross-sectional and descriptive study was conducted in 15 Community Health Units (CHUs) in Kenya that were linked to selected Primary Health Care (PHC) facilities from three rural counties. Mixed methods were used to collect data from 404 Households (HHs) selected across the sampled CHUs on Probability Proportionate to Size (PPS). The selected households were assigned unique household or respondent identifiers. The sampling frame for household surveys consisted of all women 18 - 49 years of age, who were either pregnant or in their 18 months post-delivery. From the constructed sampling frame, a simple random sampling procedure was used to select the study sample. An audit was also carried out at the selected PHC facilities and sixty-two (62) Primary Health Workers (PHCWs) including facility managers were interviewed to establish challenges affecting ICT infrastructure and sustainable financing of MNCH services. Findings: The majority of the sampled women (64.9%) were lactating at the time of the study, with 34.4% being pregnant and 0.7% both pregnant and lactating. Despite the high proportions of mothers who received Skilled Birth Attendance, discontinuity in seeking antenatal and postnatal care services was observed in all three counties. The proportion of mothers (n = 404) who reported to have attended at least one ANC was 46.8%. This was attributed to limited access to health facilities, poor staff attitude, and negative cultural practices that got exacerbated by the COVID-19 pandemic. An average of 53.2% of the respondents started attending ANC clinics much later after 12 weeks of gestation to minimize the costs and time they will spend on attending ANC clinics. It also emerged that 68.7% of the respondents had low knowledge levels of selected perinatal and infant care practices. On the making of Sexual and Reproductive Health (SRH) health-seeking decisions, 54.7% of the respondents said, it is their husbands who decide. The PHCWs expressed limited access to Continuing Professional Development (CPDs), a situation that worsened with the COVID-19 Pandemic. Notably, only 54.9% of the PHCWs reported having access to either a Smartphone or desktop at the point of service delivery. Nearly the same proportion (54.8%) has access to the internet at their workstations. Facilities reported delayed reimbursement of National Hospital Insurance Fund (NHIF) and only 54% of the women interviewed had registered in Linda mama NHIF package meant to enable them to access free maternity care. Only one county (Migori) had significant utilization of CHVs. Conclusion: There is increasing access to Skilled Birth Attendance (SBA) in rural Kenya but discontinuous pregnancy care is still a problem and it got worse during the COVID-19 pandemic. Rural PHC facilities have poor ICT infrastructure and despite the 98% rural access to a phone by women, there is limited bankable usage of handheld technology to improve health information literacy on self and infant care among women of reproductive age. Recommendations: Feasibility studies to be conducted on how to sustainably deploy Primary Health Care digital solutions to improve the quality of, access to, and Utilization of Maternal and Child Health (MNCH) services.展开更多
The partogram is an accurate labor monitoring tool for reducing maternal and perinatal mortality due to prolonged labor and dystocia. The aim of this study is to assess how the quality of the partogram has evolved in ...The partogram is an accurate labor monitoring tool for reducing maternal and perinatal mortality due to prolonged labor and dystocia. The aim of this study is to assess how the quality of the partogram has evolved in health care institutions (HCI in short) that have benefited from the primary health care support project (ASSP in short) after formative supervision. This is a descriptive study by periodic clinical audit between 2020 and 2022, carried out in 96 HCI in 3 provincial health divisions (DPS in short) of DR Congo. Each photographed partogram page was sent to the project’s central level for review by a team of experts (3 obstetric gynecologists and 3 midwives). The compliance rate for completing partograms in the 96 health facilities of the 3 DPS was 86.8%. The rate of traceability of labor continuity was 88.2%, and that of traceability of acts, incidents and treatments during labor was 87.1%. Finally, the compliance rate for filling out partograms in the immediate post-partum period was 81%. A clear improvement was noted between the January 2020 and March 2022 assessments.展开更多
BACKGROUND Data that assess maternal and infant outcomes in hepatitis C virus(HCV)-infected mothers are limited.AIM To investigate the frequency of complications and the associated risk factors.METHODS We performed a ...BACKGROUND Data that assess maternal and infant outcomes in hepatitis C virus(HCV)-infected mothers are limited.AIM To investigate the frequency of complications and the associated risk factors.METHODS We performed a cohort study to compare pregnancy and fetal outcomes of HCVviremic mothers with those of healthy mothers.Risk factors were analyzed with logistic regression.RESULTS Among 112 consecutive HCV antibody-positive mothers screened,we enrolled 79 viremic mothers.We randomly selected 115 healthy mothers from the birth registry as the control.Compared to healthy mothers,HCV mothers had a significantly higher frequency of anemia[2.6%(3/115)vs 19.0%(15/79),P<0.001]during pregnancy,medical conditions that required caesarian section[27.8%(32/115)vs 48.1%(38/79),P=0.004],and nuchal cords[9.6%(11/115)vs 34.2%(27/79),P<0.001].In addition,the mean neonatal weight in the HCV group was significantly lower(3278.3±462.0 vs 3105.1±459.4 gms;P=0.006),and the mean head circumference was smaller(33.3±0.6 vs 33.1±0.7 cm;P=0.03).In a multivariate model,HCV-infected mothers were more likely to suffer anemia[adjusted odds ratio(OR):18.1,95%confidence interval(CI):4.3-76.6],require caesarian sections(adjusted OR:2.6,95%CI:1.4-4.9),and have nuchal cords(adjusted OR:5.6,95%CI:2.4-13.0).Their neonates were also more likely to have smaller head circumferences(adjusted OR:2.1,95%CI:1.1-4.3)and lower birth weights than the average(≤3250 gms)with an adjusted OR of 2.2(95%CI:1.2-4.0).The vertical transmission rate was 1%in HCV-infected mothers.CONCLUSION Maternal HCV infections may associate with pregnancy and obstetric complications.We demonstrated a previously unreported association between maternal HCV viremia and a smaller neonatal head circumference,suggesting fetal growth restriction.展开更多
目的:分析瘢痕子宫合并妊娠期甲状腺功能减退症(甲减)对妊娠结局与母婴健康状况的影响。方法:回顾性分析暨南大学附属顺德医院妇产科2021年2月-2022年2月收治的300例分娩产妇,其中瘢痕子宫合并妊娠期甲减孕产妇100例(A组)、单纯瘢痕子...目的:分析瘢痕子宫合并妊娠期甲状腺功能减退症(甲减)对妊娠结局与母婴健康状况的影响。方法:回顾性分析暨南大学附属顺德医院妇产科2021年2月-2022年2月收治的300例分娩产妇,其中瘢痕子宫合并妊娠期甲减孕产妇100例(A组)、单纯瘢痕子宫孕产妇100例(B组)、单纯妊娠期甲减孕产妇100例(C组),分析三组孕产妇的甲状腺功能、分娩结局及母婴结局。结果:A组游离四碘甲状腺原氨酸(FT4)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPO-Ab)水平均高于C组、B组,且三组FT4、TSH、TPO-Ab水平对比,差异均有统计学意义(P<0.05)。A组住院时间、总产程时间均长于B组、C组,B组剖宫产率低于C组、A组,差异均有统计学意义(P<0.05)。B组胎儿宫内窘迫发生率、新生儿体重均低于C组、A组,A组新生儿出生后5 min Apgar评分低于B组、C组(P<0.05),B组妊娠期糖尿病、妊娠期高血压、贫血发病率均低于C组、A组,差异均有统计学意义(P<0.05)。结论:瘢痕子宫合并妊娠期甲减疾病不利于母婴健康,重点在于监测,防范风险。展开更多
目的:总结我国产妇育儿胜任感(parenting sense of competence)的影响因素。方法:计算机检索PubMed、EMbase、Web of Science、CINAHL、中国知网期刊数据库(CNKI)、维普中文科技期刊数据库(VIP)和万方数据库(Wanfang Data)从建库至2022...目的:总结我国产妇育儿胜任感(parenting sense of competence)的影响因素。方法:计算机检索PubMed、EMbase、Web of Science、CINAHL、中国知网期刊数据库(CNKI)、维普中文科技期刊数据库(VIP)和万方数据库(Wanfang Data)从建库至2022年11月文献,纳入关于我国产妇育儿胜任感影响因素的研究。2名研究者独立完成文献筛选、质量评价和信息提取,使用Stata15软件进行统计分析。结果:共纳入6项横断面研究,1项队列研究,包括3284例产妇。Meta分析结果显示,年龄26~30岁产妇比30岁以上产妇育儿胜任感低(SMD=-0.39,95%CI:-0.64~-0.14);学历高中/中专以下产妇比大专以上产妇育儿胜任感低(SMD=-0.38,95%CI:-0.52~-0.23);初产妇比经产妇育儿胜任感低(SMD=-0.47,95%CI:-0.81~-0.12);家庭收入<5000元/月产妇比≥5000元/月产妇育儿胜任感低(SMD=-0.28,95%CI:-0.38~-0.18);纯母乳喂养产妇比人工喂养产妇育儿胜任感高(SMD=0.28,95%CI:0.19~0.38);参加孕妇学校的产妇比不参加孕妇学校的产妇育儿胜任感高(SMD=0.14,95%CI:0.03~0.25)。结论:年龄、学历、产次、家庭收入、喂养方式和参加孕妇学校是中国产妇育儿胜任感的主要影响因素。医院、社区等可根据不同影响因素制定个性化干预策略,提高产妇育儿胜任感。展开更多
基金Supported by Brazil Higher Education Consortia Program(CAPES).
文摘Prenatal and postnatal period presents the highest prevalence of mental disorders in women's lives and depression is the most frequent one,affecting approximately one in every five mothers.The aggravating factor here is that during this period psychiatric symptoms affect not only women's health and well-being but may also interfere in the infant's intra and extra-uterine development.Although the causes of the relationship between maternal mental disorders and possible risks to a child's health and development remain unknown,it is suspected that these risks may be related to the use of psychotropic drugs during pregnancy,to substance abuse and the mother's lifestyle.Moreover,after delivery,maternal mental disorders may also impair the ties of affection(bonding) with the newborn and the ma-ternal capacity of caring in the post-partum period thus increasing the risk for infant infection and malnutrition,impaired child growth that is expressed in low weight and height for age,and even behavioral problems and vulnerability to presenting mental disorders in adulthood.Generally speaking,research on this theme can be divided into the type of mental disorder analyzed: studies that research minor mental disorders during pregnancy such as depression and anxiety find an association between these maternal disorders and obstetric complications such as prematurity and low birth weight,whereas studies that evaluate severe maternal mental disorders such as schizophrenia and bipolar disorder have found not only an association with general obstetric complications as well as with congenital malformations and perinatal mortality.Therefore,the success of infant growth care programs also depends on the mother's mental well being.Such findings have led to the need for new public policies in the field of maternal-infant care geared toward the population of mothers.However,more research is necessary so as to confirm the association between all factors with greater scientific rigor.
文摘Background: The last Moroccan population and family health survey (EPSF 2011) was carried out between November 2010 and March 2011. The final report and the whole database are not yet accessible while a preliminary report was released early March 2012. The information given so far does not allow for a complete evaluation of the present health situation in Morocco. However, a partial equity analysis can be devoted to the comparison of health indicators in terms of gender and urban-rural gaps. Method: 1) Questionnaires: a household questionnaire dealt with household characteristics, general health, housing condition and anthropometric data for children less than six years of age. A second questionnaire was devoted specifically to ever married women and dealt with their resources, marriage, reproductive health, family planning, AIDS/SIDA, healthcare and nutrition. 2) Data collection: data were collected through the national survey using a three-stage stratified sampling design to select 640 clusters covering the 16 Moroccan regions. A total of 15,577 households were randomly drawn, providing a sample of 75,061 individuals (51.1% females and 48.9% males) for investigation. 3) Analysis: in this short report, we relied only on partial data released by the Ministry of Health in a preliminary report. We used absolute differences and relative ratios to study the evolution of gender and urban-rural gaps on the basis of socioeconomic indicators. Results and Discussion: The Moroccan population seems to be in the last phase of its demographic transition. The total fertility rate decreased from 5.6 children per woman in 1980 to 2.5 in 2011. The mean age of first marriage went from 24 years for men and 17.5 years for women in 1960 to 31.5 years and 26.3 in 2011 for men and women respectively. The age structure is showing a trend of ageing population. Generally, health indicators related to reproductive and women’s health improved noticeably and consequently, maternal and infant mortality also decreased. However, while these achievements are praiseworthy as national averages, they remain insufficient in terms of equitable healthcare and access to health services since there is still a long way to go in order to reduce the huge gender gaps and rural-urban disparities. Conclusion: In this short report, we showed that, as averages, health indicators improved noticeably during the last decade but gender inequality and urban-rural disparities are still challenging health decision makers. Moroccan health decision makers are urged to adopt an equitable health strategy, starting by giving access to data for analysis, monitoring and evaluation.
文摘Background: Infant health inequalities responsible for high infant sicknesses and deaths in our setting could depend to a large extend on maternal inequalities like socioeconomic class (SEC), age and human immunodeficiency virus (HIV). Objective: To look at maternal inequalities (SEC, Age and HIV), to predict well-being of neonates during infancy. Methods: Subjects were selected using systematic random sampling. Maternal education, occupation, age and HIV status were obtained using a questionnaire;their SEC was derived using the Oyedeji’s model. Gestational age (GA) of the neonates was estimated from their mother’s last menstrual period, obstetric ultrasound scan reports or the Dubowitz criteria;and birthweight (BW) was determined using the basinet weighing scale, which has a sensitivity of 50 grams. Results: Ninety mother-neonatal pairs were enrolled, 47 (52.2%) neonates were males and 43 (47.8%) females. Most of the neonates were term 66 (73.3%) and of normal BW 75 (83.4%). A significant association existed between maternal variables and the likely hood of the subjects being less healthy during infancy (χ2 = 126.528, p < 0.005). Maternal age had a negative correlation coefficient with GA (r = -0.200) and BW (r = -0.115) and comparison of MA, GA and BW was significant (F = 2662.92, p < 0.0001). Conclusion: The combine effects of maternal SEC, Age and HIV have predicted less healthy neonates during infancy. Neonates in the present work are more prone to sicknesses and ill-health during infancy.
文摘Background: Adequate and quality Maternal and Child Health (MNCH) care is considered essential in reduction of maternal and child mortality. More than half of the global maternal deaths (66%) are in sub-Saharan Africa with infant mortality of 51/1000 live births in the WHO Africa region [1]. There is potential to improve access and utilization of health services through investing in Primary Health Care (PHC) digital innovations [2] especially in underserved settings [3]. In the last quarter of the year 2021 after lifting of the COVID-19 restrictions, Tekeleza project, aims to integrate digital health innovations into MNCH care within PHC settings in Kenya. The project team undertook a baseline survey in three rural counties (Kisii, Kajiado and Migori) characterized with low social-economic status to identify opportunities to leverage on the use of evidence-based digital innovations to reverse the adverse trends in Maternal and Child Health. Methods: A cross-sectional and descriptive study was conducted in 15 Community Health Units (CHUs) in Kenya that were linked to selected Primary Health Care (PHC) facilities from three rural counties. Mixed methods were used to collect data from 404 Households (HHs) selected across the sampled CHUs on Probability Proportionate to Size (PPS). The selected households were assigned unique household or respondent identifiers. The sampling frame for household surveys consisted of all women 18 - 49 years of age, who were either pregnant or in their 18 months post-delivery. From the constructed sampling frame, a simple random sampling procedure was used to select the study sample. An audit was also carried out at the selected PHC facilities and sixty-two (62) Primary Health Workers (PHCWs) including facility managers were interviewed to establish challenges affecting ICT infrastructure and sustainable financing of MNCH services. Findings: The majority of the sampled women (64.9%) were lactating at the time of the study, with 34.4% being pregnant and 0.7% both pregnant and lactating. Despite the high proportions of mothers who received Skilled Birth Attendance, discontinuity in seeking antenatal and postnatal care services was observed in all three counties. The proportion of mothers (n = 404) who reported to have attended at least one ANC was 46.8%. This was attributed to limited access to health facilities, poor staff attitude, and negative cultural practices that got exacerbated by the COVID-19 pandemic. An average of 53.2% of the respondents started attending ANC clinics much later after 12 weeks of gestation to minimize the costs and time they will spend on attending ANC clinics. It also emerged that 68.7% of the respondents had low knowledge levels of selected perinatal and infant care practices. On the making of Sexual and Reproductive Health (SRH) health-seeking decisions, 54.7% of the respondents said, it is their husbands who decide. The PHCWs expressed limited access to Continuing Professional Development (CPDs), a situation that worsened with the COVID-19 Pandemic. Notably, only 54.9% of the PHCWs reported having access to either a Smartphone or desktop at the point of service delivery. Nearly the same proportion (54.8%) has access to the internet at their workstations. Facilities reported delayed reimbursement of National Hospital Insurance Fund (NHIF) and only 54% of the women interviewed had registered in Linda mama NHIF package meant to enable them to access free maternity care. Only one county (Migori) had significant utilization of CHVs. Conclusion: There is increasing access to Skilled Birth Attendance (SBA) in rural Kenya but discontinuous pregnancy care is still a problem and it got worse during the COVID-19 pandemic. Rural PHC facilities have poor ICT infrastructure and despite the 98% rural access to a phone by women, there is limited bankable usage of handheld technology to improve health information literacy on self and infant care among women of reproductive age. Recommendations: Feasibility studies to be conducted on how to sustainably deploy Primary Health Care digital solutions to improve the quality of, access to, and Utilization of Maternal and Child Health (MNCH) services.
文摘The partogram is an accurate labor monitoring tool for reducing maternal and perinatal mortality due to prolonged labor and dystocia. The aim of this study is to assess how the quality of the partogram has evolved in health care institutions (HCI in short) that have benefited from the primary health care support project (ASSP in short) after formative supervision. This is a descriptive study by periodic clinical audit between 2020 and 2022, carried out in 96 HCI in 3 provincial health divisions (DPS in short) of DR Congo. Each photographed partogram page was sent to the project’s central level for review by a team of experts (3 obstetric gynecologists and 3 midwives). The compliance rate for completing partograms in the 96 health facilities of the 3 DPS was 86.8%. The rate of traceability of labor continuity was 88.2%, and that of traceability of acts, incidents and treatments during labor was 87.1%. Finally, the compliance rate for filling out partograms in the immediate post-partum period was 81%. A clear improvement was noted between the January 2020 and March 2022 assessments.
基金Supported by The Ministry of Science and Technology of China for the National Five-Year Key Projects in Infectious Diseases,No. 2015ZX10004801
文摘BACKGROUND Data that assess maternal and infant outcomes in hepatitis C virus(HCV)-infected mothers are limited.AIM To investigate the frequency of complications and the associated risk factors.METHODS We performed a cohort study to compare pregnancy and fetal outcomes of HCVviremic mothers with those of healthy mothers.Risk factors were analyzed with logistic regression.RESULTS Among 112 consecutive HCV antibody-positive mothers screened,we enrolled 79 viremic mothers.We randomly selected 115 healthy mothers from the birth registry as the control.Compared to healthy mothers,HCV mothers had a significantly higher frequency of anemia[2.6%(3/115)vs 19.0%(15/79),P<0.001]during pregnancy,medical conditions that required caesarian section[27.8%(32/115)vs 48.1%(38/79),P=0.004],and nuchal cords[9.6%(11/115)vs 34.2%(27/79),P<0.001].In addition,the mean neonatal weight in the HCV group was significantly lower(3278.3±462.0 vs 3105.1±459.4 gms;P=0.006),and the mean head circumference was smaller(33.3±0.6 vs 33.1±0.7 cm;P=0.03).In a multivariate model,HCV-infected mothers were more likely to suffer anemia[adjusted odds ratio(OR):18.1,95%confidence interval(CI):4.3-76.6],require caesarian sections(adjusted OR:2.6,95%CI:1.4-4.9),and have nuchal cords(adjusted OR:5.6,95%CI:2.4-13.0).Their neonates were also more likely to have smaller head circumferences(adjusted OR:2.1,95%CI:1.1-4.3)and lower birth weights than the average(≤3250 gms)with an adjusted OR of 2.2(95%CI:1.2-4.0).The vertical transmission rate was 1%in HCV-infected mothers.CONCLUSION Maternal HCV infections may associate with pregnancy and obstetric complications.We demonstrated a previously unreported association between maternal HCV viremia and a smaller neonatal head circumference,suggesting fetal growth restriction.
文摘目的:分析瘢痕子宫合并妊娠期甲状腺功能减退症(甲减)对妊娠结局与母婴健康状况的影响。方法:回顾性分析暨南大学附属顺德医院妇产科2021年2月-2022年2月收治的300例分娩产妇,其中瘢痕子宫合并妊娠期甲减孕产妇100例(A组)、单纯瘢痕子宫孕产妇100例(B组)、单纯妊娠期甲减孕产妇100例(C组),分析三组孕产妇的甲状腺功能、分娩结局及母婴结局。结果:A组游离四碘甲状腺原氨酸(FT4)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPO-Ab)水平均高于C组、B组,且三组FT4、TSH、TPO-Ab水平对比,差异均有统计学意义(P<0.05)。A组住院时间、总产程时间均长于B组、C组,B组剖宫产率低于C组、A组,差异均有统计学意义(P<0.05)。B组胎儿宫内窘迫发生率、新生儿体重均低于C组、A组,A组新生儿出生后5 min Apgar评分低于B组、C组(P<0.05),B组妊娠期糖尿病、妊娠期高血压、贫血发病率均低于C组、A组,差异均有统计学意义(P<0.05)。结论:瘢痕子宫合并妊娠期甲减疾病不利于母婴健康,重点在于监测,防范风险。
文摘目的:总结我国产妇育儿胜任感(parenting sense of competence)的影响因素。方法:计算机检索PubMed、EMbase、Web of Science、CINAHL、中国知网期刊数据库(CNKI)、维普中文科技期刊数据库(VIP)和万方数据库(Wanfang Data)从建库至2022年11月文献,纳入关于我国产妇育儿胜任感影响因素的研究。2名研究者独立完成文献筛选、质量评价和信息提取,使用Stata15软件进行统计分析。结果:共纳入6项横断面研究,1项队列研究,包括3284例产妇。Meta分析结果显示,年龄26~30岁产妇比30岁以上产妇育儿胜任感低(SMD=-0.39,95%CI:-0.64~-0.14);学历高中/中专以下产妇比大专以上产妇育儿胜任感低(SMD=-0.38,95%CI:-0.52~-0.23);初产妇比经产妇育儿胜任感低(SMD=-0.47,95%CI:-0.81~-0.12);家庭收入<5000元/月产妇比≥5000元/月产妇育儿胜任感低(SMD=-0.28,95%CI:-0.38~-0.18);纯母乳喂养产妇比人工喂养产妇育儿胜任感高(SMD=0.28,95%CI:0.19~0.38);参加孕妇学校的产妇比不参加孕妇学校的产妇育儿胜任感高(SMD=0.14,95%CI:0.03~0.25)。结论:年龄、学历、产次、家庭收入、喂养方式和参加孕妇学校是中国产妇育儿胜任感的主要影响因素。医院、社区等可根据不同影响因素制定个性化干预策略,提高产妇育儿胜任感。
