Influence of perinatal factors on full-term low-birth-weight infants and construction of a predictive model

BACKGROUND Being too light at birth can increase the risk of various diseases during infancy.AIM To explore the effect of perinatal factors on term low-birth-weight(LBW)infants and build a predictive model.This model aims to guide the clinical management of pregnant women’s healthcare during pregnancy and support the healthy growth of newborns.METHODS A retrospective analysis was conducted on data from 1794 single full-term pregnant women who gave birth.Newborns were grouped based on birth weight:Those with birth weight<2.5 kg were classified as the low-weight group,and those with birth weight between 2.5 kg and 4 kg were included in the normal group.Multiple logistic regression analysis was used to identify the factors influencing the occurrence of full-term LBW.A risk prediction model was established based on the analysis results.The effectiveness of the model was analyzed using the Hosmer–Leme show test and receiver operating characteristic(ROC)curve to verify the accuracy of the predictions.RESULTS Among the 1794 pregnant women,there were 62 cases of neonatal weight<2.5 kg,resulting in an LBW incidence rate of 3.46%.The factors influencing full-term LBW included low maternal education level[odds ratio(OR)=1.416],fewer prenatal examinations(OR=2.907),insufficient weight gain during pregnancy(OR=3.695),irregular calcium supplementation during pregnancy(OR=1.756),and pregnancy hypertension syndrome(OR=2.192).The prediction model equation was obtained as follows:Logit(P)=0.348×maternal education level+1.067×number of prenatal examinations+1.307×insufficient weight gain during pregnancy+0.563×irregular calcium supplementation during pregnancy+0.785×pregnancy hypertension syndrome−29.164.The area under the ROC curve for this model was 0.853,with a sensitivity of 0.852 and a specificity of 0.821.The Hosmer–Leme show test yieldedχ^(2)=2.185,P=0.449,indicating a good fit.The overall accuracy of the clinical validation model was 81.67%.CONCLUSION The occurrence of full-term LBW is related to maternal education,the number of prenatal examinations,weight gain during pregnancy,calcium supplementation during pregnancy,and pregnancy-induced hypertension.The constructed predictive model can effectively predict the risk of full-term LBW.

Socio-Medical and Demographic Factors Associated with Perinatal Mortality in a Southern Benin Health Zone Hospital in 2020: A Case-Control Study

Background: Perinatal mortality remains a major public health concern in developing countries such as Benin. To better steer response interventions, this study was carried out in southern Benin with the aim of identifying the demographic and socio-medical factors linked to perinatal mortality. Methods: The case-control study, held from January 1 to December 31, 2020, covered 154 targets, including 77 cases of neonates deceased within the perinatal period and 77 live-born control neonates selected on a one-for-one basis. Univariate analysis using the McNemar test and logistic regression were used to identify risk factors for perinatal mortality, at a 5% threshold of significance. Results: Sahoué/mina ethnicities, only associated socio-demographic characteristic, increased the risk of perinatal death by 2.47 times (p = 0.008). Mother’s age, education, occupation, marital status, and household size were not associated (p > 0.05). Risk of death was increased 2.5 times when the mother was referred (p = 0.007), 3.3 times when she came from a hard-to-reach locality (p Conclusion: Although attention must also be paid to referral and access to care, this study identifies antenatal consultation as the main target of any intervention to reduce perinatal mortality.

Perinatal Factors of Developmental Attention Deficit Hyperactivity Disorder in Children

Background: Attention deficit hyperactivity disorder is a common pediatric neurobehavioral disorder often treated in the primary care setting. It shows a high and chronic level of inattention, impulsivity/hyperactivity and/or both, and can affect more than 2 million school-age children. The researchers are not sure about the exact causes of the disorder, but it seems that apart from genetic factors, perinatal factors seem to dynamically contribute to the development of the disorder. Purpose: The aim of this review was to investigate the perinatal and obstetric factors related to the development of the attention deficit hyperactivity disorder in childhood. Method: An online review of English language studies published from 2002 to 2020, using the Embase, PsychINFO, PubMed and Google Scholar databases. From 1100 studies only 17 were included in the review since they met the inclusion criteria. Conclusions: The results of the review showed that apart from heredity and genetic factors, various conditions in pregnancy or the mother’s way of life in pregnancy, adverse conditions in labor and infancy can contribute on their own or in combination to the development of the attention deficit hyperactivity disorder in childhood. Obstetric vigilance to detect risk factors in pregnancy in combination with the prevention of obstetric complications is the key in preventing attention deficit hyperactivity disorder.

Perinatal and early life risk factors for inflammatory bowel disease

AIM:To investigate associations between perinatal risk factors and subsequent inflammatory bowel disease (IBD) in children and young adults.METHODS:Record linked abstracts of birth registrations,maternity,day case and inpatient admissions in a defined population of southern England.Investigation of 20 perinatal factors relating to the maternity or the birth:maternal age,Crohn's disease (CD) or ulcerative colitis (UC) in the mother,maternal social class,marital status,smoking in pregnancy,ABO blood group and rhesus status,pre-eclampsia,parity,the infant's presentation at birth,caesarean delivery,forceps delivery,sex,number of babies delivered,gestational age,birthweight,head circumference,breastfeeding and Apgar scores at one and five minutes.RESULTS:Maternity records were present for 180 children who subsequently developed IBD.Univariate analysis showed increased risks of CD among children of mothers with CD (P=0.011,based on two cases of CD in both mother and child) and children of mothers who smoked during pregnancy.Multivariate analysis confirmed increased risks of CD among children of mothers who smoked (odds ratio=2.04,95% CI=1.06-3.92) and for older mothers aged 35+ years (4.81,2.32-9.98).Multivariate analysis showed that there were no significant associations between CD and 17 other perinatal risk factors investigated.It also showed that,for UC,there were no significant associations with the perinatal factors studied.CONCLUSION:This study shows an association between CD in mother and child;and elevated risks of CD in children of older mothers and of mothers who smoked.

Analysis of clinicopathological features and prognostic factors of breast cancer brain metastasis

BACKGROUND Breast cancer(BC)has become the most common malignancy in women.The incidence and detection rates of BC brain metastasis(BCBM)have increased with the progress of imaging,multidisciplinary treatment techniques and the extension of survival time of BC patients.BM seriously affects the quality of life and survival prognosis of BC patients.Therefore,clinical research on the clinicopathological features and prognostic factors of BCBM is valuable.By analyzing the clinicopathological parameters of BCBM patients,and assessing the risk factors and prognostic indicators,we can perform hierarchical diagnosis and treatment on the high-risk population of BCBM,and achieve clinical benefits of early diagnosis and treatment.AIM To explore the clinicopathological features and prognostic factors of BCBM,and provide references for diagnosis,treatment and management of BCBM.METHODS The clinicopathological data of 68 BCBM patients admitted to the Air Force Medical Center,Chinese People’s Liberation Army(formerly Air Force General Hospital)from 2000 to 2022 were collected.Another 136 BC patients without BM were matched at a ratio of 1:2 based on the age and site of onset for retrospective analysis.Categorical data were subjected to χ^(2) test or Fisher’s exact probability test,and the variables with P<0.05 in the univariate Cox proportional hazards model were incorporated into the multivariate model to identify high-risk factors and independent prognostic factors of BCBM,with a hazard ratio(HR)>1 suggesting poor prognostic factors.The survival time of patients was estimated by the Kaplan-Meier method,and overall survival was compared between groups by log-rank test.RESULTS Multivariate Cox regression analysis showed that patients with stage Ⅲ/Ⅳ tumor at initial diagnosis[HR:5.58,95% confidence interval(CI):1.99–15.68],lung metastasis(HR:24.18,95%CI:6.40-91.43),human epidermal growth factor receptor 2(HER2)-overexpressing BC and triple-negative BC were more prone to BM.As can be seen from the prognostic data,52 of the 68 BCBM patients had died by the end of follow-up,and the median time from diagnosis of BC to the occurrence of BM and from the occurrence of BM to death or last follow-up was 33.5 and 14 mo,respectively.It was confirmed by multivariate Cox regression analysis that patients with neurological symptoms(HR:1.923,95%CI:1.005-3.680),with bone metastasis(HR:2.011,95%CI:1.056-3.831),and BM of HER2-overexpressing and triple-negative BC had shorter survival time.CONCLUSION HER2-overexpressing,triple-negative BC,late tumor stage and lung metastasis are risk factors of BM.The presence of neurological symptoms,bone metastasis,and molecular type are influencing prognosis factors of BCBM.

Influencing factors of the neurodevelopment of high-risk infants

Background High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of developmental abnormalities plays a vital role in improving high-risk infants' quality of life.Aims To describe the neurodevelopment of high-risk infants aged less than 1 year old, and to analyse the incidences and influencing factors of neurodevelopmental abnormalities in order to provide a basis for neurodevelopment monitoring and management of highrisk infants.Methods High-risk infants born between January 2016 and December 2016 in the maternity and infant health hospitals of three districts in Shanghai were followed up.The Gesell Developmental Scale was used to assess the neurodevelopmental level at the time of recruitment(0-2 months) and at 9 months. Univariate and multivariate analyses of the influencing factors were conducted.Results 484 high-risk infants(male 51 %, female 49%)with an average gestation age of 36.5±2.2 weeks were recruited. At the time of recruitment, the average age was2.1(0.8) months, and the developmental quotient(DQ)scores of full-term high-risk infants in motor(t=3.542,p=0.001), cognitive(t=3.125, p=0.002), language(t=3.189, p=0.002) and social(t=3.316, p=0.001) areas were higher than those of preterm infants. The incidences of developmental abnormalities of full-term high-risk infants in motor(χ~2 =9.452, p=0.002), cognitive(χ~2=6.258, p=0.012), language(χ~2 =12.319, p =0.001) and social(χ~2 =6.811, p=0.009) areas were lower than the preterm infants. At 9 months, there was no difference in the DQ scores and incidences of developmental abnormalities in four areas between full-term and preterm high-risk infants, and the incidence of developmental abnormalities was around 10%.Conclusion The incidence of neurodevelopmental abnormalities in high-risk infants aged less than 1 year old is high. Preterm birth and parental bad habits are significant factors affecting the neurodevelopment.Monitoring and early interventions help to improve highrisk infants' neurodevelopment.

Seroprevalence of <i>Brucella</i>Antibodies and Risk Factors Associated with Human Brucellosis in High-Risk Occupational Groups of the Noun Division in the West Region of Cameroon

Brucellosis is an anthropozoonotic disease with an important public health impact. Although the transmission of Brucella from animals to humans can occur in different epidemiological settings of sub-Saharan African countries, little data has been published on human brucellosis. This study aimed to detect Brucella antibodies and the risk factors associated to brucellosis among high-risk occupational groups of people in the Noun Division of Cameroon. For this study, a structured questionnaire was used to assess risk factors associated with human brucellosis. Thereafter, blood samples were collected from high-risk occupational groups of people in four villages. Plasma was extracted from each sample and Brucella antibodies were detected using Rose Bengal Plate Test (RBPT) and indirect Enzyme-Linked Immunosorbent Assay (i-ELISA). Of the 273 participants enrolled, the overall seroprevalence of Brucella antibodies was 12.45% with RBPT and 10.26% with i-ELISA test. This seroprevalence was significantly (P = 0.04;X2 = 9.73) higher among livestock herdsmen (15.8%), slaughterhouse workers (9.8%), butchers (4.8%), participants having no educational level (14.3%) and those experiencing above 5 years of risky activity (15%). Raw milk consumption (OR: 4.8;P = 0.001), no formal education (OR: 6.4;P = 0.03) and assistance of animal during parturition (OR: 7.2;P < 0.0001) appeared as factors that may increase the risk of Brucella infections. The detection of Brucella antibodies indicates the risk of human brucellosis in some groups of people of the Noun division. Consuming unpasteurized milk, participating in parturition and lacking knowledge on brucellosis appeared as risk factors associated with human brucellosis in western Cameroon. It raises the need of developing and implementing control measures for human and animal brucellosis.

A Case-control Study on High-risk Factors for Newborn Hearing Loss in Seven Cities of Shandong Province

To investigate the high-risk factors for newborn hearing loss and to provide information for preventing the development of hearing loss and delaying its progression, from May 2003 to June 2006, neonates who failed to pass the universal newborn hearing screening （UNHS） were referred to Jinan Newborn Hearing Screening and Rehabilitation Center from 7 newborn hearing screening centers in seven cities of Shandong province. One-to-one pair-matched case-control method was employed for statistical analysis of the basic features of definitely identified cases. High-risk factors relating to the bilateral hearing loss were evaluated by univariate and multivariate Logistic regression analysis. Our results revealed that 721 transferred newborns who didn＇t pass the heating screening received audiological and medical evaluation and 367 were confirmed to have hearing loss. Of them, 177 neonates with hearing loss who met the matching requirements were included in the study as subjects. Univariate analysis showed that high-risk factors related to hearing loss incuded age of father, education backgrounds of parents, parity, birth weight, gestational weeks, craniofacial deformity, history of receiving treatment in neonatal intensive care unit （NICU）, neonatal disease, family history of otopathy and family history of congenital hearing loss. Multivariate Logistic regression analysis revealed that 4 independent risk factors were related to bilateral hearing loss, including parity （OR=16.285, 95% CI 3.379--78,481）, neonatal disease （OR=34;968, 95% CI 2.720 449.534）, family history of congenital hearing loss （OR=69.488, 95% CI 4.417--1093.300） and birth weight （OR=0.241, 95% CI 0.090--0.648）. It is concluded that parity, neonatal disease and family history of heating loss are the promoting factors of bilateral hearing loss in neonates and appropriate intervention measures should be taken to deal with the risk factors.

Prevalence, Risk Factors and Outcome of Preterm Premature Rupture of Membranes at the Bamenda Regional Hospital

Background: Preterm premature rupture of membranes (PPROM) is one of the most common complications of pregnancy. It is one of the leading identifiable cause of preterm deliveries, and an important cause of maternal and perinatal morbidity and mortality. The aim of this study was to determine the prevalence of PPROM, to identify its associated factors and to evaluate the early outcome (within 72 hrs after delivery) following PPROM at the Bamenda Regional Hospital (BRH). Methods: A cross-sectional study was conducted in March and April 2020. Three hundred and eighty-seven women who delivered at the labour room of the BRH were included in this study. Interviewer-administered questionnaires were used to obtain data. The cases of PPROM were women who had lost amniotic fluid continuously before hospitalisation and whose gestational age was between 28 weeks + 0 days and 36 weeks + 6 days. Descriptive statistics followed by logistic regression analyses were conducted with level of significance set at p-value <0.05. Results: Among the 387 participants included in the study, 19 had PPROM giving a prevalence of 4.91%. Of 57 preterm deliveries, PPROM accounted for 33.33% (n = 19). The statistically significant independent factors associated with lower odds of PPROM were the age groups 20 - 29 years (aOR = 0.07, 95% CI: 0.01 - 0.42, p = 0.003) and ≥30 years (aOR = 0.01, 95% CI: 0.001 - 0.14, p = 0.001), and attending ANC ≥ 4 times (aOR = 0.23, 95% CI: 0.06 - 0.84, p = 0.026). Whereas, having a multiple pregnancy (aOR = 39.72, 95% CI: 7.19 - 219.33, p < 0.001), urinary tract infection during pregnancy (aOR = 104.86, 95% CI: 12.25 - 897.90, p < 0.001), genital tract infections during pregnancy (aOR = 17.34, 95% CI: 2.67 - 112.56, p = 0.003), and having a history of preterm delivery (aOR = 27.65, 95% CI: 1.76 - 434.15, p = 0.018) were associated with a higher likelihood of PPROM. The study revealed that 10.53% (n = 2) of women who had PPROM had an unfavourable outcome. Babies born by mothers who had PPROM were more likely to have an unfavourable outcome (OR = 14.44, 95% CI: 5.42 - 38.48, p < 0.001). Conclusion: Preterm premature rupture of membranes considerably causes perinatal morbidity and mortality, and thus optimum obstetric and medical care is essential for the reduction of the complications related to it.

Perinatal Stroke and Apparent Life-Threatening Event: A Case Report

To analyze how the multidisciplinary clinical, biohumoral, instrumental approach to ALTE (Apparent Life Threatening Event) episode may discover cardiovascular disease in the newborn. Introduction: In the first year of life ALTEs concern 0.8% of access to Pediatric Emergency Department. The cause of apparent life-threatening events (ALTEs) in infants reflects a differential diagnosis that includes an array of congenital or acquired disorders. Approximately 10% - 25% of ap-parent life-threatening events may remain unexplained following a thorough evaluation. Case re-port: B. E., a 2-month-old child, in wellbeing, shortly before meal, during sleep, was not responsive to repeated stimulations;he was hypotonic and unresponsive. About 15 minutes later, he pre-sented a normal tone and state of consciousness. Evaluating the referred symptoms, diagnostic protocol for ALTE was started;the Angio-MRI brain performed as second line analysis showed a focal gliotic lesion at left striatal area. The cardiological evaluation with echocardiography detected a pervium foramen ovale (PFO), with minimum shunt left-right direction. At least, biohumoral tests revealed protrombin gene heterozygosis mutation. Conclusion: Apparent Life-Threatening Events are first manifestation of stroke in infant. Discussion: This report discloses how the multidisciplinary clinical approach is essential in ALTE. The exact management of ALTE patients is very important in situations like this, when the concomitant disease is rare. In fact, arterial stroke incidence in children > 28 days of life is estimated between 1.2 and 7.9 cases/100,000 child-ren/year. However, in the last 20 years, we observed an increased incidence of stroke, probably related to two main causes: a greater attention for this disease and a major survival of children with pathology that arrange for stroke thanks to a better prevention. In conclusion, it’s a fundamental multidisciplinary approach even in following months after the events.

Large Population Screening Identified the Main Risk Factors of Stroke in Shashi District of Jingzhou City

Objective: This paper aims to screen and analyze the current status of high-risk stroke patients in Shashi District of Jingzhou City and the exposure levels of related risk factors, and provides suggestions as the references for prevention and treatment of stroke. Methods: Using cluster sampling, on-site investigations were conducted on 1060 permanent residents aged 40 years and over at 3 townships and 2 communities in Shashi District of Jingzhou City from January 2018 to December 2018. Risk assessment of stroke is based on the stroke risk screening form. Statistical analysis was performed by using SPSS 22.0 software. Results: After making a stroke risk assessment, a total of 313 high-risk stroke patients were screened, and the detection rate was 29.53%. The exposure rate of risk factors from high to low was hypertension (70.93%), dyslipidemia (46.33%), less physical exercise (46.01%), diabetes (36.10%), overweight (33.55%), smoking (33.23%), family history of stroke (24.92%), atrial fibrillation or valvular heart disease (7.35%). There are statistically significant differences among all risk factors between the high-risk group and middle and low-risk groups (P Conclusion: The detection rate of high-risk stroke patients in Shashi District of Jingzhou City is high. Hypertension, dyslipidemia and less physical exercise are the main risk factors of stroke occurrence and recurrence in the region. The prevention and treatment of risk factors for stroke should be strengthened to control the incidence and recurrence rate of stroke.

Perinatal events and the risk of developing primary sclerosing cholangitis

AIM: To investigate whether perinatal events, intrauterine or postpartum, are associated with the development of primary sclerosing cholangitis (PSC) later in life. METHODS: Birth records from 97 patients with adult PSC in Sweden were reviewed. Information on perinatal events including medications and complications during pregnancy, gestation length, birth weight and length were collected. Two control children of the same sex were selected for each subject. Conditional multiple logistic regression was used to assess associations of the perinatal measures with development of PSC. RESULTS: No significant associations were found between gestational age, birth length, breastfeeding, and the majority of medical complications including infections or medication during pregnancy for the mothers or postpartum for the children. Vaginal bleeding and peripheral oedema showed associations with PSC, with matched odds ratios of 5.70 (95% CI, 1.13-28.83) and 2.28 (95% CI, 1.04-5.03), respectively. CONCLUSION: The associations of vaginal bleeding and oedema with subsequent PSC cannot readily beexplained, so our fi ndings do not strongly support the hypothesis of a signifi cant role of perinatal events as a risk for the development of PSC later in life.

北京地区围产期抑郁发病率调查及危险因素

目的:调查北京地区孕产妇围产期抑郁发病率,分析孕晚期抑郁和产后抑郁发病的独立危险因素。方法:收集首都医科大学附属北京妇产医院门诊就诊的4476名孕产妇的人口社会学资料及临床资料,使用爱丁堡产后抑郁自评量表(Edinburgh Postnatal Depression Scale,EPDS)进行筛查,分析北京地区孕产妇女围产期抑郁发病率及年龄、配偶学历、夫妻间不良事件、代际关系、计划怀孕、个人月收入、个人最高学历、新生儿性别、月经情况等因素对围产期抑郁患病率的影响。结果:EPDS筛查结果显示,北京地区孕产妇女孕晚期抑郁和产后抑郁发病率分别为20%和15.30%,孕晚期的抑郁发病率要高于产后抑郁的发病率(P<0.01)。对于孕晚期抑郁,20~35岁的孕妇相较于大于35岁的孕妇发生孕晚期抑郁的可能性更高,具有显著性差异(P<0.05)。对于产后抑郁,个人月收入小于10000元(P<0.05)、既往有痛经史(P<0.05)、经前紧张(P<0.01)、目前存在漏尿情况(P<0.05)是产后抑郁发病的独立危险因素。结论:北京地区孕产期妇女的围产期抑郁发病率高,其中孕晚期抑郁的发病率要显著高于产后抑郁的发病率。临床需要进一步关注抑郁发病高危人群,提高围产期抑郁的早期识别和诊断。

围产期女性盆底功能障碍一级预防自我护理能力现状及影响因素研究

目的了解围产期女性盆底功能障碍(PFD)一级预防的自我护理能力现状并探讨其影响因素。方法选取2023年1-3月在我院产科住院和围产中心就诊的孕产妇320例。采用一般资料调查表和女性PFD一级预防自我护理能力量表进行问卷调查。结果围产期女性PFD一级预防自我护理能力量表得分为(106.96±22.55)分,处于中等偏下水平。多元线性回归分析显示:居住地、文化程度和生育次数为围产期女性PFD一级预防自我护理能力的影响因素(P<0.05)。结论围产期女性PFD一级预防自我护理能力处于中等偏低水平,围产期康复宣教时应尤其对文化程度低、未生育及居住地在农村的女性群体进行认知评估,并制定个性化的健康教育方案,以提升围产期女性对PFD的认知和自护能力,减轻围产期女性PDF症状,减少PDF的发病率,提高其生活质量。

晚期早产儿NRDS合并ARDS的围产期高危因素分析

目的:探讨晚期早产儿(胎龄34周至36^(+6)周)新生儿呼吸窘迫综合征(NRDS)合并新生儿急性呼吸窘迫综合征(ARDS)的高危因素。方法:回顾性分析2019年9月至2023年1月某院新生儿重症监护病房住院治疗的晚期早产儿NRDS病例为研究对象。根据是否发生ARDS分为观察组(NRDS合并ARDS组)和对照组(单纯NRDS组),对两组的围产期高危因素进行对比分析。结果:研究对象共92例,其中观察组44例、对照组48例。两组在性别、胎龄、体重、分娩方式的差异无统计学意义(P>0.05)。观察组妊娠晚期呼吸道感染、妊娠晚期阴道炎、妊娠晚期维生素D缺乏、羊水粪染、窒息发生率高于对照组,差异具有统计学意义(P<0.05)。两组妊娠期糖尿病、妊娠期高血压、产前促肺治疗、胎膜早破、脐带缠绕、前置胎盘、胎盘早剥、低体重、宫内窘迫的发生率无统计学意义(P>0.05)。将单因素分析中有统计学意义的变量(妊娠晚期呼吸道感染、妊娠晚期阴道炎、妊娠晚期维生素D缺乏、羊水粪染、窒息)纳入到Logistics回归分析中,经逐步Logistics回归分析妊娠晚期呼吸道感染(OR=9.613,95%CI 1.056-87.489,P<0.05);妊娠晚期阴道炎(OR=11.469,95%CI 1.286-102.294,P<0.05);妊娠晚期维生素D缺乏具有统计学意义(OR=7.499,95%CI 1.887-29.802,P<0.05),与晚期早产儿NRDS合并ARDS的关联均有统计学意义。结论:妊娠晚期呼吸道感染、妊娠晚期阴道炎、妊娠晚期维生素D缺乏是晚期早产儿NRDS合并ARDS的独立危险因素。

围产期日粮添加白藜芦醇对山羊生产性能、血液指标及炎症因子基因表达的影响

本试验旨在从山羊生长性能、血液指标和炎症因子基因表达方面研究白藜芦醇对围产期山羊的影响。18只妊娠129 d (即产前21 d)的经产苏白母山羊分为Con组(基础日粮)和Res组(添加白藜芦醇400 mg·kg^(-1)干物质采食量)。采集产前15 d(d-15)、产后0 d(d0)和15 d(d15)的血液,测定生产性能、血液指标及炎症因子基因表达。预试验1周,正式试验4周。结果发现,Res处理不显著影响母羊采食量、羔羊出生体重、体尺和日增重,分娩前后母羊采食量变化显著(P=0.023),两组母羊分娩当日采食量最低。生化指标方面:Res处理显著影响d0的游离脂肪酸(NEFA)水平,时间因素与Res的交互作用显著(P<0.05);Res处理对总胆固醇(TC)有影响趋势(P=0.093);Res处理不显著影响甘油三酯水平(TG),但分娩前后两组TG显著变化(P=0.002);Res处理不显著影响高密度脂蛋白(HDL)水平,但Res和时间的交互作用有影响趋势(P=0.055);而低密度脂蛋白(LDL)和葡萄糖(Glu)均无显著变化(P>0.05)。抗氧化指标方面:Res处理提高d15的超氧化物歧化酶(SOD)活性(P<0.05);Res处理对总抗氧化能力(T-AOC)水平有影响趋势(P=0.078);而谷胱甘肽过氧化物酶(GSH-Px)及丙二醛(MDA)含量无显著差异(P>0.05)。免疫指标方面:Res处理显著影响d0的免疫球蛋白A(IgA)(P<0.05)及d0和d15的免疫球蛋白M(IgM)含量(P<0.05),但试验期间免疫球蛋白G(IgG)含量无显著变化(P>0.05)。Res处理产后15 d的TNFα及干扰素γ(IFNγ)表达量显著降低(P<0.05),但Nrf2、HO-1、IL-1和IL-6无显著变化(P>0.05)。日粮添加白藜芦醇能影响围产期母羊血液游离脂肪酸水平,并在一定程度上增强母羊的抗氧化性能,降低炎症反应。

儿童抽动障碍围产期危险因素的Scoping分析

目的探讨导致儿童抽动障碍的围产期危险因素。方法对中国知网、万方数字化期刊全文数据库、PubMed和Web of Science建库至2023年3月20日的学位、期刊、会议论文进行检索,筛选出与儿童抽动障碍的围产期危险因素相关的文献,提取作者、年份、国家、研究对象、患者年龄、样本量、纳入时间、研究设计、诊断标准和危险因素进行分析。结果共检索文献307篇,其中中文85篇,英文222篇,最终纳入25篇,来自于11个国家。数据多源于精神病学、儿科学、公共健康主题期刊。诊断标准包括美国精神障碍诊断与统计手册、耶鲁综合抽动严重程度量表、国际疾病分类和中国精神障碍分类与诊断标准。结论母体自身因素是诱发儿童抽动障碍的主要风险因素,家族遗传史、孕期患有身体或心理疾病、孕期营养不良、用药等均增加发病风险。宫内发育不良、分娩意外、新生儿疾病或家庭环境不和谐也容易增加儿童抽动障碍的发病风险。

围产期抑郁障碍产妇妊娠晚期社会心理因素调查分析及预测模型构建

目的调查分析围产期抑郁障碍(PDD)产妇妊娠晚期的社会心理因素,并构建PDD预测模型。方法选取88例确诊PDD的产妇纳入研究组,另按照1∶1的比例选取正常建档产检的健康产妇88例纳入对照组,收集2组产妇的一般资料和产前社会心理因素相关情况,进行单因素及多因素Logistic回归分析,构建产妇PDD预测模型并评估其预测效能。结果单因素及多因素Logistic回归分析结果显示,妊娠年龄、经期情绪、不良妊娠史、产妇性别歧视、公婆性别歧视、收入满意情况、两系三代抑郁史均为产妇发生PDD的独立影响因素(P<0.05)。据此构建产妇PDD预测模型,模型方程为■,其中logit(P)=1.599×妊娠年龄+1.744×经期情绪不良+0.837×不良妊娠史+1.589×产妇性别歧视+0.820×公婆性别歧视+1.089×收入不满意+2.163×两系三代抑郁史-3.211。受试者工作特征曲线显示,该模型预测产妇PDD的曲线下面积为0.955,95%CI为0.907~0.998,灵敏度为0.964,特异度为0.731,此时最佳截断值为5.154。结论妊娠年龄、经期情绪、不良妊娠史、产妇性别歧视、公婆性别歧视、收入满意情况、两系三代抑郁史均为产妇发生PDD的独立影响因素,基于这些因素构建的预测模型对产妇PDD具有良好的预测效能,有助于PDD的早期防治。

围产期创伤后应激障碍影响因素及干预策略的研究进展

围产期创伤后应激障碍(PTSD)会对妇女的身心健康、母婴关系、胎儿及新生儿生长发育产生不利影响,尽早预防围产期PTSD的发生并为患有围产期PTSD的孕产妇提供有效的治疗措施具有重要意义。本文综述了围产期PTSD的影响因素以及针对性的干预策略,旨在为临床防治围产期PTSD提供参考依据。