Process Capability Analysis of Delivering Neonatal Care with Normal Weight （Case Study of Neonatal Weight Data at a Maternity Clinic in Banjarmasin）

Statistical Quality Control （SQC） is used to analyze and monitor quality characteristic measurements of normal neonatal weight in a maternity clinic in Banjarmasin in this paper. The objective of this study is to assist medical practitioners in observing pregnant women to deliver their babies with normal weight. It is also assumed that pregnant women who delivered their babies in the clinic have been monitored during their nine-month pregnancy. Thus, they can manage their own pregnancy to deliver normal weight babies. The use of Statistical Process Control （SPC） tools, such as frequency histogram, probability plot, and the implementation of Shewhart, R, and S control charts as primary techniques, are presented to display the monitoring aspects of the process. In addition, Process Capability Analysis （PCA） is performed to ensure that the process outcomes are capable of meeting certain requirements or specifications. The Process Capability Ratio （PCR） for the process is also presented. This analysis is an essential part of an overall quality improvement program.

Role of relaxin in diastasis of the pubic symphysis peripartum

BACKGROUND Separation of the pubic symphysis can occur during the peripartum period.Relaxin(RLX)is a hormone primarily secreted by the corpus luteum that can mediate hemodynamic changes during pregnancy as well as loosen the pelvic ligaments.However,it is unknown whether RLX is associated with peripartum pubic symphysis separation and if the association is affected by other factors.AIM To study the association between RLX and peripartum pubic symphysis separation and evaluate other factors that might affect this association.METHODS We performed a cross-sectional study of pregnant women between April 2019 and January 2020.Baseline demographic characteristics,including gestational age,weight,neonatal weight,delivery mode and duration of the first and second stages of labor,were recorded.The clinical symptoms were used as a screening index during pregnancy,and the patients with pubic symphysis and inguinal pain were examined by color Doppler ultrasonography to determine whether there was pubic symphysis separation.Serum RLX concentrations were evaluated 1 d after delivery using an enzyme-linked immunosorbent assay,and pubic symphysis separation was diagnosed based on postpartum X-ray examination.We used an independent-sample t test to analyze the association between serum RLX levels and peripartum pubic symphysis separation.Multivariate regression analysis was used to evaluate whether the association between RLX and peripartum pubic symphysis separation was confounded by other factors,and the association between RLX and the severity of pubic symphysis separation was also assessed.We used Pearson correlation analysis to determine the factors related to RLX levels as well as the correlation between the degree of pubic symphysis separation and activities of daily living(ADL)and pain.RESULTS A total of 54 women were enrolled in the study,with 15 exhibiting(observational group)and 39 not exhibiting(control group)peripartum pubic symphysis separation.There were no statistically significant differences in terms of maternal age,gestational age,pre-pregnancy weight,weight gain during pregnancy,delivery modes,or duration of the first or second stages of labor between the 2 groups.We did,however,note a statistically significant difference in serum RLX concentrations and neonatal weight between the observational and control groups(122.3±0.7μg/mL vs 170.4±42.3μg/mL,P<0.05;3676.000±521.725 g vs 3379.487±402.420 g,P<0.05,respectively).Multivariate regression analyses showed that serum RLX level[odds ratio(OR):1.022)and neonatal weight(OR:1.002)were associated with pubic symphysis separation peripartum.The degree of separation of the pubic symphysis was negatively correlated with ADL and positively correlated with pain.There was no statistically significant association between serum RLX levels and the severity of pubic symphysis separation after adjusting for confounding factors.CONCLUSION Serum RLX levels and neonatal weight were associated with the occurrence,but not the severity,of peripartum pubic symphysis separation.

Effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight

To evaluate the effects of maternal pre-pregnancy body mass index （pre-BMI） and gestational weight gain （GWG） on neonatal birth weight （NBW） in the population of Chinese healthy pregnant women, attempting to guide weight control in pregnancy. A retrospective cohort study of 3772 Chinese women was conducted. The population was stratified by maternal pre-BMI categories as underweight （〈18.5 kg/m2）, normal weight （18.5-23.9 kg/m2）, overweight （24.0-27.9 kg/m2）, and obesity （〉28.0 kg/m2）. The NBW differences were tested among the four groups, and then deeper associations among maternal pre-BMI, GWG, and NBW were investigated by multivariate analysis. NBW increased significantly with the increase of maternal pre-BMI level （P〈0.05）, except overweight to obesity （P〉0.05）. The multivariate analysis showed that both pre-BMI and GWG were positively correlated with NBW （P〈0.05）. Compared with normal pre-BMI, underweight predicted an increased odds ratio of small-for-gestational-age （SGA） and decreased odds ratio for macrosomia and large-for-gestational-age （LGA）, and the results were opposite for overweight. With the increase of GWG, the risk of SGA decreased and the risks of macrosomia and LGA increased. In addition, in different pre-BMI categories, the effects of weight gain in the first trimester on NBW were different （P〈0.05）. NBW is positively affected by both maternal pre-BMI and GWG, extreme pre-BMI and GWG are both associated with increased risks of abnormal birth weight, and maternal pre-BMI may modify the effect of weight gain in each trimester on NBW. A valid GWG guideline for Chinese women is an urgent requirement, whereas existing recommendations seem to be not very suitable for the Chinese.