目的:探索北方农村地区妇女孕期化肥暴露与其子代高出生体重(HBW)发生风险之间的关联。方法:在2007-2012年山西省平定县出生人口监测系统中妊娠时间≥37周、出生体重≥4000g的新生儿中随机选取296例新生儿作为HBW病例进行随访,并将病例...目的:探索北方农村地区妇女孕期化肥暴露与其子代高出生体重(HBW)发生风险之间的关联。方法:在2007-2012年山西省平定县出生人口监测系统中妊娠时间≥37周、出生体重≥4000g的新生儿中随机选取296例新生儿作为HBW病例进行随访,并将病例分为≥4000~<4200g HBW组(171例)和≥4200 g HBW组(125例);随机选择204例妊娠≥37周,出生体重≥2500~<4000 g的健康新生儿作为对照。根据妇女居住村庄村级化肥年施用量及妇女所在家庭化肥年施用量衡量妇女孕期化肥暴露。采用分层多因素Logistic回归分析探索妇女孕期化肥暴露与HBW发生风险的关联。结果:调整混杂因素后,≥4000~<4200 g HBW组孕期暴露于村级年化肥施用量≥100吨的妇女,生育HBW的风险是村级年化肥施用量<50吨妇女的2.46倍(95%CI 1.02~5.95);合并的HBW组病例对照的分层多因素logistic回归结果显示,调整了混杂因素后,孕期暴露于村级年化肥施用量≥100吨的妇女,生育HBW的风险是暴露于村级年化肥施用量<50吨妇女的2.16倍(95%CI 1.05~4.44)。结论:北方农村地区妇女孕期暴露于化肥施用可能是高出生体重的危险因素,建议妇女孕期尽量避免化肥施用暴露。展开更多
自1986年Barker等提出“成人疾病的官内起源学说(Fetal Origin of Adult Disease)”以来,对生命早期的生长发育与成人期疾病关系的研究在全世界范围内取得了长足的进展。胎儿宫内营养和发育状况与出生后的健康状况息息相关。出生体...自1986年Barker等提出“成人疾病的官内起源学说(Fetal Origin of Adult Disease)”以来,对生命早期的生长发育与成人期疾病关系的研究在全世界范围内取得了长足的进展。胎儿宫内营养和发育状况与出生后的健康状况息息相关。出生体重是反映宫内生长情况的重要的可测量指标,巨大儿可能是胎儿在母体内因某些诱因而体重过度增长的体现。展开更多
Objective: This prospective study sought to examine the outcomes of 79 consecutive first pregnancies ( > 20 weeks of gestation) in women following laparoscopic adjustable gastric banding (LAGB) for severe obesity. ...Objective: This prospective study sought to examine the outcomes of 79 consecutive first pregnancies ( > 20 weeks of gestation) in women following laparoscopic adjustable gastric banding (LAGB) for severe obesity. METHODS: The 79 women are from a cohort of 1,382 consecutive patients. The prospectively collected data from 79 first pregnancies has been compared with these patients’previous penultimate pregnancies (n = 40), obstetric histories from matched severely obese subjects (n = 79), and community outcomes. RESULTS: The mean maternal weight gain was 9.6 ±9.0 kg, compared with 14.4 ±9.7 kg for the 40 penultimate pregnancies of women in this group (P< .001). There was no difference in birth weights: 3,397 g compared with 3,350 g for preband pregnancies, and these were consistent with normal community birth weights. The incidence of pregnancy-induced hypertension (10%) and gestational diabetes (6.3%) were comparable with community levels (12%and 5.5%) and lower than the obese cohort (38%and 19%) and these patients’penultimate pregnancies (45%and 15%). Monitoring and, if necessary, band adjustments during pregnancy provided more favorable maternal weight outcomes (P = .027). Neonatal outcomes, including stillbirths, preterm deliveries, low birth weight, and high birth weight, were consistent with community values. One woman developed anemia during pregnancy. CONCLUSION: Pregnancy outcomes after LAGB are consistent with general community outcomes rather than outcomes from severely obese women. The adjustability of the LAGB assists in achieving these outcomes. Adjustability is appealing because it allows adaptation to the altered requirements of pregnancy.展开更多
文摘目的:探索北方农村地区妇女孕期化肥暴露与其子代高出生体重(HBW)发生风险之间的关联。方法:在2007-2012年山西省平定县出生人口监测系统中妊娠时间≥37周、出生体重≥4000g的新生儿中随机选取296例新生儿作为HBW病例进行随访,并将病例分为≥4000~<4200g HBW组(171例)和≥4200 g HBW组(125例);随机选择204例妊娠≥37周,出生体重≥2500~<4000 g的健康新生儿作为对照。根据妇女居住村庄村级化肥年施用量及妇女所在家庭化肥年施用量衡量妇女孕期化肥暴露。采用分层多因素Logistic回归分析探索妇女孕期化肥暴露与HBW发生风险的关联。结果:调整混杂因素后,≥4000~<4200 g HBW组孕期暴露于村级年化肥施用量≥100吨的妇女,生育HBW的风险是村级年化肥施用量<50吨妇女的2.46倍(95%CI 1.02~5.95);合并的HBW组病例对照的分层多因素logistic回归结果显示,调整了混杂因素后,孕期暴露于村级年化肥施用量≥100吨的妇女,生育HBW的风险是暴露于村级年化肥施用量<50吨妇女的2.16倍(95%CI 1.05~4.44)。结论:北方农村地区妇女孕期暴露于化肥施用可能是高出生体重的危险因素,建议妇女孕期尽量避免化肥施用暴露。
文摘自1986年Barker等提出“成人疾病的官内起源学说(Fetal Origin of Adult Disease)”以来,对生命早期的生长发育与成人期疾病关系的研究在全世界范围内取得了长足的进展。胎儿宫内营养和发育状况与出生后的健康状况息息相关。出生体重是反映宫内生长情况的重要的可测量指标,巨大儿可能是胎儿在母体内因某些诱因而体重过度增长的体现。
文摘Objective: This prospective study sought to examine the outcomes of 79 consecutive first pregnancies ( > 20 weeks of gestation) in women following laparoscopic adjustable gastric banding (LAGB) for severe obesity. METHODS: The 79 women are from a cohort of 1,382 consecutive patients. The prospectively collected data from 79 first pregnancies has been compared with these patients’previous penultimate pregnancies (n = 40), obstetric histories from matched severely obese subjects (n = 79), and community outcomes. RESULTS: The mean maternal weight gain was 9.6 ±9.0 kg, compared with 14.4 ±9.7 kg for the 40 penultimate pregnancies of women in this group (P< .001). There was no difference in birth weights: 3,397 g compared with 3,350 g for preband pregnancies, and these were consistent with normal community birth weights. The incidence of pregnancy-induced hypertension (10%) and gestational diabetes (6.3%) were comparable with community levels (12%and 5.5%) and lower than the obese cohort (38%and 19%) and these patients’penultimate pregnancies (45%and 15%). Monitoring and, if necessary, band adjustments during pregnancy provided more favorable maternal weight outcomes (P = .027). Neonatal outcomes, including stillbirths, preterm deliveries, low birth weight, and high birth weight, were consistent with community values. One woman developed anemia during pregnancy. CONCLUSION: Pregnancy outcomes after LAGB are consistent with general community outcomes rather than outcomes from severely obese women. The adjustability of the LAGB assists in achieving these outcomes. Adjustability is appealing because it allows adaptation to the altered requirements of pregnancy.