Neonatal Infection among Women with Prior Premature Labor

Objectives: Since studies demonstrate that neonates born to mothers having been cared for premature labor will suffer from congenital neonatal sepsis, we aimed to evaluate the prevalence and main risk factors of neonatal infection among mothers having experienced a prior premature labor. Methods: This was a cross sectional study carried out from January 1st throughout 31st December, 2013 at the university clinics of Kinshasa. It concerned all delivered women at term having been cared for premature labor prior to giving birth a live newborn. Maternal variables of interest were: parity, gestation, age, intrapartum fever, malaria, urogenital infection during the last 2 weeks before delivery (UGI), premature rupture of membranes (PROM), cervical cerclage, meconium-stained amniotic fluid (MSAF) and the way of delivery. For neonates attention was paid on gestational age, birth weight, admission at neonatal intensive care unit (ANICU) and infection as stated within three days after birth. T-test and Chi-square were used where appropriate. Logistic analysis was used to determine the risk for maternal variables to induce neonatal infection (OR and CI), the significance stated at p < 0.05. Results: Fifty two mother-infant couples were recruited. Of these 19 neonates were infected (prevalence of 36.5%). Mean age, gestational age and birth weight were 30.19 ± 5.32 years, 37.2 ± 2 weeks and 2638 ± 588 g, respectively. Infected neonates had their gestational age and birth weight significantly lower whilst proportion of ANICU higher than that on non infected. Prematurity, PROM, UGI, prior cerclage and MSAF were significantly more frequent in couples with neonatal infection. Prematurity, birth weight <2500 g and UGI were found to enhance the risk by 3 to 4 times. Conclusion: The prevalence of neonatal infection was very high. Prematurity, birth weight <2500 g and maternal UGI were found to enhance the risk by 3 to 4 times.

Terminal Pregnancy Complicated by Measles and Premature Labor:a Case Report

Measles infection in pregnant women is a very dangerous clinical condition.Patients usually had complicated pneumonia,and virus could pass through the placenta to the fetus and lead to premature delivery,stillbirth,miscarriage and neonatal measles.In this report,one such case,which was diagnosed by clinical signs and symptoms,clinical and laboratory examination was described.After proper therapeutic treatment,the infection was well-controlled and a baby was born by nature labor.

Prevention and not merely prediction of preterm labor and delivery

Different methods have been proposed to screen forpreterm labor and delivery; most of these aim to predict the risk that preterm delivery is going to take place.However, interesting though this knowledge might be,knowing the future is of no use when no changes canbe made. Recent publications have suggested new andexciting modalities to actually diminish the frequencyof preterm birth in patients selected by transvaginalcervical length measurement; these modalities includevaginal progesterone and vaginal pessaries. Althoughpromising, many questions remain to be answered; notleast about the long term outcome for both neonatesand mothers, but also on the eventual introduction ofsuch strategies to the general obstetric population. Oneof the main problems that urgently needs clarificationis how we are going to offer this best of medicine tothose needing it most: deprived and socially isolatedwomen who have the highest risk for preterm laborand delivery, probably not due to any congenital cervical problems, but to a combination of environmental,microbiological and social factors, including transgenerational poverty and deprivation.

Co-Morbidities Associated with Prematurity in Two Referral Hospitals in Cameroon

Introduction: Prematurity is the leading cause of neonatal death in Africa. More than a million children die each year due to co-morbidities related to prematurity. In addition to being one of the causes of neonatal deaths, the health problems associated with prematurity can also lead to severe lifelong impairment in those who survive. Objectives: This paper aims to determine the epidemiology and identify co-morbidities of prematurity in the neonatology units of the Douala General Hospital (DGH) and the Laquintinie Hospital of Douala (LHD). Patients and Methodology: We conducted an analytical retrospective cohort study from January 2015 to January 2018 in the neonatology department of the GDH and the LHD, which are considered reference hospitals for the management of preterm babies in Cameroon. We included all newborns aged less than 37 weeks admitted to the neonatology units of the GDH and the LHD. The descriptive component was based on the analysis of quantitative variables using measures of central tendency. The analytical component was evaluated using Spearman correlations and the Chi-square and Fisher tests. Simple and multiple logistic regressions measured factors predictive of mortality. The Kaplan Meier survival curve used the Log Rank test and significance at p ≤ 0.05. Results: We recorded 908 preterm newborns in neonatal service and 1,124 preterm deliveries in maternity, representing an incidence of 32.5% in neonatal unit and 10.6% in maternity. 51% of whom were girls, given a sex ratio M/F of 0.9. Hypertension was the main prenatal pathology (9.1%), while premature rupture of membranes: PROM (35.5%) and eclampsia/pre-eclampsia (18.6%) were the most common obstetrical pathologies. 75.9% of deliveries were vaginal with 65.2% being performed in our referral hospitals. Gestational age ranged from 22 to 36 weeks, with a mean of 32.4 weeks. Late preterm birth rate was 53.7%, and birth weight varied between 590 and 3200 g with an average of 1747 ± 479 g. The percentage of low birth weight (1500 - 2499 g) preterm infants was predominant (65.3%), and the intrauterine growth restriction (IUGR) was estimated to be 12.4%. The majority (96.7%) had pathologies in the neonatal period, the most common being neonatal infection (86.9%). The case-fatality rate was 27.4%, compared to 72.6% live births. Factors influencing mortality are risk of premature labour, gestational age ≤ 32 SA, premature birth in hospitals other than our two referral hospitals, birth weight ≤ 1500 g, Apgar at the 10th minute, late secondary anaemia, hospital resuscitation, oxygen therapy, and duration of hospitalization Conclusion: The incidence of prematurity and the mortality rate remains high in neonatal units in Cameroon. Adequate monitoring of pregnancies and management of preterm infants remains a challenge in our context.

Factors of Fetal Origin in the Regulation of Labor Initiation and Preterm Birth

Preterm birth is the leading cause of mortality and morbidity in newborns and children under 5 years-of-age.In order to improve the survival rate and quality of preterm infants,there is critical need to identify the specific mechanisms underlying the initiation of labor.Pregnancy represents a period of constant interactive dialog between mother and fetus.A disturbance in the pattern of maternal-fetal communication can induce physiological or pathological labor.Although a number of studies have investigated the contributions of maternal factors to the initiation of labor,the concept that fetal organ development and maternal adaptation are coordinated has emerged over recent years,thus emphasizing that factors of fetal origin may serve as hormonal signals for the initiation of labor.In this review,we summarize and discuss several specific mechanisms by which factors of fetal origin may influence parturition during term or preterm labor,including the specific regulation of fetal organs,including the lungs and accessory organs during pregnancy.Future research may focus on the specific pathways by which signals from the fetal lungs and other fetal organs interact with the maternal system to initiate eventual labor.

New insights on premature ejaculation： a review of ：lefinition, classification, prevalence and treatmeni

There are ongoing debates about the definition, classification and prevalence of premature ejaculation （PE）. The first evidence-based definition of PE was limited to heterosexual men with lifelong PE who engage in vaginal intercourse. Unfortunately, many patients with the complaint of PE do not meet these criteria. However, these men can be diagnosed as one of the PE subtypes, namely acquired PE, natural variable PE or premature-like ejaculatory dysfunction. Nevertheless, the validity of these subtypes has not yet been supported by evidence. The absence of a universally accepted PE definition and lack of standards for data acquisition have resulted in prevalence studies that have reported conflicting rates. The very high prevalence of 20%-30% is probably due to the vague terminology used in the definitions at the time when such surveys were conducted. Although many men may complain of PE when questioned for a population-based prevalence study, only a few of them will actively seek treatment for their complaint, even though most of these patients would define symptoms congruent with PE. The complaints of acquired PE patients may be more severe, whereas complaints of patients experiencing premature-like ejaculatory dysfunction seem to be least severe among men with various forms of PE. Although numerous treatment modalities have been proposed for management of PE, only antidepressants and topical anaesthetic creams have currently been proven to be effective. However, as none of the treatment modalities have been approved by the regulatory agencies, further studies must be carried to develop a beneficial treatment strategy for PE.

Prevalence of premature ejaculation in young and middle-aged men in Korea： a multicenter intemet-based survey from the Korean Andrological Society

In this study, we aimed to investigate the prevalence and perception of premature ejaculation （PE） in young and middle-aged Korean men. The study was conducted using an Internet-assisted questionnaire. A total of 2 037 Korean male adults, aged 20 years or older, were randomly sampled based on age and residency. The questionnaire developed by the PE Study Group of the Korean Andrological Society includes four categories （overall sexual function, symptoms, distress and treatment） with a total of 16 questions. For each question, symptoms were evaluated by a scale ranging from 0 to 10. Intravaginal ejaculation latency time was ‘5-10 min＇ in 38.6%, followed by ‘longer than 10 min＇ in 2919%, ‘2-5 min＇ in 23.6%, ‘1-2 min＇ in 5.4% and ‘shorter than 1 min＇ in 2.5%. In our series, 27.5% of respondents reported having PE. Control over ejaculation within a recent 3-month period was 6.2 points on average. Respondent complaints of PE-related stress averaged 7.1 points and stress-related complaints from sexual partners averaged 7.1 points. The effect of PE on sexual life was 6.8 points. Of the respondents determined as having PE, 42.6% responded that they were inclined to receive treatment. Results from this study suggest that the prevalence of PE diagnosed by the respondent on his own was approximately 27.5% in young and middle-aged men in Korea. PE-related stress had a significant effect on the stress, sexual activity and quality of life of the respondent and his sexual partner.

Epidemiology of Sexual dysfunction in Asia compared to the rest of the world

There have been a limited number of epidemiological studies published on sexual disorders in persons from Asia. This paper aims to assess the reports of sexual dysfunction epidemiological studies published in the English language that involved Asian countries. Key points are summarized in this paper from nine epidemiological papers on sexual dysfunction from Asia that were published in the English language. Seven met the criteria for evidence-based studies reaching a Prins score of at least 10 or more. Papers included in this report came from national and regional representative studies in peer review journals. These results for sexual dysfunction in the nine papers are summarized for various sexual dysfunctions in men and women in Asian countries. In three of these, worldwide data were presented in the same paper allowing comparisons with Asian data on prevalence rates. Detailed descriptions from each of these studies are presented in paragraph form. More detailed data on erectile dysfunction （ED） is presented in a tabular form. Collectively, there seems to be a need for country- and population-specific further descriptive and analytical epidemiological studies in all of the sexual disorders from Asia. This critical review paper should help guide these studies for reachinj[ evidence-based literature standards.

子宫肌瘤孕妇发生妊娠期肌瘤性疼痛综合征的影响因素及对妊娠结局影响

目的分析子宫肌瘤孕妇发生妊娠期肌瘤性疼痛综合征的影响因素及对妊娠结局影响。方法395例子宫肌瘤孕妇根据是否出现妊娠期肌瘤性疼痛综合征分为病例组(74例)和对照组(321例),采用单因素分析法及多因素Logistic回归分析法分析子宫肌瘤孕妇发生妊娠期肌瘤性疼痛综合征的影响因素,另比较两组妊娠结局。结果年龄是发生妊娠期肌瘤性疼痛综合征的影响因素,年龄每减小1岁,妊娠期肌瘤性疼痛综合征的风险增加0.911倍(OR=0.911,95%CI 0.852~0.973,P=0.006)。病例组产后出血占22.38%、先兆早产占23.44%,对照组产后出血占35.69%、先兆早产占8.39%,两组产后出血、先兆早产发生率比较,P均<0.05。结论子宫肌瘤孕妇发生妊娠期肌瘤性疼痛综合征的影响因素是年龄,肌瘤性疼痛综合征增加先兆早产的发生风险。

中国劳动力流动健康效应及作用机制研究

2020年“七普”数据显示中国流动人口3.76亿人,“流动中国”格局已然形成。健康影响着劳动力流动决策,流动对劳动力健康也产生广泛影响。一方面,流动者面临更大的健康风险,在流入地生活和工作环境较差、社会融入感不强,其健康问题值得关注;另一方面,流动者从低效率产业向高效率产业、从低收入就业岗位向高收入就业岗位转移,增进了个人资源积累,可以对健康资本进行更多投资。中国劳动力发生流动行为后的健康水平是否得到改善?引起流动者健康改善的发生机制是什么?劳动力短期和长期流动是否存在传统的“流行病学悖论”?为回答这些问题,本研究基于Grossman健康需求模型构建包括收入、流动决策和健康的理论分析框架,解析劳动力流动行为与健康效应的关系。理论分析表明如果流动者的健康投入效应大于其他产品投入带来的潜在负向效应,则劳动力流动行为对健康效应具有正向影响。基于此,本研究进一步采用CFPS2014-2018年面板数据和有序Probit模型实证检验我国劳动力流动的健康效应和作用机制。实证研究发现劳动力流动有着显著的健康促进效应,在剔除劳动力自我选择效应后结果依然稳健;分异估计表明具有农业户籍、流入高收入地区和优质医疗资源集聚区,劳动力流动的健康促进效应更为明显;机制分析发现影响流动劳动力健康效应的主要机制是收入水平、社会资本以及在流入地获得的医疗资源;动态分析表明劳动力流动虽然存在短期“流行病学悖论”现象,但劳动力流动长期健康效应依然显著为正。这表明持续推动劳动力有序流动或许是一种改进国民健康水平的有效方式。因此,应增加那些处于社会中下层地位的劳动力社会流动的机会,进而改善他们的健康状况。同时,促进流动劳动力与本地居民的深度融合,提升流动劳动力医疗服务需求的平等程度和满足程度,赋予其与本地劳动力同等的参与权和保障权,通过恰当的就业政策和收入政策激励用人单位提升流动劳动力的收入水平和社会地位,从而稳定和提升他们的健康水平以及城市适应性。

间苯三酚与阿托西班在先兆早产治疗中的临床效果对比分析

目的比较分析间苯三酚与阿托西班治疗先兆早产的临床效果。方法筛选2021年1月至2023年3月上饶市妇幼保健院住院的82例先兆早产孕妇作为研究对象,随机数字表法分A组和B组,各41例。在常规治疗的基础上,A组采用间苯三酚治疗;B组采用阿托西班治疗。比较A、B两组患者用药后的药物起效时间,延长妊娠时间,临床效果,保胎成功率,性激素水平(孕酮、雌三醇),新生儿状态(体质量、头围、身长、Apgar评分)及用药不良反应。结果治疗后,A组患者的药物起效时间较B组相比更快,差异有统计学意义(P<0.05);A组延长妊娠时间较B组更短,差异有统计学意义(P<0.05);A组用药后的临床有效率与B组的临床有效率相比较低,差异有统计学意义(P<0.05);A组保胎成功率与B组相比较低,差异有统计学意义(P<0.05);A组用药后孕酮较B组低,雌三醇较B组高,差异有统计学意义(P<0.05);A组新生儿的体质量、头围、身长、Apgar评分与B组新生儿相比略低,但差异无统计学意义(P>0.05)。比较两组用药后不良反应发生率,A组略低于B组,但差异无统计学意义(P>0.05)。结论在治疗先兆早产时,阿托西班的药物起效时间相较于间苯三酚稍慢,但妊娠延长时间相较于间苯三酚更长,且阿托西班治疗先兆早产后的临床有效率、保胎成功率及改善患者性激素水平的作用与间苯三酚相比更好,故针对治疗先兆早产的患者应优先选用阿托西班。

Preterm Labor,a Syndrome Attributed to the Combination of External and Internal Factors

Preterm labor(before 37 weeks’gestation)is the leading cause of neonatal mortality and morbidity,which can be divided into iatrogenic preterm labor,infectious preterm labor,and spontaneous preterm labor(sPTL).Up to now,there continue to be great difficulties in prediction and prevention of sPTL,owing to multiple risk factors,pathogenesis,and pathologic processes contributing to the event,which have not been fully clarified.Pregnancy maintenance and parturition is a complicated process with continuous maternal-fetal dialogue,in which both maternal and fetal factors participate and affect the outcome of pregnancy,including sPTL.Besides,external factors can also participate in sPTL,individually or through the interaction with internal factors.In this article,we summarize recent studies regarding sPTL from our and other groups,and discuss the risk factors and pathogenesis of preterm birth from both external and internal(maternal and fetal)aspects,so as to provide theoretical evidences for the diagnosis,prevention,and treatment of sPTL in the future.

孕妇宫颈分泌物中胎盘α1-微球蛋白、胎儿纤维连接蛋白水平预测自发性早产价值

目的:探究宫颈分泌物中胎盘α1-微球蛋白(PAMG-1)和胎儿纤维连接蛋白(fFN)水平对自发性早产的预测价值。方法:收集2021年4月-2023年4月本院收治的128例发生自发性早产患者临床资料纳入早产组,同期产前检查并足月分娩的正常孕妇128例临床资料纳入正常组。比较两组临床资料,宫颈分泌物PAMG-1、fFN水平;采用受试者工作曲线(ROC)分析PAMG-1、fFN对孕妇发生自发性早产的预测价值。结果:PAMG-1、fFN对孕妇发生自发性早产的预测准确性分别为68.0%和67.6%、阳性预测值分别为76.1%和73.2%、阴性预测值分别为63.7%和64.2%,2项联合预测的准确性(69.9%)和阳性预测值(79.3%)提高(P<0.05);经ROC曲线分析,PAMG-1、fFN预测孕妇发生自发性早产的曲线下面积分别为0.680和0.679,灵敏度分别为52.3%、55.5%,特异度分别为83.6%、79.7%,2项联合预测的曲线下面积为0.699,灵敏度53.9%、特异度85.9%。结论:PAMG-1、fFN可作为孕妇发生自发生性早产的预测指标,且2项联合可提高预测效能。

Analysis of risk factors for retinopathy of prematurity

AIM: To analyze the incidence and risk factors for retinopathy of prematurity (ROP). METHODS: A retrospective analysis was conducted on 568 premature infants from September 2005 to December 2010 with birth weight (BW) equal to or less than 2 500g or a gestational age (GA) at birth of 34 weeks or less. All of the members were examined by indirect binocular ophthalmoscopy. RESULTS: ROP occurred with an incidence rate of 10.7% among 568 premature infants, and stages 3 and above ROP occurred with an incidence rate of 2.5%. This study showed the infants were more prone to develop ROP with short geststional age, low BW, long time of oxygen inhalation, and severe infants diseases. Twins had a significantly higher rate of ROP (18.3%) than singleton babies (9.8%), ROP were severer in twins than singleton babies. CONCLUSION: Short GA, low BW, long time of oxygen inhalation, severe infants diseases, and non-singleton babies were the most significant risk factors associated with ROP.

Twelve-year profile of screening results of retinopathy of prematurity at a tertiary care institute in Northwest China

AIM:To report the changes in detection rate and characteristics of retinopathy of prematurity(ROP)in infants,during a 12-year period in Northwest China.METHODS:The medical records of infants were retrospectively collected and reviewed using an established clinical database.The detection rate and severity of ROP were compared between two consecutive periods(P1:2008-2013,P2:2014-2019).Gender,gestational age(GA),birth weight(BW),multiple births,delivery pattern,and postmenstrual age of the first fundus screen were analyzed in all visiting infants.RESULTS:During the 12-year study period,7832 infants were initially included;among them,1266(16.16%)were diagnosed with ROP,441 of whom(5.63%)developed severe ROP.Throughout the study period,the total number of infants being screened showed a trend of slight fluctuation after a rapid increase;however,an annual increase was observed in the number of infants diagnosed with ROP and severe ROP.The proportion of each stage at the first screening of infants with ROP was stable.The detection rate of ROP increased from 2.33%in 2008 to 16.18%in 2010,decreased to 10.73%in 2014,and then increased to 27.47%in 2019.For severe ROP,the detection rate gradually increased from 0 in 2008 to 12.49%in 2019.Among the infants with ROP,96(7.58%)did not meet the screening criteria set by the Chinese Medical Association in 2014(GA<32wk,or BW<2000 g);among them,14(1.11%)needed treatment because of severe ROP.CONCLUSION:From 2008 to 2019,the detection rates of ROP and severe ROP in infants screened in Northwest China were 16.16%and 5.63%,respectively.The characteristics of the ROP infants were similar to those in other middle-income regions.The"tertiary prevention network of ROP"is a potentially effective screening approach.

Heterotopic pregnancy after assisted reproductive techniques with favorable outcome of the intrauterine pregnancy:A case report

BACKGROUND Heterotopic pregnancy(HP)is a rare condition in which both ectopic and intrauterine pregnancies occur.HP is uncommon after natural conception but has recently received more attention due to the widespread use of assisted reproductive techniques(ART)such as ovulation promotion therapy.CASE SUMMARY Here,we describe a case of HP that occurred after ART with concurrent tubal and intrauterine singleton pregnancies.This was treated successfully with surgery to preserve the intrauterine pregnancy,resulting in the birth of a low-weight premature infant.This case report aims to increase awareness of the possibility of HP during routine first-trimester ultrasound examinations,especially in pregnancies resulting from ART and even if multiple intrauterine pregnancies are present.CONCLUSION This case alerts us to the importance of comprehensive data collection during regular consultations.It is important for us to remind ourselves of the possibility of HP in all patients presenting after ART,especially in women with an established and stable intrauterine pregnancy that complain of constant abdominal discomfort and also in women with an unusually raised human chorionic gonadotropin level compared with simplex intrauterine pregnancy.This will allow symptomatic and timeous treatment of patients with better results.

足月胎膜早破孕妇不同时机引产对分娩方式及母婴结局的影响分析

目的分析足月胎膜早破孕妇不同时机引产对分娩方式及母婴结局的影响。方法70例足月胎膜早破孕妇,以随机数字表法分为观察组及对照组,每组35例。观察组选择破膜后2~12 h引产,对照组选择破膜12 h以后引产。比较两组孕妇分娩方式、不良分娩结局及新生儿不良结局发生情况、Apgar评分。结果观察组自然分娩比例高于对照组,剖宫产比例低于对照组,差异有统计学意义(P<0.05);两组产钳助产比例比较,差异无统计学意义(P>0.05)。观察组孕妇不良分娩结局发生率5.71%低于对照组的22.86%,差异有统计学意义(P<0.05)。观察组新生儿不良结局发生率2.86%低于对照组的20.00%,差异有统计学意义(P<0.05)。观察组新生儿心跳、呼吸、肤色、反射、肌肉张力评分分别为(1.44±0.42)、(1.45±0.34)、(1.53±0.30)、(1.65±0.42)、(1.22±0.58)分,均高于对照组的(1.07±0.31)、(1.02±0.27)、(1.11±0.16)、(1.05±0.22)、(0.94±0.42)分,差异有统计学意义(P<0.05)。结论针对足月胎膜早破孕妇需重视其引产时机选择,宜在短时间(2~12 h)内完成,可有效降低孕妇的剖宫产率,提高自然分娩率,同时改善母婴结局效果显著,可参考实施。

妊娠期糖尿病足月胎膜早破引产时机的探讨及其对母儿结局的影响

目的:探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)足月胎膜早破(premature rupture of membrane,PROM)孕妇不同引产时机对母儿结局的影响。方法:回顾性分析南京市妇幼保健院2017年6月—2021年7月,除GDM以外无其他合并症及并发症的足月胎膜早破催产素引产的孕妇585例,根据PROM距离启动催产素(oxytocin)引产的时间间隔(P-O)分为3组:A组(2~6 h),B组(6~9 h)和C组(9~12 h)。对3组病例的一般临床资料、母儿主要结局进行统计学分析。结果:(1)PROM距离分娩(delivery)的时间(P-D)随着引产启动时间(P-O)的延迟而增加(P_(趋势)<0.05),其中A组的P-D时间最短(P<0.05);(2)剖宫产、产间发热、绒毛膜羊膜炎、胎儿宫内窘迫的发生率会随着P-O的延长而升高(P_(趋势)<0.05),其中A组发生率最低(P<0.05);3组子宫收缩乏力、产后出血、产褥病率等发生率未见统计学差异;(3)3组产妇因子宫收缩乏力而剖宫产的发生率随着P-O的延迟而增加(P_(趋势)<0.05);(4)A组新生儿败血症的发病率、新生儿颅内出血的发生率显著低于C组(P<0.05)。结论:妊娠期糖尿病足月胎膜早破孕妇在无其他并发症且排除阴道分娩禁忌症情况下,选择2~6 h内催产素引产,既可以减少临床抗菌素的使用,也可以显著降低母儿不良结局的发生率。

自由体位待产对头位已衔接的足月胎膜早破初产妇产程及母婴结局的影响分析

目的:探究头位已衔接的足月胎膜早破初产妇不同待产体位对产程和母婴结局的影响。方法:回顾性分析南京市江宁医院2021年3月-2022年5月接收的189例头位已衔接足月胎膜早破初产妇,按照不同待产体位将其分为A组(n=92)和B组(n=97)。A组采用平卧位或侧卧臀高位至宫口全开,B组采用自由体位至宫口全开。比较两组产程、产后并发症发生率、子宫颈Bishop评分和Apgar评分。结果:B组各产程时间明显短于A组,产后并发症发生率显著低于A组,子宫颈Bishop评分、各时点Apgar评分均显著高于A组(P<0.05)。结论:对头位已衔接的足月胎膜早破初产妇采用自由体位待产,可促进子宫颈成熟,有效缩短产程,降低产后并发症发生率,并提高新生儿心搏速率、肌张力、反射等。

基于母婴健康队列的早产发生率及其影响因素

目的了解云南省曲靖市早产发生情况,并探讨其影响因素,为早期干预提供科学依据。方法以曲靖市妇幼保健院为依托,选取2020年9月1日至2021年10月31日符合纳入标准的孕产妇为研究对象,随访孕妇的基本情况及分娩结局,采用卡方检验、Logistic回归模型分析早产流行病学特征及其影响因素。结果7302名孕妇中发生早产477例,早产率为6.53%;其中晚期早产、中期早产、早期早产分别占77.15%、12.79%、10.06%。多因素分析结果显示,早产的危险因素有:文化程度低(即小学及以下、初中、高中)、孕次≥3次、产次≥3次、前置胎盘、双胎或多胎妊娠、有剖宫产史、有流产史、产检次数≤8次、妊娠期高血压、妊娠期糖尿病、胎膜早破、胎儿或子宫畸形(P值均<0.05)。结论早产的发生率较高,可能受孕妇的文化程度、孕期前置胎盘、双胎或多胎妊娠、产检次数、妊娠期高血压、妊娠期糖尿病、胎膜早破、胎儿或子宫畸形以及既往有剖宫产史、流产史等影响。应加强早期准确识别早产高危因素的能力,做到早发现、早预防、早治疗,减轻其带来的母胎影响,促进母婴健康。