Medical and non-medical expenses could be incurred during antenatal care, however, few studies about it in Beijing were found. Hence, this study assesses the cost of antenatal care in Beijing and explores it’s influencing factors, aiming to inform targeted strategies. A cross-sectional study was conducted in Beijing from October 14 to December 16, 2024. A cluster sampling technique was used to select subjects. Data were collected through an in-person questionnaire. The cost of antenatal care includes direct costs and indirect costs. The demographic characteristics were statistically described. Univariate analysis and quantile regression model were applied. A total of 253 pregnant women in Beijing were recruited in this study, and the cost of antenatal care was USD 2,198. The results of the univariate analysis showed statistically significant differences between antenatal cost and pregnant women’s age, family size, gravidity, parity, pregnancy complication, whether or not to hire caregivers, whether the caregiver missed work or not and outpatient visits times (P < 0.05). The results of the quantile regression modeling showed that age, pregnancy complications, whether or not to hire caregivers, whether the caregiver missed work or not, and outpatient visits times can affect the cost of antenatal care at one or more quantiles (P < 0.05). There are high proportion of direct medical costs. It is suggested that reducing the lost wages of pregnant women and caregivers by increasing leaves for them, and controlling complications to alleviate the financial burden of pregnancy.

Depression and anxiety are common in adolescence girls. This study aims to examine the prevalence and risk factors associated with depressive and anxiety symptoms in Chinese adolescent girls. A cross-sectional study was conducted in six provinces in the eastern, central, and western regions of China. A total of 4,658 adolescence girls aged 10-19 years old was included in this study. Depressive and anxiety symptoms were assessed by the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorders-7(GAD-7), respectively. Logistic regression models were used to estimate the effects of sociodemographic, academic pressure, physical/mental violence, interpersonal relationship, and lifestyle on depressive and anxiety symptoms. In our study, the prevalence rates of depressive and anxiety symptoms were 6.0% (279/4658) and 2.6% (122/4658), respectively. The multivariable logistic regression models show that risk factors including education level of junior high school and above, suffering from physical/mental violence, having academic pressure, having poor interpersonal relationship problems significantly increase the risk of both depressive and anxiety symptoms (P < 0.05), while additionally shorter night time sleep duration significantly increases the risk of depression symptoms (OR = 1.46. 95%CI:1.08-1.97, P = 0.01). The prevalence of depressive and anxiety symptoms are 6.0% and 2.6%, respectively among Chinese adolescent girls, with certain sociodemographic, academic pressure, and interpersonal relationship problem being the risk factors of depressive and anxiety symptoms.

OBJECTIVE:This study aimed to examine the association between severity of menopausal symptoms and cardiovascular disease (CVD) risk among middle-aged Chinese women. METHODS:A cross-sectional study recruited 9679 women aged 40-70 years from three socioeconomic regions of China in 2018. Menopausal symptoms were assessed by the modified Kupperman Menopausal Index (KMI). The severity of individual symptoms was classified as none (0 points), mild (1 points) and moderate-to-severe symptoms (2-3 points), and overall menopausal symptoms were classified as none (<15 points), mild (15-24 points) or moderate-to-severe (≥25 points) according to the sum score of the KMI. Logistic regression models were used to examine associations of the severity of menopausal symptoms with CVD risk. RESULTS:A total of 5.6% of participants reported being diagnosed with CVD. Overall menopausal symptoms were more common in women aged 60-70 years than in women aged 40-59 years. After multiple adjustment, mild (odds ratio [OR] = 2.07, 95% confidence interval [CI]: 1.64-2.61) and moderate-to-severe (OR = 2.64, 95% CI: 1.92-3.63) overall menopausal symptoms were associated with increased risk of CVD compared with no symptoms. Significant positive associations between the severity of individual menopausal symptoms and CVD risk were observed for all 13 items. CONCLUSION:The severity of menopausal symptoms was positively associated with CVD risk in middle-aged Chinese women.

Objectives To investigate the association of hypertension with depressive and anxiety disorders in middle-aged and older Chinese women, and to further assess whether the association was influenced by socioeconomic status (SES).Design Nationwide cross-sectional study.Setting Six provinces of the eastern, central and western regions of China.Participants Women aged 40–70 years were included by a multistage stratified random cluster sampling in 2018 (N=9900).Primary outcome measures Depressive and anxiety disorders were measured by the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, respectively. Logistic regression models were used to evaluate the OR and 95% CI for hypertension and the odds of depressive and anxiety disorders.Results 18.5% of participants reported having hypertension; 20.9% and 15.3% of women experienced depressive and anxiety disorders, respectively. After adjusting for potential confounders, women diagnosed with hypertension were more likely to have depressive (OR=1.27, 95% CI 1.11 to 1.45) and anxiety disorders (OR=1.48, 95% CI 1.28 to 1.71) than those without hypertension. Stratified analyses demonstrated that hypertension was significantly associated with higher odds of depressive disorders in women living in rural areas (OR=1.34, 95% CI 1.13 to 1.59), with lower levels of education (OR=1.28, 95% CI 1.12 to 1.46) and with average monthly household income <¥3000 (OR=1.33, 95% CI 1.12 to 1.59), while hypertension was significantly correlated with increased odds of anxiety disorders in women living in urban (OR=1.41, 95% CI 1.12 to 1.79) and rural areas (OR=1.53, 95% CI 1.27 to 1.84), with lower levels of education (OR=1.47, 95% CI 1.27 to 1.70), and with average monthly household income <¥3000 (OR=1.45, 95% CI 1.20 to 1.75) and ≥¥3000 (OR=1.49, 95% CI 1.18 to 1.86).Conclusions Hypertension was associated with increased odds of depressive and anxiety disorders among middle-aged and older women, especially in those with low SES. Effective strategies and actions for identification and management of hypertension and depressive and anxiety disorders are needed.

This study analyzed the anemia status and change trend of 219 835 pregnant women in eight provinces from 2016 to 2020 in the Maternal and Newborn Health Monitoring Program(MNHMP). The results showed that from 2016 to 2020, the anemia rate of pregnant women in eight provinces was 41.27%, and the rates of mild, moderate and severe anemia were 28.56%, 12.59% and 0.12% respectively; the anemia rates in eastern, central and western regions were 41.87%, 36.09% and 44.63% respectively, and the anemia rates in urban and rural areas were 39.87% and 42.23%. From 2016 to 2020, the anemia rate of pregnant women decreased from 44.93% to 38.22%, with an average annual decline of 3.86% (95% CI:-5.84%, -1.85%). The anemia rate among pregnant women of the eastern region (AAPC=-6.16%, 95% CI:-9.79%, -2.38%) fell faster than that among pregnant women of the central region (AAPC=0.71%, 95% CI:-6.59%, 8.57%) and western region (AAPC=-1.53%, 95% CI:-5.19%, 2.28%). From 2016 to 2020, the moderate anemia rate in pregnant women decreased from 14.98% to 10.74%, with an average annual decline of 8.72% (95% CI:-12.90%, -4.34%), with a statistically significant difference ( P<0.05); AAPC for mild and severe anemia in pregnant women was 1.56% (95% CI: 3.44%, 0.36%) and 18.86% (95% CI: 39.88%, 9.52%), respectively, without statistically significant difference ( P>0.05).

Abstract Background Depression and anxiety are common mental health problems for adolescence girls,. A number of previous studies have reported that depression and anxiety are influenced by multiple factorial. This study was to evaluate the influencing factors of depressive and anxiety symptoms in Chinese student girls aged 10–19 years old. Methods This study was cross-sectional research including 4,658 student girls aged 10–19 years old, which conducted in 2018 from the Chinese eastern, central and western regions. Using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorders-7 to assess depressive and anxiety symptoms. And using logistic regression models to estimated odds ratios (ORs) for depressive and anxiety symptoms about relation to sociodemographic, academic pressure, violence,interpersonal relationship problem and lifestyle. Results Among all girls, our study found that the prevalence rates of depressive and anxiety symptoms were 21.3% (990/4658)and 12.3% (573/4658), respectively. The logistic regression models showed that the risk factors of depressive symptoms were junior higher school and above, nighttime sleep duration ≤ 7 hours, no regular physical activity, drinking. And for anxiety symptoms, in addition to the above factors, smoking also had association with risk of anxiety symptoms. Conclusion Depressive and anxiety symptoms were common among Chinese adolescent girls, and sociodemographic, academic pressure, interpersonal relationship problem, and lifestyle have association with the risk of depressive and anxiety symptoms.

Abstract Background Allergic diseases are highly prevalent in the women of childbearing age. As we know, the immune system could change when pregnancy, which may affect the course of allergic diseases. Meanwhile, they also can affect the course and outcome of pregnancy. The data on incidence of allergies during pregnancy is lacking and conducting clinical trials in pregnant women was limited, therefore, we observed a prebirth cohort to supplement the relevant data and strengthen concerned research conductions. Objective We aim to obtain the incidence of allergies in urban pregnancy and explore the relevant factors of allergic diseases in urban pregnancy. Methods We design a multicenter and prospective cohort in 20 institutions above municipal level which were eligible according to the study design from 14 provinces covering all-side of China. This cohort was conducted from 13+6 weeks of gestation to 12 months postpartum and in our study, we chose the prenatal part to analyze. The outcome was developing allergies during pregnancy, which were diagnosed by clinicians according to the uniform criterion from National Health Commission. All the data was collected by electronic questionnaires through tablet computers. Results The incidence of allergic diseases in urban pregnant women was 21.0% (95%CI 20.0% ~ 22.0%). From social demography data, the history of allergies of pregnant women and their parents had statistical significance(p < 0.01); For exposure to living or working environment, house decoration for less than half a year, exposure to plush toys, disinfectants, insecticides, antihistamines, glucocorticoids, antipyretic analgesics, tocolytic agent and probiotics had statistical significance (all p < 0.05); For psychological status, self-rated depression and anxiety had statistical significance (p = 0.026;p = 0.006). Conclusion The incidence of allergic diseases in urban pregnant women was similar to the former study and kept a medium–high level. The history of allergies of pregnant women and their parents, house decoration time, exposure to plush toys, disinfectants, insecticides, antihistamines, glucocorticoids, antipyretic analgesics, tocolytic agents, probiotics, self-rated depression, and anxiety were relevant factors of allergic diseases during pregnancy.

孕产妇贫血是导致孕产妇死亡和不良妊娠结局的关键因素,目前在全球仍处于较高的流行水平.为降低孕产妇贫血患病率,提高母儿健康水平,各国政府先后出台了多项政策、策略措施,并提出了防控目标.但由于现有国内外很多研究中孕产妇贫血的诊断标准、研究对象等存在差异,导致孕产妇贫血患病率的范围较大,从而对我国制定政策及对现有策略措施的评价带来困扰.本研究对孕产妇贫血的诊断和流行状况进行综述,旨在为后续研究提供参考和新思路.

孕产妇死亡率和婴儿死亡率是国际上公认反映一个国家和地区国民健康水平和社会文明程度的综合指标.当前,我国母婴健康领域存在一系列挑战,如高龄孕妇增多,孕产妇并发症和合并症的增加,死胎/死产,早产、出生缺陷等新生儿疾病,孕产妇、胎儿及新生儿营养,孕产妇心理健康等问题突出.因此,需要与时俱进不断完善妇幼保健服务体系,依法依规推进母婴安全服务,落实预防为主的母婴安全措施,全面提升危重孕产妇救治能力,科学实施母婴安全效果评价.与此同时,加强具有中国特色的妇幼健康服务网络建设,优化服务流程,提升服务质量.

BACKGROUND:Primary human papillomavirus (HPV) screening is recommended for the detection of cervical intraepithelial neoplasia (CIN) in the general population; however, the triage for HPV-positive women remains a challenge. This study aimed to evaluate the age-specific effectiveness of primary HPV screening versus primary cytology screening for identifying optimal strategies for women of different ages. METHODS:The dataset of the prevalence round screening was derived from the National Cervical Cancer Screening Program in China. Primary cervical screening protocols included cytology only, HPV testing with cytology triage, and HPV testing with HPV-16/18 genotyping plus cytology triage. The primary outcomes were age-specific detection rate, colposcopy referral rate and positive predictive value (PPV) for CIN2+. Multivariate Poisson regression was used to evaluate the relative effectiveness of HPV testing and cytology according to age groups. The I2 statistic with a random-effect model was used to test the heterogeneity in relative effectiveness of HPV testing versus cytology between age groups. RESULTS:This study included 1,160,981 women. HPV testing with HPV-16/18 genotyping plus cytology triage significantly increased the CIN2+ detection by 36% (rate ratio [RR]: 1.36, 95% confidential interval [CI] 1.21-1.54) for women aged 35-44 years and by 34% (RR: 1.34, 95% CI 1.20-1.51) for women aged 45-54 years compared with cytology only. HPV testing with cytology triage had similar CIN2+ detection rate compared with cytology only. The PPVs were substantially increased for both HPV testing groups. Among women aged 55-64 years old, HPV testing with HPV-16/18 genotyping plus cytology triage increased the colposcopy referral rate by 19% (RR 1.19, 95% CI 1.10-1.29) compared with cytology only, but did not increase the CIN2+ detection (1.09, 0.91-1.30). The effectiveness of HPV testing with cytology triage did not change in older women. The between-age-group heterogeneity in the effectiveness was statistically significant for HPV testing with HPV-16/18 genotyping plus cytology triage versus cytology only. CONCLUSIONS:Our results suggested that the effectiveness of primary HPV screening with different triage strategies differed among age groups. HPV testing with HPV-16/18 genotyping plus cytology triage could be used for women aged 35-54 years to detect more lesions, and HPV testing with cytology triage could balance the CIN2+ detection and the number of colposcopies for women aged 55-64 years. Longitudinal data including both prevalence and incidence screening rounds are warranted to assess age-specific triage strategies.

Background Social media has become an important source of health information during the COVID-19 pandemic. Very little is known about the potential mental impact of social media use on pregnant women. Objective This study aims to examine the association between using social media for health information and risk perception for COVID-19, worry due to COVID-19, and depression among pregnant women in China. Methods A total of 4580 pregnant women were recruited from various provinces of China. The participants completed a cross-sectional, web-based survey in March 2020. Results More than one-third (1794/4580, 39.2%) of the participants reported always using social media for obtaining health information. Results of structural equation modeling showed that the frequency of social media use for health information was positively associated with perceived susceptibility (β=.05; P<.001) and perceived severity (β=.12; P<.001) of COVID-19, which, in turn, were positively associated with worry due to COVID-19 (β=.19 and β=.72, respectively; P<.001). Perceived susceptibility (β=.09; P<.001), perceived severity (β=.08; P<.001), and worry due to COVID-19 (β=.15; P<.001) all had a positive association with depression. Bootstrapping analysis showed that the indirect effects of frequency of social media use for health information on both worry due to COVID-19 (β=.09, 95% CI 0.07-0.12) and depression (β=.05, 95% CI 0.02-0.07) were statistically significant. Conclusions This study provides empirical evidence on how social media use for health information might have a negative impact on the mental health of pregnant women. Interventions are needed to equip this population with the skills to use social media properly and with caution.

Background The COVID-19 has caused significant toll over the globe. Pregnant women are at risk of infection. The present study examined the frequency of washing hands with soap and wearing face mask when going out, prevalence of depression and anxiety, and identified their associated factors among pregnant women during the early phase of COVID-19 outbreak in China. Methods A cross-sectional online survey was conducted between 24 February and 3 March 2020. A total of 15 428 pregnant women who were using maternal health care services in China completed a questionnaire which assessed their socio-demographic and pregnancy-related characteristics, contextual, cognitive and social factors related to COVID-19, frequency of washing hands and wearing face masks, and depression and anxiety. Logistics regression analyses were performed to identify the associated factors of preventive behaviours and mental health. Results The prevalence of probable anxiety and depression was 28.2% and 43.6% respectively. 19.8% reported always wearing face mask when going out, and 19.1% reported washing hands with soap for more than 10 times per day. Results from logistic regression analyses showed that older age was associated with lower levels of depression and anxiety ( OR = 0.42–0.67) and higher frequency of washing hands ( OR = 1.57–3.40). Higher level of education level was associated with probable depression ( OR = 1.31–1.45) and higher frequency of wearing face mask ( OR = 1.50–1.57). After adjusting for significant socio-demographic and pregnancy-related factors, place of residence being locked down (a OR = 1.10–1.11), being quarantined (a OR = 1.42–1.57), personally knowing someone being infected with COVID-19 (a OR = 1.80–1.92), perception that COVID-19 would pose long term physical harm to human (a OR = 1.25–1.28) were associated with higher levels of depression and anxiety, while the perception that the disease will be under control in the coming month was associated with lower levels of depression and anxiety (a OR = 0.59–0.63) and lower tendency of always wearing face mask (a OR = 0.85). Social support was associated with lower levels of depression and anxiety (a OR = 0.86–0,87) and higher frequency of washing hands (a OR = 1.06). Conclusions The mental health and preventive behaviours of pregnant women during COVID-19 outbreak was associated with a range of socio-demographic, pregnancy-related, contextual, cognitive and social factors. Interventions to mitigate their mental health problems and to promote preventive behaviours are highly warranted.

目的 通过对平顶山市2018年居民死亡特征分析,掌握主要死亡原因和顺位等,为政府制定相关政策提供参考依据.方法 采用描述流行病学方法分析死因监测系统中2018年平顶山市的死因监测数据.结果 2018年平顶山市居民粗死亡率596.37/10万,标化死亡率为509.60/10万,其中男性粗死亡率为682.09/10万,标化死亡率为639.04/10万,女性粗死亡率为504.45/10万,标化死亡率为386.37/10万.男性粗死亡率为女性的1.35倍,标化死亡率为女性的1.65倍.＜1岁组死亡率较高,1～＜5岁组迅速下降,之后随年龄升高死亡率逐渐升高,85岁及以上年龄组死亡率达最高.死因顺位前10位的疾病依次为:心脏病、脑血管疾病、恶性肿瘤、呼吸系统疾病、损伤及中毒、内分泌营养代谢痰病、消化系统疾病、神经系统疾病、泌尿生殖系统疾病、传染病,占全部死亡人数的95.21％(23016/24175);3大类疾病死因构成中慢性非传染性疾病占88.95％.结论 心脏病、脑血管病和恶性肿瘤等慢性非传染性疾病已成为平顶山市居民死亡的主要原因,应引起相关部门重视,从慢性病危险因素着手,动员各部门参与,以基层医疗机构为依托,以健康促进策略为导向,采取综合的慢性病防控措施,减少人群慢性病发生和死亡.

Background Mental health problems are prevalent among pregnant women, and it is expected that their mental health will worsen during the COVID-19 pandemic. Furthermore, the underutilization of mental health services among pregnant women has been widely documented. Objective We aimed to identify factors that are associated with pregnant women’s intentions to seek mental health services. We specifically assessed pregnant women who were at risk of mental health problems in mainland China. Methods A web-based survey was conducted from February to March, 2020 among 19,515 pregnant women who were recruited from maternal health care centers across various regions of China. A subsample of 6248 pregnant women with probable depression (ie, those with a score of ≥10 on the 9-item Patient Health Questionnaire) or anxiety (ie, those with a score of ≥5 on the 7-item General Anxiety Disorder Scale) was included in our analysis. Results More than half (3292/6248, 52.7%) of the participants reported that they did not need mental health services. Furthermore, 28.3% (1770/6248) of participants felt that they needed mental health services, but had no intentions of seeking help, and only 19% (1186/6248) felt that they needed mental health services and had intentions of seek help. The results from our multivariate logistic regression analysis showed that age, education level, and gestational age were factors of not seeking help. However, COVID-19–related lockdowns in participants’ cities of residence, social support during the COVID-19 pandemic, and trust in health care providers were protective factors of participants’ intentions to seek help from mental health services. Conclusions Interventions that promote seeking help for mental health problems among pregnant women should also promote social support from health care providers and trust between pregnant women and their care providers.

目的 了解儿童家长儿童保健知识知晓情况,分析知识知晓的影响因素,为进一步开展针对性健康教育提供依据.方法 选择在东部、中部和西部地区部分县/市妇幼保健机构儿童保健门诊接受健康体检的2975名儿童家长进行问卷调查.结果 调查地区儿童家长儿童保健知识知晓率为25.9％.城市儿童家长知识知晓率(32.6％)高于农村儿童家长(21.5％)(P<0.05).医护人员(59.1％)、母婴健康类APP(50.4％)、微信/百度(38.1％)是儿童家长获取健康教育知识最常见的途径.Logistic回归分析显示,儿童家长儿童保健知识知晓水平与调查者为孩子的父亲(OR=1.602,95％CI:1.196～2.145)、孩子的年龄是0～岁(OR=2.749,95％CI:2.183～3.461)和3～6岁(OR=1.923,95％CI:1.540～2.403)、汉族(OR=2.693,95％CI:2.128～3.409)、城市(OR=1.324,95％CI:1.085～1.615)、东部地区(OR=1.449,95％CI:1.151～1.824)、高中/中专(OR=1.496,95％CI:1.126～1.990)、大专及以上(OR=1.957,95％CI:1.521～2.519)、家庭平均月收入5001～10000元(OR=1.341,95％CI:1.080～1.665)、>10000元(OR=1.630,95％CI:1.258～2.112)以及多种途径获取知识(OR=3.876,95％CI:2.118～7.095)有关.结论 调查的2975名儿童家长儿童保健知识知晓水平较低,应针对不同地区人群特点开展多层次、多渠道的专业性的健康教育服务.

Background Randomized controlled trials have shown a higher sensitivity and longer negative predictive value of high-risk human papillomavirus (HPV) testing than cytology for cervical cancer screening; however, little is known about the effectiveness of HPV testing in middle-income countries. Understanding the characteristics of HPV testing may increase the priority of HPV testing in health policies. The study aims to evaluate the effectiveness of HPV testing in the national cervical cancer screening programme in China. Methods We performed a nationwide, population-based study using individual data from the national cervical cancer screening programme in rural China between 2015 and 2017. The analyses included 1,160,981 women aged 35–64 years who underwent cytology alone or high-risk HPV testing with cytology or genotyping triage. The main outcome was cervical intraepithelial neoplasia 2 or worse (CIN2+). We used multivariate logistic regressions and performed sensitivity analyses with propensity score matching to compare the screening positive, colposcopy referral, detection rate, and positive predictive value (PPV). Results The screening positive rates for HPV testing and cytology were 10.1% and 4.0%, respectively. The per protocol colposcopy referral rate of HPV testing was significantly lower than that of cytology (3.5% vs 4.0%), and this difference was mostly due to the low referral threshold of cytology (≥ASC-US). Overall, HPV testing detected more CIN2+ (5.5 vs. 4.4 per 1000, adjusted odds ratio [aOR]=1.18, 95% confidence interval 1.11–1.25) and had a higher PPV (13.8% vs 10.9%, aOR 1.29, 95% CI 1.21–1.37) than cytology. The colposcopy referrals of HPV testing in comparison to cytology differed by income status; it significantly increased in lower-middle-income areas (3.7% vs 3.1%, aOR 1.21, 95% CI 1.17–1.25) and significantly decreased in upper-middle-income areas (3.4% vs 4.9%, aOR 0.69, 95% CI 0.67–0.71). Sensitivity analyses demonstrated the reliability and robustness of the results. Conclusions The introduction of HPV testing could improve both the CIN2+ detection rate and efficiency of cervical cancer screening programme, supporting the introduction of primary screening with high-risk HPV testing in China. Further study is needed to investigate the long-term effect of this change.

目的 了解中国不同地区孕产妇健康知识知晓情况,分析孕产妇健康知识知晓的影响因素,为进一步开展针对性的健康教育提供依据.方法 于2019年12月-2020年5月,通过方便抽样方法,选择在东部、中部和西部地区部分县级妇幼保健机构进行产检或分娩的2 599名孕产妇,对其进行问卷调查.结果 调查地区孕产妇健康知识知晓率为31.36％.城市户籍孕产妇知晓率(34.41％)高于农村户籍(29.37％),东部地区孕产妇知晓率(41.57％)高于中部(28.08％)和西部(26.38％),不同地区和城乡之间差异均有统计学意义(均P＜0.05).医护人员咨询(66.67％)、新媒体(57.60％)是最常见的孕产妇获取健康知识的途径.logistic回归分析显示,年龄≥41岁、初产妇、高中及以上学历、通过多种途径获取知识以及居住于东部地区是影响孕产妇健康知识知晓的保护因素,经产妇、初中及以下学历、无业、通过单一途径获取知识、居住于中部和西部地区为孕产妇健康知识知晓的危险因素.结论 调查地区孕产妇健康知识知晓水平较低,孕产妇的年龄、生育情况、文化程度、职业、所在地区以及知识获取途径是其主要影响因素;应针对不同人群特点开展多层次、多渠道的专业性健康教育服务.

BACKGROUND COVID-19 is an emerging infectious disease that has created health care challenges worldwide. Pregnant women are particularly affected by this disease. OBJECTIVE The aims of this study are to assess the levels of perceived threat (susceptibility, severity, impact), negative emotions (fear, worry), and self-efficacy of pregnant women in China related to COVID-19 and to examine their associations with mental health (depression and anxiety) and personal protective behavior (wearing a face mask). METHODS A total of 4087 pregnant women from China completed a cross-sectional web-based survey between March 3 and 10, 2020. RESULTS The prevalence of probable depression and anxiety was 48.7% (1989/4087) and 33.0% (1347/4087), respectively; 23.8% participants (974/4087) reported always wearing a face mask when going out. Of the 4087 participants, 32.1% (1313) and 36.4% (1490) perceived themselves or their family members to be susceptible to COVID-19 infection, respectively; 3216-3518 (78.7%-86.1%) agreed the disease would have various severe consequences. Additionally, 2275 of the 4087 participants (55.7%) showed self-efficacy in protecting themselves from contracting COVID-19, and 2232 (54.6%) showed efficacy in protecting their family members; 1303 (31.9%) reported a high level of fear of the disease, and 2780-3056 (68.0%-74.8%) expressed worry about various aspects of COVID-19. The results of the multivariate multinominal logistic regression analyses showed that perceived severity, perceived impact, fear, and worry were risk factors for probable depression and anxiety, while self-efficacy was a protective factor. The results of the multivariate logistic regression analysis showed that perceived susceptibility was associated with always wearing a face mask. CONCLUSIONS Chinese pregnant women showed high levels of mental distress but low levels of personal protective behavior during the COVID-19 pandemic. Interventions are needed to promote the mental health and health behavior of pregnant women during the pandemic.

BACKGROUND: Although lockdown and mandatory quarantine have played crucial roles in the sharp decrease in the number of newly confirmed/suspected COVID-19 cases, concerns are raised over their threat to mental health especially among vulnerable groups including pregnant women. Few empirical studies have tested whether and how these control measures may affect mental health. No study investigated prevalence and impacts of utilizing eHealth among pregnant women during the outbreak. OBJECTIVE: This study investigated 1) the roles of lockdown and mandatory quarantine in affecting mental health problems (i.e., anxiety and depressive symptoms), 2) the potential mediation effects of perceived social support and maladaptive cognition, and 3) the moderation roles of eHealth-related factors (i.e., social media use for health information and means of utilizing prenatal care services during COVID-19) among pregnant women in China. METHODS: An online cross-sectional survey was conducted among 19,515 pregnant women from all 34 Chinese provincial-level administrative regions (24 February-10 March, 2020). RESULTS: Of the participants, 62.6% reported lockdown in the areas of residence and 3.8% were subjected to mandatory quarantine; 44.6% reported probable depression, 29.2% had probable anxiety, and 7.4% reported suicidal ideation. Only 3.3% of the participants reported using online prenatal care service during the outbreak. Significant socio-demographic/maternal variables of anxiety/depressive symptoms included age, education, occupation, area of residence, gestational duration, number of children born, complication during pregnancy, means of utilizing prenatal care services, and social media use for health information. Multiple Indicators Multiple Causes (MIMIC) modeling [χ2(df)=495.21(14), p<.05, CFI=.99, NNFI=.98, RMSEA=.04 (90%CI=.038, .045)] showed quarantine status was strongly associated with poor mental health status directly and indirectly through decreased perceived social support and increased maladaptive cognition (B=.04, s =.02, 95%CI=.01 to .02, p=.001), while lockdown was indirectly associated with mental health through increased social support and maladaptive cognition among pregnant women (B=.03, s=.03, 95%CI=.02 to .03, p=.001). Multi-group analyses revealed social media use for health information and means of utilizing prenatal care services were significant moderators of the model paths. CONCLUSIONS: The findings provide epidemiological evidence for the importance to integrate mental health care and eHealth into the planning and implementation of control measure policy. The observed social and cognitive mechanisms and moderators are modifiable, and can inform the design of evidence-based mental health promotion among pregnant women.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?:After menopause, women are prone to chronic diseases such as cardiovascular disease, diabetes and osteoporosis and gynecological diseases such as pelvic floor dysfunction and reproductive tract infection.WHAT IS ADDED BY THIS REPORT?:The prevalence of hypertension, diabetes, cardiovascular disease and osteoporosis increased with age, while the prevalence of vaginitis and cervicitis decreased with the increase of age. The proportions of women aged 50-70 years old suffering from chronic and gynecological diseases in western and rural areas were significantly higher than those in eastern, central and urban areas.WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?:It is necessary to take targeted intervention measures in the western region and rural areas, in order to narrow the gap in health of menopausal and older women between different areas of China.