What is already known about this topic?:In recent years, there has been a significant increase in the proportion of women of advanced maternal age (AMA), accompanied by a rise in adverse pregnancy outcomes in certain regions of China. What is added by this report?:From 2016 to 2022, there was an observed increase in the proportion of AMA, educational levels, and incidences of preterm birth and low birth weight (LBW) in both primiparous and multiparous women. Concurrently, there was a declining trend in the rate of cesarean deliveries and the incidence of macrosomia among multiparous women. What are the implications for public health practice?:In addition to focusing on health management for AMA individuals, proactive steps should be undertaken to enhance the quality of medical services and promote childbirth at optimal ages, thereby reducing the incidence of adverse pregnancy outcomes.

Antenatal care (ANC) plays a crucial role in ensuring maternal and child safety and reducing adverse delivery outcomes. This study aimed to analyze the association between the quality of ANC and the occurrence of preterm birth and low birth weight in a sample of the population from 16 regions in 8 provinces in China. Data from all closed cases of pregnant women and newborns reported in the Maternal and Child Health Monitoring System from January 1, 2018, to December 31, 2018, in 16 monitoring regions across 8 provinces in China were collected and included in the analysis, resulting in a total of 49,084 pregnant women and 49,026 newborns. The mean number of ANC visits was 6.95 ± 3.45. By percentage, 78.79

Abstract Objective To assess the prevalence of anemia among pregnant women across their entire pregnancy and the factors affecting it in the monitoring areas. Methods A total of 108,351 pregnant women who received antenatal health care and delivered from January 1, 2016 to December 31, 2020 in 15 monitoring counties of 8 provinces in the Maternal and Newborn Health Monitoring Program (MNHMP) of National Center for Women and Children’s Health (NCWCH) were selected as the study subjects. The anemia status among the subjects across their first, second and third trimester of pregnancy and the influencing factors were analyzed. Results From 2016 to 2020, the prevalence of anemia at any stage during pregnancy in the monitoring areas was 43.59%. The prevalence of anemia among pregnant women across all three trimesters was 3.95%, and the prevalence of mild and moderate-to-severe anemia was 1.04% and 2.90%, respectively. Protective factors were living in the northern area (OR = 0.395) and being a member of an ethnic minority (OR = 0.632). The risk factors were residing in rural areas (OR = 1.207), with no more than junior high school education (OR = 1.203), having ≥ 3 gravidities (OR = 1.195) and multiple fetuses (OR = 1.478). Conclusions Although the prevalence of anemia among pregnant women across all trimesters in the monitoring area was low, the severity of anemia was high. Since the prevalence of anemia among pregnant women across their entire pregnancy in the monitoring area is affected by many different factors, more attention should be paid to pregnant women living in rural areas, with low literacy, ≥ 3 gravidities and multiple fetuses for early intervention.

BACKGROUND:Heat exposure during pregnancy can increase the risk of preterm birth (PTB) through a range of potential mechanisms including pregnancy complications, hormone secretion and infections. However, current research mainly focuses on the effect of heat exposure on pathophysiological pathways of pregnant women, but ignore that maternal heat exposure can also cause physiological changes to the fetus, which will affect the risk of PTB. OBJECTIVE:In this study, we aimed to explore the mediating role of fetal heart rate (FHR) in the relationship between maternal heat exposure and PTB incidence. METHODS:We assigned heat exposure to a multi-center birth cohort in China during 2015-2018, which included all 162,407 singleton live births with several times FHR measurements during the second and third trimesters. We examined the associations between heat exposure, FHR and PTB in the entire pregnancy, each trimester and the last gestational month. The inverse odds ratio-weighted approach applied to the Cox regression was used to identify the mediation effect of heat exposure on PTB and its clinical subtypes via FHR. FINDINGS:Exposure to heat significantly increased the risk of PTB during the third trimester and the entire pregnancy, hazard ratios and 95 % CIs were 1.266 (1.161, 1.379) and 1.328 (1.218, 1.447). Heat exposure during the third trimester and entire pregnancy increased FHR in the third trimester by 0.24 bpm and 0.14 bpm. The proportion of heat exposure mediated by FHR elevation on PTB and its subtype ranged from 3.68 % to 24.06 %, with the significant mediation effect found for both medically indicated PTB and spontaneous PTB. CONCLUSIONS:This study suggests that heat exposure during pregnancy has an important impact on fetal health, and FHR, as a surrogate marker of fetal physiology, may mediate the increased risk of PTB caused by extreme heat. Monitoring and managing physiological changes in the fetus would constitute a promising avenue to reduce adverse birth outcomes associated with maternal heat exposure.

The purpose of this study was to investigate the effect of feeding patterns during the first 6 months on weight development of infants ages 0-12 months. Using monitoring data from the Maternal and Child Health Project conducted by the National Center for Women and Children's Health of the Chinese Center for Disease Control and Prevention from September 2015 to June 2019, we categorized feeding patterns during the first 6 months as exclusive breastfeeding, formula feeding, or mixed feeding. We calculated weight-for-age Z scores (WAZ) according to the World Health Organization's (WHO) 2006 Child Growth Standard using WHO Anthro version 3.2.2. A multilevel model was used to analyze the effect of feeding patterns during the first 6 months on the WAZ of infants ages 0-12 months in monitoring regions. Length of follow-up (age of infants) was assigned to level 1, and infants was assigned to level 2. Characteristics of infants, mothers, and families and region of the country were adjusted for in the model. The average weight of infants ages 0-12 months in our study (except the birth weights of boys who were formula fed or mixed fed) was greater than the WHO growth standard. After we adjusted for confounding factors, the multilevel model showed that the WAZ of exclusively breastfed and mixed-fed infants were statistically significantly higher than those of formula-fed infants (coefficients = 0.329 and 0.159, respectively; P < 0.05), and there was a negative interaction between feeding patterns and age (both coefficients = - 0.020; P < 0.05). Infants who were exclusively breastfed were heavier than formula-fed infants from birth until 12 months of age. Mixed-fed infants were heavier than formula-fed infants before 8 months, after which the latter overtook the former. Infants' weight development may be influenced by feeding patterns during the first 6 months. Exclusive breastfeeding during the first 6 months may be beneficial for weight development of infants in infancy.

Background: Previous epidemiological findings on extreme temperature and preterm birth (PTB) were heterogeneous, especially for extreme cold exposure. Measured and unmeasured individual-level factors such as genetic factors or lifecourse exposures may constitute important contributors but have not been addressed.Objectives: We aimed to examine the association of gestational heat and cold exposure with PTB using a novel sibling -matched study. Methods: Based on a multi-center population-based birth cohort across 16 counties in China, we included 10,826 sib-ling pairs born from March 2013 to December 2018. Conditional logistic and Cox Proportional Hazard regression models were used to estimate the effects of heat and cold exposure on PTB in each trimester, one and four weeks before delivery and the entire pregnancy. We also tested the heterogeneity in the association of temperature with PTB be-tween siblings.Findings: Exposure to heat during the third trimester and the entire pregnancy increased the risk of PTB. For heat (> 90th) defined with mean temperature, the odds ratios were 2.32 (1.63, 3.30) and 3.19 (2.22, 4.58), respectively. Cold exposure (< 10th) during the first, the third, and the entire pregnancy was associated with a higher PTB risk, with ORs (95%CIs) of 2.04 (1.43, 2.90), 3.13 (2.14, 4.58), and 4.26 (2.94, 6.19), respectively. We found slightly stronger associations of heat exposure during the entire pregnancy with the firstborn PTB, and stronger associations of cold exposure during one week and four weeks before delivery with secondborn PTB.Conclusions: Using a sibling-matched study, we took into account some mother-level unobserved confounding. Our re-search strengthens the evidence that gestational exposure to heat and cold increases the risk of PTB. Our findings may have important implications for improving the health of newborns in the context of climate change.

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).

Background Heat events increase the risk of preterm birth (PTB), and identifying the risk-related event thresholds contributes to developing early warning system for pregnant women and guiding their public health response. However, the event thresholds that cause the risk remain unclear. We aimed to investigate the effects of heat events defined with different intensities and durations on PTB throughout pregnancy, and to determine thresholds for the high-risk heat events. Methods Using a population-based birth cohort data, we included 210,798 singleton live births in eight provinces in China during 2014-2018. Daily meteorological variables and inverse distance weighted methods were used to estimate exposures at a resolution of 1 km x 1 km. A series of cut off temperature intensities (50th-97.5th percentiles, or 18 degrees C-35 degrees C) and durations (at least 1, 2, 3, 4 or 5 consecutive days) were used to define the heat events. Cox regression models were used to estimate the effects of heat events on PTB in various gestational weeks during the entire pregnancy, and event thresholds were determined by calculating population attributable fractions. Findings The hazard ratios of heat event exposure on PTB ranged from 1.07 (95% CI: 1.00, 1.13) to 1.43 (1.15, 1.77). Adverse effects of heat event exposure were prominently detected in gestational week 1-4, week 21-32 and the four weeks before delivery. The heat event thresholds were determined to be daily maximum temperature at the 90th percentile of the distribution or 30 degrees C lasting for at least one day. If pregnant women were able to avoid the heat exposures from the early warning systems triggered by these thresholds, approximately 15% or 17% of the number of total PTB cases could have been avoided. Interpretation Exposure to heat event can increase the risk of PTB when thermal event exceeds a specific intensity and duration threshold, particularly in the first four gestational weeks, and between week 21 and the last four weeks. This study provides compelling evidence for the development of heat-health early warning systems for pregnant women that could substantially mitigate the risk of PTB.

目的 探讨婴幼儿体格发育轨迹及其影响因素,为促进婴幼儿生长发育提供科学依据.方法 采用前瞻性队列研究设计,基于方便抽样于2015年9月—2019年6月在河北正定县、辽宁立山区、湖南岳阳县、厦门市海沧区和集美区5个区/县构建母婴健康动态监测队列,招募符合要求的孕晚期孕妇并随访其子代至3岁.采用基于群组轨迹模型(GBTM)分析0～3岁婴幼儿体格发育轨迹,应用Group Lasso回归模型进行影响因素的初步筛选,进一步用无序多分类Logistic回归分析体格发育轨迹的影响因素.结果 本研究共纳入2330名婴幼儿.基于贝叶斯信息准则等原则,采用GBTM将婴幼儿体格发育轨迹分为缓慢生长、追赶生长、中速生长和加速生长组(占比分别为25.4％、18.8％、38.4％和17.4％).以中速生长组作为参考,经无序多分类Logistic回归分析发现:父亲消瘦(OR=1.80,95％CI:1.08～3.01)、母亲孕前消瘦(OR=1.61,95％CI:1.23～2.11)、母亲孕晚期户外运动时长小于1 h(OR=1.30,95％CI:1.04～1.63)、孕期未服用铁剂(OR=1.47,95％CI:1.17～1.85)、6月龄室外活动时长<3 h(OR=1.36,95％CI:1.06～1.75)可显著增加缓慢生长模式发生的风险(P<0.05);1月龄时睡眠质量好(OR=0.74,95％CI:0.58～0.94)可显著降低缓慢生长模式的发生风险(P<0.05);母亲孕前肥胖(OR=1.69,95％CI:1.07～2.66)、分娩方式为剖宫产(OR=1.43,95％CI:1.12～1.83)、纯母乳喂养时长<6个月(OR=1.39,95％CI:1.07～1.79)可显著增加加速生长模式的发生风险(P<0.05).结论 婴幼儿体格发育轨迹存在异质性.与中速生长组的婴幼儿相比,父亲消瘦、母亲孕前消瘦、母亲孕晚期户外运动时长小于1h、孕期未补充铁剂、6月龄室外活动时长<3h的婴幼儿更易出现缓慢生长;母亲孕前肥胖、剖宫产、纯母乳喂养时长小于6个月婴幼儿更易表现为加速生长.本研究结果为科学、合理指导婴幼儿生长发育提供了科学证据.

ObjectiveTo examine revenue situation of maternal and child health (MCH) institutions at all administrative levels in China and to provide evidences for governmental decision-making. MethodsThe data on revenue of 3 094 MCH institutions in 31 provincial level administrative regions across the mainland of China in 2020 were collected through the national monitoring and direct reporting system for MCH institutions; other relevant information were also extracted from China Health Statistical Yearbook of 2020. The revenue and financial subsidy income of the MCH institutions in 2020 were analyzed and compared. ResultsThe entire financial subsidy income of 63.09 billion yuan RMB accounted for 28.7% of the total revenue of MCH institutions in 2020 and the proportion was much lower than that for other public welfare institutions including the centers for disease control and prevention (73.6%) and health supervision institutes (91.5%). There were obvious differences in the median values (million yuan) of the revenue for the MCH institutions in various regions, at different administrative levels, and belong to different financial management categories, with significant higher medians for the MCH institutions in the eastern region (25.81), at provincial level (712.17) and under the combined financial management for public welfare of first- and second-category (70.33) compared to other MCH institutions. ConclusionAt present, unreasonable composition, single source, and insufficient financial support are main problems for revenue of MCH institutions in China, suggesting that guarantee mechanism and policy flexibility relevant to revenue of MCH institutions need to be improved urgently.

目的 了解并分析6月龄前不同喂养方式下监测地区0～24月龄婴幼儿各随访点的身长水平现状和差异.方法 基于我国5省监测区县儿童随访数据,分别描述6月龄前不同喂养方式下南、北方监测地区0～24月龄男、女童各随访点(出生、1、3、6、8、12、18、24月龄)的身长水平,并采用t检验或方差分析等统计方法对其进行分析.结果 各随访时间点男童的平均身长高于女童,北方监测地区儿童的平均身长高于南方监测地区,差异均有统计学意义(P<0.05).6月龄前不同喂养方式下北方监测地区男童8、12、18、24月龄身长的组间差异有统计学意义(F值分别为6.56、6.93、5.25、6.99,P<0.05),女童仅24月龄时身长水平存在统计学差异(F=4.39,P<0.05),其余随访月龄不同喂养方式间的身长差异均无统计学意义(P>0.05).南方监测地区男童、女童各随访点身长水平在不同喂养方式间的差异均无统计学意义(P>0.05).结论 6月龄前不同喂养方式下,南北方监测地区儿童的6月龄内身长水平无明显差异;6月龄后仅北方监测地区8～24月龄男童和24月龄女童呈现部分差异,关于6月龄前喂养方式对儿童6月龄之后身长的影响尚待进一步研究明确.

What is already known about this topic? Several studies have reported that maternal antenatal intention to breastfeed is a strong predictor of actual breastfeeding duration. However, little research has investigated whether maternal postpartum intention also extends breastfeeding duration. What is added by this report? Maternal postpartum intention to breastfeed was a protective factor for extending actual breastfeeding duration after controlling potential confounders. What are the implications for public health practice? It is crucial to address and promote intrinsic and extrinsic factors that influence a mother’s intention to breastfeed after delivery, thereby extending the actual breastfeeding duration.

Objective:To acquire the impact of COVID-19 pandemic on the operation of tertiary maternal and child health(MCH) hospitals in China, for decision making support of health administrative departments and hospital managers.Methods:The National Maternal and Child Health Institutions Resources and Operations Survey Direct Reporting System was used to collect the resource allocation, workload, treatment quality, work efficiency and asset operation of the tertiary MCH hospitals in China in 2019(pre pandemic) and 2020(during pandemic). Statistical descriptions were made using median.Results:In 2019 and 2020, the number of tertiary MCH hospitals in China was 236 and 258, respectively, and their relevant data were analyzed. In terms of resource allocation, the number of health technicians in 2019 and 2020 was 560 and 548, respectively, and the actual number of available beds was 308 and 305 respectively. In terms of workload, the annual outpatient visits in 2020 were 337 990, a decrease of 23.6%from that in 2019; The total number of emergency visits was 28 997, a decrease of 32.5%; The total number of discharged patients was 13 673, a decrease by 20.5%; A total of 4 723 training sessions on MCH were held for primary institutions, an increase of 1.2 percent. A total of 1 953 724 primary-level health technicians were trained, an increase of 175.2 percent. In terms of work efficiency, the average length of hospital stay of discharged patients decreased from 5.56 days in 2019 to 5.00 days in 2020. Bed utilization rate decreased from 88.90% to 69.15%; Bed turnover decreased from 53.69 to 44.22. In terms of treatment quality, the critical illness mortality rate of inpatients was 0.37% in 2020, 0.11% lower than that in 2019. The in-hospital mortality rate for neonatal patients was 0.04%, a 0.03% drop. In terms of asset operation, the total revenue in 2020 was 248.355 million yuan, an increase of 4.46% compared with 2019, in which the proportion of financial subsidies increased from 11.26% to 15.72%.Conclusions:The in-hospital services and institutional health care services of tertiary MCH hospitals in China were downsized by the COVID-19 pandemic, while the work efficiency was relatively stable, along with acceptable resource allocation, good treatment quality and asset operation.

目的 探讨6月龄前不同喂养方式对监测地区0～12月龄婴儿身长的影响.方法 采用2015年9月至2019年6月中国疾病预防控制中心妇幼保健中心开展的母婴健康动态追踪监测项目随访数据,该项目选取了南、北方地区共5个监测区县(河北省石家庄市正定县,辽宁省鞍山市立山区,福建省厦门市海沧区、集美区,湖南省岳阳市岳阳县),所监测区县符合条件的孕晚期孕妇及所生儿童作为监测对象,并追踪随访观察至儿童满3周岁,系统、动态收集孕妇及各阶段儿童体格健康信息以及养育情况和喂养情况等信息.本研究纳入上述项目中0～12月龄婴儿,将6月龄前婴儿喂养方式分为纯母乳喂养、人工喂养、混合喂养,并构建时间-婴儿两水平生长模型,调整婴儿特征(包括性别、辅食添加时间、出生身长),母亲及家庭特征(包括母亲身高、母亲文化程度、父亲身高、家庭年收入、监测地区),分析6月龄前不同喂养方式对监测地区0～12月龄婴儿身长的影响.结果 婴儿身长测量值显示,出生、1、3、6月龄不同喂养方式婴儿身长水平相近(P>0.05),8、12月龄人工喂养组婴儿身长则高于混合喂养组和纯母乳喂养组婴儿(P<0.05).模型分析结果显示,调整婴儿、母亲及家庭特征后,6月龄前不同喂养方式对0～12月龄婴儿身长的整体影响,差异具有统计学意义,且与时间存在交互作用(P<0.05).纯母乳喂养和混合喂养婴儿6个月前平均身长均高于人工喂养婴儿,之后随着婴儿月龄的增长,纯母乳喂养婴儿和混合喂养婴儿平均身长逐渐低于人工喂养婴儿,人工喂养婴儿平均身长分别于7、10月龄高于混合喂养和纯母乳喂养婴儿.结论 6月龄前不同喂养方式下0～12月龄婴儿身长生长模式不同,在婴儿生长早期,6月龄前坚持纯母乳喂养婴儿身长更长;而在婴儿生长后期(10～12月龄),6月龄前人工喂养婴儿身长更长.

Background: Hypertensive disorders of pregnancy (HDP) is a generally accepted risk factor of preterm birth (PTB). Most related studies focus on the effects of various HDP on pregnancy outcomes. Based on large-scale maternal health monitoring data, this study analyzes the dose-response relationship between maternal Blood pressure (BP) in different trimesters and PTB. Methods: Through the Maternal and Newborn Health Monitoring System in China, a total of 212,941 single-fetus pregnant women who delivered during 2014-2018 in 13 counties of 6 provinces in China were included in this study. BP level, distribution and changes in each trimester were described with linear trend test. Multivariate logistic regression analysis was performed to estimate the associations between BP groups in different gestational trimesters and PTB. Then a restricted cubic spline (RCS) was used to delineate the dose-response relationships between BP (both diastolic and systolic) during each trimester and PTB. Results: The overall incidences of HDP and PTB were 7.07% and 4.04% respectively. The detection rates of HDP in the 1st, 2nd and 3rd trimesters were 1.03%, 2.06% and 6.23% respectively. Taking the group of normal BP as reference, the odds ratios(OR) of PTB for the groups of hypertension in the 1st, 2nd and 3rd trimesters was 3.23, 2.70 and 2.05 respectively (P<0.001). Hypotension in 3rd trimester was associated with a 1.5-fold higher risk of PTB (P<0.001). OR of PTB had a nonlinearly U-shaped association with SBP and DBP in the 1st, 2nd and 3rd trimesters. Conclusions: The risks of PTB varied among pregnant women with the same BP in different trimesters. An increase of BP within the normal range during pregnancy could prevent PTB. Hypotension in 3rd trimester was associated with a high risk of PTB.

What is already known about this topic? As a major cause of maternal and neonatal mortality and morbidity, hypertensive disorders of pregnancy (HDP) are a global public health problem affecting maternal and children’s health. What is added by this report? The incidence of HDP was 6.40% among 277,632 pregnant women. With the progress of pregnancy, the proportion of pregnant women with high normal blood pressure (BP) and the incidence of HDP increased gradually. The incidence of HDP increased with pregnancy age, body mass index, and BP of pregnant women during first trimester. What are the implications for public health practice? To reduce the incidence of HDP effectively, we should pay more attention to older women who plan to become pregnant, measures should be taken to control BP and weight in pre-pregnancy.

Background Antenatal care (ANC) played a crucial role in ensuring maternal and child safety and reducing the risk of complications, disability, and death in mothers and their infants. The objective of this study was to evaluate the current status of ANC emphasizing the number, timing, and content of examinations on a national scale. Methods The data was collected from maternal and newborn’s health monitoring system at 8 provinces in China. After ethical approval, all pregnant women registered in the system at their first prenatal care visit, we included 49,084 pregnant women who had delivered between January 1, 2018 and December 31, 2018. Descriptive statistics of all study variables were calculated proportions and chi-square for categorical variables. Results Of the 49,084 women included in this study, the mean number of ANC visits was 6.95 ± 3.45. By percentage, 78.79% women received ANC examinations at least five times, 39.93% of the women received ANC examinations at least eight times and 16.66% of the women received ANC examinations at least 11 times. The proportion of first ANC examination in first trimester was 61.87%. The percentage of normative ANC examinations and the percentage of qualified ANC examinations were 30.98 and 8.03% respectively. Only 49.40% of the total women received all six kinds of examination items in first ANC examination: 91.47% received a blood test, 91.62% received a urine test, 81.56% received a liver function examination, 80.52% received a renal function examination, 79.07% received a blood glucose test, and 86.66% received a HIV/HBV/syphilis tests. 50.85% women received the first ANC examination in maternal and child health care (MCH) institutions, 14.07% in a general hospital, 18.83% in a township hospital, 13.15% in a community health services center, and 3.08% in an unspecified place. The proportion of women who received each of the ANC examination items in community health services center was the highest, but that in the MCH institutions was the lowest. Conclusions There is a big difference between the results of this study and the data in official reports, this study found the current status of antenatal care is not optimal in China, findings from this study suggest that the systematization, continuity and quality of ANC examinations need to be improved.

目的 了解2015-2019年我国妇幼保健机构科研课题承担情况,为促进妇幼保健机构的科研合作和人才队伍建设提供依据.方法 利用全国妇幼保健机构监测调查数据,采用描述性分析方法分析不同行政区划和不同地区妇幼保健机构科研课题承担情况.结果 2015-2019年全国妇幼保健机构新承担科研课题共计21482项,新承担和独立承担课题分别增长了8.62％和3.95％,平均年增长率为2.09％和0.97％;妇幼保健机构在承担课题、独立承担课题以及独立承担国家级、省级、地市级课题方面,省级机构承担课题均数及平均增长率均最高,地市级机构承担课题总量最高,东部地区承担科研课题总量高于中部和西部地区机构并且其承担比例在60％以上.结论 妇幼保健机构承担科研课题量稳步增加,机构间和地区间存在一定差异.

[目的]了解我国市(地)级妇幼保健机构大部制改革的效果,为其它妇幼保健机构的改革提供参考.[方法]通过全国妇幼保健机构监测网络直报系统,收集2018年全国市(地)级妇幼保健机构的相关信息,运用倾向性评分匹配法确定改革组与未改革组,通过卡方检验与秩和检验进行组间比较.[结果]全国市(地)级妇幼保健机构进行大部制改革的比例为29.02％.匹配前改革组机构的资源配置等基础指标均高于未改革组机构,差异均有统计学意义(P<0.01).因此以地区、机构性质、机构等级评审级别、实有床位数4个指标为协变量进行倾向性评分匹配,匹配后两组机构资源配置等基本指标的差异无统计学意义(P>0.05),改革组机构和未改革组机构具有可比性.匹配后改革组机构的平均住院日低于未改革组机构,改革组机构年门诊人次数、本年度共为基层举办各类妇幼保健业务技术培训班期次、培训基层卫生技术人员数、因群体妇幼保健工作下基层人·天数、接受基层进修人员数(一个月以上)均高于未改革组机构,差异均有统计学意义(P<0.05).[结论]我国进行大部制改革的市(地)级妇幼保健机构比例较低,大部制改革效果逐渐显现,但仍有待进一步推进.

目的 了解2017年全国妇幼保健机构业务科室设置现状及达标情况.方法 通过全国妇幼保健机构监测直报系统,收集2017年全国各级妇幼保健机构的资源及运营等基本情况,分析各级妇幼保健机构业务科室设置现状,并根据2015年《国家卫生计生委办公厅关于印发各级妇幼保健机构业务部门设置指南的通知》对各级妇幼保健机构业务科室设置达标情况进行分析.结果 省、地市级妇幼保健机构业务科室设置按照80％标准,其达标率为17.1％.县区级妇幼保健机构按照6个基本业务科室独立设置标准,达标率为26.0％.其中,各级妇幼保健机构中,有住院服务机构的达标率高于无住院服务机构.此外,在有住院服务机构中,东部地区达标率高于中部和西部地区.结论 目前全国各级妇幼保健机构业务科室设置不健全,达标率均较低.各级政府应加大投入,各级妇幼保健机构应完善服务提供,加强业务科室设置,找准保健与临床之间的结合点,促进保健与临床融合发展.