To investigate the impact of COVID-19 infection on maternal and neonatal outcomes and immunity in pregnant women in China. 283 pregnant women with COVID-19 were included in the prospective observational cohort study and divided into five groups based on infection stage. Antibody levels were measured in plasma, umbilical cord blood, and breast milk, and combined with clinical data and 6-month follow-up results. We measured SARS-CoV-2 antibody levels using a chemiluminescence immunoassay and analyzed the data with the Kruskal-Wallis test, χ2 test, or Fisher’s exact test. No significant differences were found in age, BMI, weight change during pregnancy, or the incidence of gestational hypertension, gestational diabetes, gestational hypothyroidism, intrahepatic cholestasis, transaminitis, preterm birth, small for gestational age, neonatal NICU transfers, developmental delays, and hearing damage among the five groups. The incidence of COVID-19 in infants from mothers infected at different stages of pregnancy was significantly lower than in the uninfected group (P < 0.05). Maternal and umbilical cord blood showed significantly higher IgG levels in the infected group compared to the uninfected group at different stages of pregnancy (P < 0.05). The median transplacental antibody transfer ratio across all infection groups was 1.15 (0.98–1.30), with no significant differences between them. The reinfection group had significantly higher IgA levels during pregnancy compared to other groups (P < 0.05). No adverse outcomes were observed in mothers or infants at any stage of maternal SARS-CoV-2 infection. Antibodies in umbilical cord blood and breast milk may offer passive immunity to newborns for 1–3 months. Reinfection during pregnancy may extend this immunity without raising the risk of adverse outcomes.

BACKGROUND:Prenatal mental health is an increasing public concern. At present, it has been shown that increasing physical activity (PA) is effective in promoting mental health of pregnant women. However, mental health may depend not only on the amount of time spent on a specific activity, but also on the intensity and type of the activity that it replaces. This study is aimed to explore the impact of replacing 60 min of one health behavior with another on the mental health of pregnant women. METHODS:The cross-sectional study recruited 983 pregnant women from Chongqing, China between June and December 2021. The pregnant women self-reported their movement behaviors using the Pregnancy Physical Activity Questionnaire-Chinese version (PPAQ-C). Participants also completed three measures of mental health: Childbirth Attitudes Questionnaire (CAQ), 9-item Patient Health Questionnaire (PHQ-9) and the Positive affect sub-scale. An Isotemporal Substitution Model was used to evaluate mental health after replacing one movement behavior. RESULTS:The analysis showed that replacing 60 min of sedentary behavior (SB) with moderate-to-vigorous intensity PA (MVPA) promoted positive emotions, and replacing SB with light intensity PA (LPA) reduced childbirth fear. Regarding PA types, replacing inactivity with household, occupational, or transport PA could reduce fear, and replacing inactivity, occupational, household or transport PA with sport PA could improve positive emotions and alleviate depression. CONCLUSION:An active pregnancy lifestyle with higher levels of moderate-to-vigorous physical activity and light physical activity and less sedentary behavior time and other inactive states may improve mental health. Future health promotion for pregnant women should consider the flexibility of physical activity types and intensities.

Background As the world's population ages, bone health has become a major public problem. The incidence of osteoporosis in women will further increase due to the decline of oestrogen after menopause. In this study, we used a health ecology model to explore the factors affecting abnormal bone mass in perimenopausal and postmenopausal women at different levels, and to provide a basis for the management and prevention of abnormal bone mass in women at this stage of life in China. Methods From October 2022 to September 2023, perimenopausal and postmenopausal women aged ≥ 40 years admitted to five recruited hospitals in China were recruited by purposive sampling method.Information on five levels of the health ecology model, including personal traits, behavioral characteristics, interpersonal network, working and living conditions, and policy environment was collected through structured questionnaires, and the data were analyzed using a structural equation model. Results Among 531 participants, 248 subjects had normal bone mass, 230 had osteopenia and 53 had osteoporosis. The results of the structural equation model showed that personal traits had the strongest direct positive effect on bone mass abnormality (β = 0.417, P < 0.05); behavioural characteristics had a direct positive effect on bone mass abnormality (β = 0.253, P < 0.05); interpersonal network had a direct negative effect on bone mass abnormality (β=-0.268, P < 0.05) and an indirect effect through personal traits; living conditions have a direct negative effect on bone mass abnormalities (β=-0.248,P < 0.05), and indirect effect through behavioural traits and interpersonal network; medical insurance can have an indirect effect on bone mass abnormalities through living conditions and interpersonal network. Conclusion Currently, the prevalence of abnormal bone mass in perimenopausal and postmenopausal women is high in China. Combined with the health ecology model, we found that personal characteristics and unhealthy behavior characteristics are risk factors for abnormal bone mass, higher social support and living conditions are protective factors for abnormal bone mass, which could indirectly affect abnormal bone mass, and medical insurance can indirectly affect abnormal bone mass. Future policy recommendations for the prevention of abnormal bone mass can be based on the factors and pathways that affect abnormal bone mass in perimenopausal and postmenopausal women identified in this study, in order to reduce the incidence of abnormal bone mass and improve the quality of life of perimenopausal and postmenopausal women.

BackgroundMenopausal women may experience menopausal syndrome and long-term effects caused by low estrogen levels, such as senile dementia and osteoporosis in the elderly. Most menopausal women may have misconceptions about menopause and low use of pharmacological interventions. These misconceptions may damage the quality of life and miss the critical period for preventing senile diseases. Thus, enhancing the awareness of menopausal women regarding psychosocial and physical changes through health education programs was a way to improve positive attitudes toward menopause and make further treatment options.ObjectivesThis study aimed to evaluate the effect of multidisciplinary health education based on lifestyle medicine on menopausal syndrome and lifestyle behaviors of menopausal women.MethodsThe study was conducted in several hospitals in Chongqing, China. The two groups were from different hospitals with similar medical levels in order to reduce information contamination. It was designed as a clinical controlled trial in which the intervention group (n = 100) and control group (n = 87) were matched for age, age at menarche, menopausal symptoms and drug use status at enrollment. Women in the intervention group received multidisciplinary health education based on lifestyle medicine for 2 months while those in the control group received routine outpatient health guidance. Menopausal syndrome, physical activity and dietary status of participants were assessed before and after the intervention. Paired t-tests and Independent-sample t-tests were adopted for comparison within and between groups, respectively, in the normal variables. Wilcoxon signed-rank tests and Mann-Whitney U tests were adopted for comparison within and between group, respectively, in the abnormal variables. Categorical variables were tested using Pearson's χ2. P-value < 0.05 was statistically significant in statistical tests.ResultsPost intervention testing indicated that menopausal syndrome of participants was significantly improved in the intervention group compared to the control group (P < 0.001). Between-group comparison showed a significant improvement of weekly energy expenditure of total physical activity (P = 0.001) and participation in exercise (P < 0.001) in the intervention group compared to the control group after the intervention. The dietary status of participants was significantly improved in the intervention group compared to the control group (P < 0.001). In the intervention group, the menopausal syndrome of participants improved more in the hormone drug group than in the non-hormone group (P = 0.007), as did the control group (P = 0.02). In the hormone drug group, the physical activity (P = 0.003) and dietary status (P = 0.001) mproved more in the intervention group than in the control group.ConclusionsThe multidisciplinary health education based on lifestyle medicine was effective in improving the menopausal syndrome and healthy lifestyle behaviors of menopausal women. Studies with extended observation period and larger sample size are in need to evaluate the long-term scale-up effects of the multidisciplinary health education.

Objective To investigate the effect of music intervention combined with health education on the mode of delivery and childbirth experience. Methods 98 primiparas in the late-pregnancy who underwent regular obstetric checkups and delivered in the hospital from December 2020 to January 2022 were included for the study, and primiparas who voluntarily participated in the music intervention combined with health education served as the trial group（n=49）, while primiparas who did not participate in the music intervention combined with health education during the same period of gestation（within 2weeks difference in gestational weeks） served as the control group（n=49）. The mode of delivery and delivery experience scores were compared between the two groups. Results The rate of spontaneous delivery was significantly higher in the trial group（79.6%） than in the control group（57.1%）（P＜0.05）. The total childbirth experience score and the scores of each dimension were significantly higher in the trial group than in the control group（P＜0.05）. Conclusion The application of music intervention combined with health education can increase the rate of spontaneous birth and improve the childbirth experience,which is worthy of clinical promotion.

目的 评估CO2点阵激光治疗绝经期泌尿生殖综合征的临床效果.方法 回顾性分析2018年1月至2019年12月于我院妇科门诊就诊、行CO2点阵激光治疗的绝经期泌尿生殖综合征患者61例,对比患者自主感受评价、阴道健康评分以及临床疗效总体评价,并观察长期疗效.结果 CO2点阵激光治疗后,干涩、瘙痒、灼热感、性交痛的患者自主感受评价均显著改善,有瘙痒、灼热感、性交痛的人数百分比从治疗1次开始即显著降低;治疗后患者阴道健康评分均显著高于治疗前,治疗1次后即有评分数值的提升,治疗2次以上改善程度更为显著(P<0.05).患者临床疗效总体自我评价良好,治疗1次、2次、3次的总体自我评价有效率分别为88.2％,90％,94.2％.治疗后6-12个月临床疗效总体自我评价有效率为80％.结论 CO2点阵激光对绝经期泌尿生殖综合征的阴道症状有确切疗效,治疗后长期随访效果良好.

目的 调查重庆地区妊娠期女性维生素D水平及评价维生素D补充方案的效果.方法 选取2020年10月至2021年10月在重庆地区重庆医科大学附属第三医院妇产中心参加孕早、中期检查的252例妊娠期女性为研究对象,采用液相色谱串联质谱法检测孕早、中期血清中的维生素D水平,并填写妊娠期女性维生素D生活素养调查问卷;同时选取该院2020年5月至2021年10月492例第1次检测维生素D的孕早、中期妊娠期女性,根据不同维生素D水平采用不同维生素D补充方案干预后分别在孕24～28周、孕36～40周进行第2次、第3次维生素D水平的检测,评价妊娠期女性补充维生素D后的效果.结果 252例妊娠期女性的维生素D水平为(20.31±9.07)ng/mL,其中有93例为未补充含维生素D药物的妊娠期女性,补充与未补充含维生素D药物的妊娠期女性的维生素D缺乏情况相比,差异有统计学意义(P<0.01);多元逐步回归分析结果显示,是否补充含有维生素D的药物、补充含维生素D药物的持续时间是妊娠期女性维生素D水平的主要影响因素.根据492例妊娠期女性第1次维生素D水平的检测结果制订补充方案实施后,血清维生素D水平随着补充时间有所上升,并能达到或维持正常水平,第2次与第1次检测结果比较,差异有统计学意义(P<0.05).结论 重庆地区妊娠期女性存在不同程度的维生素D不足或缺乏,针对妊娠期女性有必要进行维生素D水平的筛查.医学干预措施应重视健康的孕期生活习惯、科学的膳食指导,尤其应加强含有维生素D药物有效补充的宣教.

目的:了解"一日门诊"持续性综合管理更年期参与者的真实体验,为更年期女性健康管理进一步实施提供依据.方法:采用目的抽样法,选取参加"一日门诊"持续性综合管理的更年期病人22例进行深度访谈,运用Colaizzi现象学研究法,对访谈资料进行整理和分析.结果:共提炼出更年期症状改善积极体验、更年期心理积极体验、强化自我健康管理意识和行为、提高更年期就医的准确性4个一级主题.结论:"一日门诊"持续性综合管理模式,可改善更年期病人的身心体验,增强自我健康管理意识和行为.

目的 构建针对孕晚期孕妇的"互联网+"集中群组化保健课程,为开展孕晚期孕妇线上健康教育提供参考.方法 通过查阅文献及专家论证,初步形成孕晚期"互联网+"集中群组化保健课程相关内容,并于2020年2月—6月,运用德尔菲法对北京、上海、四川、湖南、湖北、重庆6个省份的临床、教学领域的专家进行2轮函询.结果 2轮函询问卷的回收率分别为94％和100％,专家权威系数为0.863;专家意见协调系数分别为0.33、0.58(均P<0.05),变异系数为0.02～0.21.最终课程包括4个模块(一级条目)、18个项目(二级条目).结论 "互联网+"集中群组化孕晚期保健课程具有很好的科学性及可靠性,可用于孕晚期孕妇的线上健康教育.

目的:探讨集中群组孕期健康教育对女性孕晚期心理的影响.方法:采用深入访谈法,对25例参加过集中群组孕期健康教育的孕妇在课程结束后进行深度访谈,访谈内容根据Colaizzi的现象学分析法进行整理.结果:通过对访谈资料进行分析,共提炼出5个主题:提升了孕期的自我护理效能;降低了因担忧母婴安全而产生的压力;缓解了面对分娩的焦虑和恐惧;打消了对产后母乳喂养的顾虑;增加了对母亲角色适应的自信.结论:集中群组孕期健康教育对孕晚期女性的心理起到积极的作用,可有效提升女性围生期心理体验及孕育幸福感.

目的 探讨音乐分娩产前培训对孕晚期妇女分娩恐惧及自我效能的影响.方法 将192例定期产前检查的孕晚期妇女随机分为干预组和对照组,对照组给予常规产前健康教育,干预组在常规产前健康教育基础上实施为期3周的音乐分娩产前培训,利用分娩态度问卷、分娩自我效能感量表对两组孕妇分别在入组前、干预后进行分娩恐惧及分娩自我效能的评价.结果 干预前,两组孕妇基线资料、分娩恐惧以及分娩自我效能得分差异无统计学意义(P>0.05);干预后,干预组孕妇分娩恐惧、分娩自我效能及其各维度评分均优于干预前和对照组同期(P<0.01或P<0.05).结论 音乐分娩产前培训能提升孕晚期妇女的分娩自我效能感,有效减轻其分娩恐惧,音乐分娩产前培训能给孕晚期妇女带来积极的孕产期心理体验,并为进一步完善产前教育体系提供了依据.

目的 调查孕妇音乐胎教知信行现状,并进行影响因素分析,为孕妇提供科学的音乐胎教指导.方法 选取2019年12月 ～2020年2月在重庆市三所医院孕妇学校学习的312名孕妇为研究对象,采用自制的孕妇音乐胎教知信行调查问卷对孕妇音乐胎教知信行进行调查,并采用单因素ANOVA方差分析及Logistic多因素分析法分析其影响因素.结果 共发放问卷312份,回收312份,剔除无效问卷25份(剔除标准:缺项、逻辑混乱等),有效问卷287份,有效率为92.0％.287名孕妇音乐胎教的知识得分为(6.53±1.98)分,信念得分为(30.13±4.74)分,行为得分为(7.42±2.46),合格率分别为84.0％、91.3％、15.7％.经单因素ANOVA方差分析显示,孕妇的年龄、孕周、职业、家庭月收入、参加讲座原因均与孕妇音乐胎教的知识、信念、行为得分有关,差异均有统计学意义(P<0.05);胎次与孕妇音乐胎教的信念得分、行为得分有关,差异均有统计学意义(P<0.05);学历与孕妇音乐胎教的知识得分、信念得分有关,差异均有统计学意义(P<0.05);经Logistic回归多因素分析显示,孕周<10周是孕妇音乐胎教知识和信念情况的阻碍因素;孕妇获取胎教音乐的主要来源是音乐APP(44.8％)和育儿APP(29.6％).结论 孕妇的知识、信念维度得分处于中高水平,行为维度得分偏低,音乐胎教执行力较差,孕妇学校应对不同孕周的孕妇进行针对性的科学指导,尤其是孕周较小的孕妇,同时合理利用音乐、育儿APP进行音乐胎教宣传,推动音乐胎教的发展和应用.

Milk lipid secretion is a critical process for the delivery of nutrition and energy from parent to offspring. However, the underlying molecular mechanism is less clear. Here we report that TDP-43, a RNA-binding protein, underwent positive selection in the mammalian lineage. Furthermore, TDP-43 gene ( Tardbp ) loss induces accumulation of large lipid droplets and severe lipid secretion deficiency in mammary epithelial cells to outside alveolar lumens, eventually resulting in lactation failure and pup starvation within three weeks postpartum. In human milk samples from lactating women, the expression levels of TDP-43 is positively correlated with higher milk output. Mechanistically, TDP-43 exerts post-transcriptional regulation of Btn1a1 and Xdh mRNA stability, which are required for the secretion of lipid droplets from epithelial cells to the lumen. Taken together, our results highlights the critical role of TDP-43 in milk lipid secretion, providing a potential strategy for the screening and intervention of clinical lactation insufficiency.

目的 探讨孕晚期的孕妇分娩恐惧状况,并分析其影响因素,为产前干预的开展提供理论依据.方法 采用横断面调查方法,于2019年6月至12月抽取在重庆市某三级甲等医院产科定期进行产前检查且符合入选标准的278名孕晚期孕妇作为研究对象.以孕妇一般资料调查问卷、分娩态度问卷为研究工具,进行问卷调查.结果 孕妇分娩态度总均分为(33.58±7.27)分,处于轻度分娩恐惧水平,其中无分娩恐惧的孕妇69名,占24.82％;轻度分娩恐惧的孕妇143名,占51.44％;中度分娩恐惧的孕妇66名,占23.74％.多元逐步回归分析结果显示,孕期与配偶关系、产前教育及亲友态度对孕妇分娩方式的影响是分娩恐惧的主要影响因素.结论 大多数孕妇孕晚期存在不同程度的分娩恐惧,胎儿的健康情况是引起其分娩恐惧重要的内容,且受各种来源的社会或家庭支持的影响,医疗护理需积极利用相关支持有针对性开展产前干预,以提升孕晚期孕妇的自我效能感,降低其分娩恐惧水平,实现孕期正性体验.

分娩恐惧严重影响母婴的身心健康,降低了孕妇的分娩体验感.本研究对影响产前分娩恐惧的负性情绪、人格特征、社会支持、家庭支持等社会心理因素进行综述,并对国内外音乐疗法对孕产期心理的干预现状进行总结,以期为分娩恐惧的预防和治疗提供参考依据.