Introduction There have been many researches done on the association between maternal exposure to ambient air pollution and adverse pregnancy outcomes, but few studies related to very low birth weight (VLBW). This study thus explores the association between maternal exposure to ambient air pollutants and the risk of VLBW, and estimates the sensitive exposure time window. Methods A retrospective cohort study analyzed in Chongqing, China, during 2015–2020. The Generalized Additive Model were applied to estimate exposures for each participant during each trimester and the entire pregnancy period. Results For each 10 μg/m 3 increase in PM 2.5 during pregnancy, the relative risk of VLBW increased on the first trimester, with RR = 1.100 (95% CI: 1.012, 1.195) in the single-pollutant model. Similarly, for each 10 μg/m 3 increase in PM 10 , there was a 12.9% (RR = 1.129, 95% CI: 1.055, 1.209) increase for VLBW on the first trimester in the single-pollutant model, and an 11.5% (RR = 1.115, 95% CI: 1.024, 1.213) increase in the multi-pollutant model, respectively. The first and second trimester exposures of NO 2 were found to have statistically significant RR values for VLBW. The RR values on the first trimester were 1.131 (95% CI: 1.037, 1.233) and 1.112 (95% CI: 1.015, 1.218) in the single-pollutant model and multi-pollutant model, respectively; The RR values on the second trimester were 1.129 (95% CI: 1.027, 1.241) and 1.146 (95% CI: 1.038, 1.265) in the single-pollutant model and multi-pollutant model, respectively. The RR of O3 exposure for VLBW on the entire trimester was 1.076 (95% CI: 1.010–1.146), and on the second trimester was 1.078 (95% CI: 1:016, 1.144) in the single-pollutant model. Conclusion This study indicates that maternal exposure to high levels of PM 2.5 , PM 10 , NO 2 , and O 3 during pregnancy may increase the risk of very low birth weight, especially for exposure on the first and second trimester. Reducing the risk of early maternal exposure to ambient air pollution is thus necessary for pregnant women.

Accumulating evidence suggested that the risk of preterm births (PTBs) following prenatal exposure to air pollution was inconclusive. The aim of this study is to investigate the relationship between air pollution exposure in the days before delivery and PTB and assess the threshold effect of short-term prenatal exposure to air pollution on PTB. This study collected data including meteorological factors, air pollutants, and information in Birth Certificate System from 9 districts during 2015–2020 in Chongqing, China. Generalized additive models (GAMs) with the distributed lag non-linear models were conducted to assess the acute impact of air pollutants on the daily counts of PTB, after controlling for potential confounding factors. We observed that PM2.5 was related to increased occurrence of PTB on lag 0–3 and lag 10–21 days, with the strongest on the first day (RR = 1.017, 95

目的 通过分析二级妇幼保健院评审结果中医技质量安全管理存在的问题,为妇幼保健院提高医技质量提供借鉴.方法 分析2020-2021年重庆市20所二级甲等妇幼保健院评审医技质量管理条款评审结果,对比临床检验、影像检查(含特殊检查)条款达标率,分析重庆市各片区间的差异.结果 医技质量管理条款总体达标率较高,医院间医技质量管理持续改进A达标率差异大,最低为9.41％,最高为26.98％.医技质量管理A达标率在不同片区间的差异有统计学意义(P＜0.05).渝东北片区优于其他片区,A达标率为45.19％;渝东南片区整体达标率最低,A达标率仅为14.10％.临床检验质量管理优于影像检查(含特殊检查)质量管理,临床检验质量管理条款C达标率超过影像检查(含特殊检查)质量管理条款3.81％,B达标率超过13.42％,A达标率超过5.44％.结论 等级评审可促进妇幼保健院医技质量管理的发展,但人员、质量管理体系、质量管理工具应用、外检管理等需持续改进,地域间、专业领域间发展不均衡现象亟待改善.

Recent study results on the association between maternal exposure to ambient air pollution with preterm birth have been inconsistent. The sensitive window of exposure and influence level of air pollutants varied greatly. We aimed to explore the association between maternal exposure to ambient air pollutants and the risk of preterm birth, and to estimate the sensitive exposure time window. A total of 572,116 mother–newborn pairs, daily concentrations of air pollutants from nearest monitoring stations were used to estimate exposures for each participant during 2015–2020 in Chongqing, China. We applied a generalized additive model and estimated RRs and 95% CIs for preterm birth in each trimester and the entire pregnancy period. In the single-pollutant model, we observed that each 10 μg/m3 increase in PM2.5 had a statistically significant effect on the third trimester and entire pregnancy, with RR = 1.036 (95% CI: 1.021, 1.051) and RR = 1.101 (95% CI: 1.075, 1.128), respectively. Similarly, for each 10 μg/m3 increase in PM10, there were 2.7% (RR = 1.027, 95% CI: 1.016, 1.038) increase for PTB on the third trimester, and 3.8% (RR = 1.038, 95% CI: 1.020, 1.057) increase during the whole pregnancy. We found that for each 10 mg/m3 CO increases, the relative risk of PTB increased on the first trimester (RR = 1.081, 95% CI: 1.007, 1.162), second trimester (RR = 1.116, 95% CI: 1.035, 1.204), third trimester (RR = 1.167, 95% CI: 1.090, 1.250) and whole pregnancy (RR = 1.098, 95% CI: 1.011, 1.192). No statistically significant RR was found for SO2 and NO2 on each trimester of pregnancy. Our study indicates that maternal exposure to high levels of PM2.5 and PM10 during pregnancy may increase the risk for preterm birth, especially for women at the late stage of pregnancy. Statistically increased risks of preterm birth were associated with CO exposure during each trimester and entire pregnancy. Reducing exposure to ambient air pollutants for pregnant women is clearly necessary to improve the health of infants.

Background: Gestational diabetes mellitus (GDM) may lead to many adverse effects on women and their offspring. Method: 24,429 pregnant women were enrolled during early pregnancy from January 2018 to December 2021. The self-reported intake of folic acid supplements was assessed via a questionnaire. Oral glucose tolerance tests were used for the diagnosis of GDM. The association between intake or not, dose, and duration of folic acid and GDM risk was assessed. Results: 6396 (26.18%) women were diagnosed with GDM. In the univariate models, folic acid was found to be correlated with total GDM risk (OR = 0.82, 95% CI: 0.70~0.95, p = 0.009). After adjusting for potential confounders, the association with total GDM risk was not significant, but the association of folic acid with 2-h PBG diagnosed GDM risk was consistently significant (OR = 0.75, 95% CI: 0.63~0.90, p = 0.002). No significant association between the dose and duration of folic acid supplementation and GDM risk was observed in the analyses. Conclusion: Folic acid supplementation might be a protective factor for the risk of GDM caused by the high level of postprandial blood glucose, but the dose or duration-related association between folic acid supplementation and GDM risk is not clear.

目的 探讨妇幼保健机构高危孕产妇一体化管理模式的应用效果.方法 通过对高危孕产妇管理过程中存在问题的系统分析,提出一体化管理流程、具体措施并建设高危孕产妇管理系统实行信息化管理,收集2016—2019年机构内孕产妇管理情况,采用Cochran-Armitage趋势检验进行分析,观察推行新管理模式的实施成效.结果 2016—2019年,机构分娩孕产妇数逐年上升,高危孕产妇占比从70.61％上升至87.56％,差异有统计学意义(Z=3.32,P<0.01).危重孕产妇抢救数持续下降,占比从1.15％下降至0.23％,但差异无统计学意义(Z=-0.92,P=0.36).结论 推行高危孕产妇新型一体化管理模式可有效减少危重情况的发生,控制孕产妇死亡率,有助于推动孕产妇安全保障工作的进展.

目的 系统评价剖宫产与阴道顺产两种不同分娩方式对盆底功能的影响.方法 全面检索2015年1月-2019年4月期间维普期刊网、万方数据库、中国期刊全文数据库、PubMed数据库、Library of Congress数据库、Web of Science数据库中公开发表的关于剖宫产与阴道顺产对盆底功能影响的相关文献.提取数据后,采用Stata 15.0软件进行Meta分析.结果 共纳入20个符合要求的文献,7081例产妇,其中剖宫产2965例,阴道顺产4116例.Meta分析结果显示:两种不同分娩方式在阴道前壁脱垂率、阴道后壁脱垂率、子宫脱垂率、尿失禁发生率、盆腔器宫脱垂发生率、浅层肌力受损、深层肌力受损等方面比较,差异均有统计学意义(P＜0.05).结论 剖宫产对盆底功能的影响较阴道顺产小,在一定程度上降低了盆底肌肉损伤及盆底功能障碍性疾病(pelvic floor disease,PFD)的发生率,但剖宫产不能完全避免PFD的发生,不能作为选择剖宫产的依据.

Objective To analyze the relationship between air pollutants and spontaneous abortion in Chongqing. Methods Time trend bias was controlled by time-stratified case-crossover design. The distribution lag nonlinear model was employed to study the relationship between air pollution and the number of spontaneous abortion in the main urban area of Chongqing and to control the influence of confounding factors such as meteorological factors. Based on the single pollutant model, the two-pollutant model was used to control the influence of other pollutants on correlation. Results During the study period, the average daily concentration of PM2.5, PM10, NO2 and SO2 in the air was 39.32, 63.31, 41.04 and 8.86μg/m3, respectively. All pollutants except NO2 were associated with the risk of spontaneous abortion, and all the associations reached the peak value at the lag of 3 d. For the increase of every 10μg/m3, the relative risk value was 1.069 (95%CI: 1.010~1.132), 1.046 (95%CI: 1.007~1.086) and 1.511 (95%CI: 1.148~1.989), respectively. These associations still existed in the two-pollutants model. Conclusion Short-term exposure of PM2.5, PM10 and SO2 in the ambient air may increase the risk of spontaneous abortion in Chongqing.