To establish gestational age-specific reference ranges for two new indices, the forehead-anterior cerebral artery angle (FACAA) and forehead-anterior cerebral artery distance (FACAD), and to objectively evaluate their diagnostic effectiveness, measured using Doppler technology with microvascular flow imaging, for identifying holoprosencephaly, even the semilobar and lobar types, in early pregnancy. We evaluated FACAA and FACAD in 462 normal fetuses between 12 and 34 gestational weeks (GW) to generate normative reference ranges. Additionally, we evaluated these two indices in 41 fetuses with holoprosencephaly and 34 fetuses with similar two-dimensional ultrasound features (the study group), including 20 fetuses with agenesis of the corpus callosum and 14 with isolated absent septum pellucidum/septo-optic dysplasia. In the normal group, FACAA was almost stable throughout pregnancy, whereas FACAD increased with GW. All fetuses with holoprosencephaly had both smaller FACAA (13.99–38.00°, ≤5th percentile) and shorter FACAD (1.6–10.5 mm, ≤5th percentile). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and negative likelihood ratio (LR–) of FACAA for the prediction of holoprosencephaly in fetuses with an intracranial malformation were 100

What is already known on this topic? A new conceptual term, small and vulnerable newborns (SVN), bringing preterm birth, small for gestational age (SGA), or low birth weight (LBW) together is being advocated for assessing whether a child is at high risk. What is added by this report? According to the new conceptual term, the increasing incidence of high-risk newborns (from 9.82% % to 10.96%) % ) has been observed among 2,005,408 newborns over the period from 2013 to 2022, which is higher than using any of the three definitions of SVN. Maternal age >= 35, primiparity, and multiple births are high risks for SVN. What are the implications for public health practice? The new conceptual framework should be used to better assess the number of high-risk newborns. Attention should be paid to multiple births to prevent preterm-related SVN. To reduce term newborns who are SGA, we need to be concerned not only with multiple pregnancies but also with first-time mothers.

What is already known about this topic? With socioeconomic development, the increase of older pregnancies and multiparas has brought risks to mothers and infants. What is added by this report? As parities increased, the proportion of women of advanced maternal age (AMA) and non-local domicile increased, while the proportion of women with higher education levels decreased. Women with >= 3 parities are more likely to have preterm birth (PTB) and macrosomia. What are the implications for public health practice? women at different parities offers a robust foundation for tailored strategies against adverse pregnancy outcomes.

Adenomyosis has been associated with adverse fertility and pregnancy outcomes, and its impact on the outcomes of in vitro fertilization (IVF) has received much attention. It is controversial whether the freeze-all strategy is better than fresh embryo transfer (ET) in women with adenomyosis. Women with adenomyosis were enrolled in this retrospective study from January 2018 to December 2021 and were divided into two groups: freeze-all (n = 98) and fresh ET (n = 91). Data analysis showed that freeze-all ET was associated with a lower rate of premature rupture of membranes (PROM) compared with fresh ET (1.0% vs. 6.6%, p = 0.042; adjusted OR 0.17 (0.01-2.50), p = 0.194). Freeze-all ET also had a lower risk of low birth weight compared with fresh ET (1.1% vs. 7.0%, p = 0.049; adjusted OR 0.54 (0.04-7.47), p = 0.642). There was a nonsignificant trend toward a lower miscarriage rate in freeze-all ET (8.9% vs. 11.6%; p = 0.549). The live birth rate was comparable in the two groups (19.1% vs. 27.1%; p = 0.212). The freeze-all ET strategy does not improve pregnancy outcomes for all patients with adenomyosis and may be more appropriate for certain patients. Further large-scale prospective studies are needed to confirm this result.

目的 探讨宫内暴露于妊娠期糖尿病是否增加儿童3岁内发生超重肥胖的风险,为预防儿童肥胖提供科学依据.方法 采用前瞻性队列研究,自2014年9月-2015年8月从北京市16个社区入组符合标准的儿童2 275名,从新生儿期随访至3岁.结果 宫内暴露于妊娠期糖尿病的儿童在1、2、3岁时的BMI均高于非暴露组,但差异无统计学意义(P＞0.05).出生时为巨大儿(OR = 2.01,95％CI:1.40～2.89)、母亲孕前体重指数较高(OR= 1.09,95％CI:1.06～1.13)、母亲孕期体重增加过多(OR=1.01,95％CI:0.99～1.03)是儿童1岁内超重肥胖的危险因素(P＜0.05);家庭人均收入较高(OR = 0.83,95％CI:0.71～0.98)是儿童1岁内超重肥胖的保护因素(P＜0.05).出生时为巨大儿(OR = 1.66,95％CI:1.07～2.58)、母亲孕前体重指数较高(OR=1.14,95％CI:1.09-1.18)、母亲孕期体重增加过多(OR= 1.02,95％CI:1.00～1.04)是儿童2岁内超重肥胖的危险因素(P＜0.05);家庭人均收入较高(OR = 0.61,95％CI:0.49～0.75)和纯母乳喂养持续6个月(OR=0.61,95％CI:0.45～0.84)是儿童2岁内超重肥胖的保护因素(P＜0.05).出生时为巨大儿(OR =1.89,95％CI:1.23～2.91)、母亲孕前体重指数较高(OR= 1.14,95％CI:1.09～1.18)也是儿童3岁内超重肥胖的危险因素(PP＜0.05);家庭人均收入较高(OR = 0.66,95％CI:0.54～0.81)和纯母乳喂养持续6个月(OR = 0.55,95％CI:0.40～0.75)是儿童3岁时超重肥胖的保护因素(P＜0.05).辅食添加时间与3岁内儿童超重肥胖无相关性.结论 为了减少儿童在3岁内发生超重肥胖,应严格控制孕妇孕前和孕期的体重,尽可能地坚持纯母乳喂养6个月.

目的:探讨抗苗勒管激素(AMH)对不同体质量指数(BMI)多囊卵巢综合征(PCOS)患者控制性超促排卵过程中发生卵巢过度刺激综合征(OHSS)的预测作用.方法:采用回顾性病例分析,将251例行控制性超促排卵的PCOS患者根据BMI分为3组,正常组(18.5 kg/m2≤BMI＜24.0 kg/m2)92例、超重组(24.0 kg/m2≤BMI＜28.0 kg/m2)90例、肥胖组(BMI≥28 kg/m2)69例,比较3组患者的临床特征、控制性超促排卵和OHSS发生情况,并采用受试者工作曲线(ROC)评估AMH对PCOS患者OHSS发生的预测作用.结果:①3组PCOS患者的BMI、AMH、基础黄体生成素(LH)水平、促性腺激素(Gn)使用天数、Gn用量、绒促性素(HCG)扳机日雌二醇(E2)水平差异均有统计学意义(P＜0.05),正常组的中重度OHSS发生率(18.48％)明显高于超重组(5.56％)和肥胖组(5.80％),差异有统计学意义(P＜0.05).②多因素Logistic回归分析示:高BMI是PCOS患者发生OHSS的保护因素(OR0.58,P＜0.05),高水平的AMH是OHSS发生的危险因素(OR1.23,P＜0.05).③正常组AMH阈值12.06 ng/ml时,预测OHSS发生的灵敏度为70.32％,特异度为88.96％,曲线下面积(AUC)最高为0.81;超重组AMH 10.25 ng/ml时,预测OHSS发生的灵敏度为85.36％,特异度为45.57％,AUC为0.53;肥胖组AMH 10.38 ng/ml时,预测OHSS发生的灵敏度为73.26％,特异度为56.78％,AUC为0.80.结论:可以采用AMH联合BMI评估PCOS患者发生OHSS的风险,其中AMH对正常BMI的PCOS患者发生OHSS的预测效果最佳,阈值为12.06 ng/ml,而对肥胖和超重的PCOS发生OHSS的预测有限.

目的 分析北京市社区妇幼保健人员分布均衡性及人员密度对儿童健康结果的影响.方法 采用横断面调查北京市所有承担社区妇幼保健工作的机构和个人.采用基尼系数和泰尔指数分析社区妇幼保健人员分布的均衡性;采用线性回归分析社区妇幼保健人员密度对儿童健康结果的影响.结果 2017年北京市社区妇幼保健人员密度为平均每5 000常住人口拥有0.65名妇幼人员.全市总体上妇幼保健人员数量分布的基尼系数为0.343,泰尔-T指数为0.202,泰尔-L指数为0.194.区内不均衡性在总体不均衡性中比例较大.社区妇幼保健人员密度与婴儿死亡率呈负相关.结论 北京市社区妇幼保健人员分布以区内不均衡为主.拥有足够数量的社区妇幼保健人员是保障服务人群健康结果的必要条件.

目的:探讨超高龄经产妇围生期妊娠并发症及妊娠结局的特点,为临床上预防高龄经产妇围生期不良结局提供指导.方法:选取北京市朝阳区、海淀区6家助产机构2016年11月—2017年2月分娩的经产妇,按照产妇年龄分为超高龄经产妇组(≥40岁)198例、一般高龄经产妇组(35～39岁)1110例、非高龄经产妇组(<35岁)1645例,对其一般人口学资料、妊娠合并症和并发症及新生儿健康状况等进行横断面调查,比较不同组别产妇妊娠并发症和不良妊娠结局的差异.结果:①超高龄经产妇组和一般高龄经产妇组选择剖宫产的比例比非高龄经产妇组高,分别为27.3％,22.1％和16.8％,差异有统计学意义(均P'<0.017).超高龄经产妇组的分娩孕周比非高龄经产妇组小,差异有统计学意义(P'<0.017).②校正了孕期增重、分娩方式、胎数和分娩孕周等影响因素之后,超高龄经产妇组发生妊娠期高血压、妊娠期糖尿病、产后出血、多次(≥2次)流产的风险高于非高龄经产妇组,OR值分别为3.70,1.98,1.74,3.44,均有统计学意义(均P<0.05);发生甲状腺疾病(甲减、亚甲减或甲亢)的风险低于非高龄经产妇组(OR=0.40,P=0.032);胎盘相关疾病和危重症2组比较差异无统计学意义.一般高龄经产妇发生妊娠期高血压、妊娠期糖尿病、多次(≥2次)流产的风险高于非高龄经产妇组,OR值分别为1.92,1.57,1.76,均有统计学意义.③超高龄经产妇组新生儿转入新生儿重症监护病房(NICU)、发生新生儿呼吸窘迫综合征(NRDS)的风险高于非高龄经产妇组,OR值分别为2.11和4.28,有统计学意义.一般高龄经产妇组新生儿发生NRDS的风险高于非高龄经产妇组(OR=2.11),有统计学意义.结论:超高龄经产妇发生妊娠不良结局的风险高于非高龄经产妇,对有可能成为超高龄产妇的育龄妇女,孕前应充分评估身体健康状况,加强孕前健康管理,对已妊娠的超高龄经产妇应严格进行围生期的随访和管理,以减少不良妊娠结局的发生.

目的 通过绩效考核结果分析,了解绩效考核效果,发现工作中的问题,不断提高政府部门对妇幼卫生工作重要性认识,促进妇幼卫生体系建设与发展.规范妇幼卫生各项服务,提高服务能力与水平,推动医药卫生体制改革相关政策的落实.方法 通过听取相关部门汇报、查阅资料、问卷调查、现场查看与日常工作相结合等方式,对辖区卫生行政部门、妇幼保健机构,助产机构、基层卫生服务机构、托幼机构等部门的妇幼卫生工作,进行整体评估.结果 6年的北京市妇幼卫生绩效考核发现,大部分区县在政府保障、妇幼保健网络建设、妇幼健康状况、妇幼保健管理与服务均有不同程度提升,实现持续改进.但部分远郊区县发展相对滞后,妇幼工作有待持续改进.结论 通过绩效考核,进一步推动妇幼卫生事业发展,及时发现工作中的问题,明确责任单位,督促积极整改,实现北京市妇幼卫生工作持续改进.

目的 了解生育政策调整后一孩、二孩产妇的构成及其不良妊娠结局的差异.方法 选取北京市朝阳区、海淀区6家助产机构2016年11-12月分娩的产妇,分为一孩组、二孩组,对其一般人口学资料、妊娠合并症和并发症、分娩方式及新生儿健康状况等进行横断面调查,比较不同组别产妇构成和不良妊娠结局的差异.结果 ①参与调查的产妇中,一孩产妇占产妇总数的62.9％,双独夫妇生育二孩者占4.8％,非双独夫妇生育二孩者占31.4％.3组产妇中非双独二孩组产妇年龄平均为33.9岁,一孩初产妇组年龄平均为29.8岁,两组差异有统计学意义(P＜0.05).②一孩初产妇组剖宫产率最低为29.4％,双独二孩经产妇组剖宫产率为40.6％,非双独二孩经产妇组剖宫产率最高为42.9％,差异有统计学意义(P＜0.05),2个二孩组剖宫产率差异无统计学意义(P＞0.05).③当调整了其他危险因素之后,二孩经产妇组发生急产的比例是一孩初产妇组的8.69倍,胎盘植入发生率是一孩初产妇组的1.67倍,前置胎盘发生率是一孩初产妇组的1.70倍,差异有统计学意义(P＜0.05).与一孩初产妇组相比,二孩经产妇组发生死胎死产、胎盘早剥、胎盘粘连及危重症的比例没有明显增加,差异无统计学意义(P＞0.05).④当调整了其他危险因素之后,二孩经产妇组的新生儿发生转入NICU、新生儿败血症、出生缺陷、呼吸窘迫、巨大儿及早产的比例与一孩初产妇组相比,差异均无统计学意义(均P＞0.05).结论 生育政策的调整促进了剖宫产率的下降,但是产科、儿科将面临更多的妊娠不良结局,尤其是前置胎盘、胎盘植入及急产等,因而需要提升产科、儿科医疗质量,以保障母儿平安.

目的:探讨接受辅助生殖助孕治疗的多囊卵巢综合征(PCOS)不孕患者和非PCOS不孕患者发生卵巢过度刺激d综合征(OHSS)的预测因子. 方法:回顾性分析2013年1～12月在我院生殖医学科就诊并行IVF/ICSI助孕治疗的不孕患者的临床资料(共1 233个周期).根据患者合并PCOS及OHSS发生情况将1 233个周期分为4组:PCOS-非OHSS组(n=83)、PCOS-OHSS组(n=8)、非PCOS-非OHSS组(n=1 123)和非PCOS-OHSS组(n=19).比较4组患者的基本情况、促排卵情况及妊娠结局,分析非PCOS患者和PCOS患者发生OHSS的预测因子,并通过受试者工作特征曲线(ROC曲线)及曲线下面积(AUC)分析预测因子的预测能力. 结果:各组的促排卵情况及妊娠结局比较发现,非PCOS-OHSS组的HCG日E2、获卵数、优质胚胎数、临床妊娠率和活产率均显著高于非PCOS-非OHSS组(P＜0.05);PCOS-OHSS组的HCG日E2、获卵数和优质胚胎数显著高于PCOS-非OHSS组(P＜0.05).促排卵持续时间、临床妊娠率和活产率等指标比较组间没有显著性差异(P＞0.05).对于非PCOS患者,预测OHSS的最佳截止点分别是:AFC 11.5个、HCG日E2 14 751.9 pmol/L、获卵数14.5个,敏感性分别为78.9％、89.5％、89.5％,特异性分别为65.1％、71.1％和74.5％;对于PCOS患者,预测OHSS的最佳截止点分别是:AFC 13.5个、HCG日E2 29 200.0 pmol/L、获卵数25.5个,敏感性和特异性分别为87.5％、87.5％、87.5％和34.9％、93.9％、94.0％.HCG日E2和获卵数组合模型与模型内单个变量的AUC值无显著差异.非PCOS组中,组合模型确定的最佳阈值与单个变量相比具有更高的特异性,但敏感性略低;PCOS组中,组合模型确定的最佳阈值具有略低的特异性,但敏感性更高. 结论:HCG日E2和获卵数对PCOS和非PCOS不孕患者OHSS的发生均有较好的预测作用,但两者的临界值不同.在临床应用时可以单独考虑.

Objective To understand the incidence and risk factors of iron deficiency anemia of 6～8-month-old infants in Beijing,in order to provide data support for further development interventions of infant anemia.Methods A cohort study was conducted,and stratified cluster sampling was used to select newborns having their health care in the community healthcare centers,and then following up the infants till the first blood test.After data cleaning,the single factor and Logistic regression were used to explore the risk factors of iron deficiency anemia.Results A total of 2 243 children were involved in this study,and the incidence of iron deficiency anemia was 19.6％ (446/2 243).Logistic regression showed that infants at the age of 6 to 8 months old whose parents' owning agricultural registered permanent residence(OR =1.568,95 ％ CI:1.164～2.112), whose family had more than one child (OR=1.490,95 ％CI:1.150～ 1.929), whose father was younger than 25 years old when the child was born (OR=1.660,95 ％CI:1.119～ 2.464),whose mother did not use chalybeate before pregnancy (OR=1.440,95％CI:1.071～1.936),who was delivered in the second level hospital (OR=1.465,95％CI:1.112～1.931),who are low birth weight (OR=3.340,95％CI:1.398～7.980),who was a boy (OR=1.285,95％CI:1.025～1.611) and who was breastfed (OR=2.217,95％CI:1.584～3.102) have a higher risk to anemia.Conclusion 1)The incidence of iron deficiency anemia in 6 to 8-month-old infant is high in Beijing.2)The factors influencing the infant iron status and socio-economic factors can lead iron deficiency anemia in infants.

目的 利用既有业务信息系统中收集的变量,构建北京地区6～8个月龄婴儿贫血的预测模型,以期早期发现婴儿贫血的高危人群.方法 采用队列研究的方法,分层整群抽取2014年10月-2016年8月在北京市西城区、海淀区和密云区的16家项目社区卫生服务中心进行儿童保健的新生儿进行随访调查,直至其6～8个月龄进行血常规检测为止.数据清洁整理后,应用Logistic回归构建预测模型.结果 利用Logistic回归分析对2 350名新生儿的相关指标进行筛选,共筛选出8个在既有业务信息系统中采集的变量,进行预测模型构建,分别为儿童保健社区所在辖区、母亲文化程度、父亲年龄、家庭儿童数、分娩机构级别、儿童性别、出生体质量及喂养方式.构建模型的ROC曲线下面积(AUG)为0.670,95％ CI为0.643～0.698 (P＜0.05).根据ROC曲线,确定婴儿贫血的临界点后,该模型对婴儿贫血的阴性预测率为90.6％,灵敏度为81.2％,特异度为42.4％.结论 利用既有业务信息系统收集的变量可构建6～8个月龄婴儿贫血的预测模型,该预测模型有较高的阴性预测率,能较好发现婴儿贫血高危人群.

目的 调查北京市东城区婴幼儿养育现状,为进一步针对性的干预提供依据.方法 采用自编儿童养育现状调查问卷对北京市东城区460名6月～3岁儿童家庭进行入户调查.结果 在养育行为方面:有15.2％的家庭曾经体罚过儿童,不能满足儿童接触大自然和与他人交往需求的家庭分别占34.6％、53％,有31.3％的儿童每天使用电子产品的时间超过1h,53％的家庭当儿童遇到问题时常常会帮忙解决,43.3％的家庭很少设定儿童玩的时间.母亲自身特征方面:母亲文化程度越高,陪伴儿童时间越短(x2 =0.153,P=0.001);母亲文化程度大学及以上者,更易鼓励子女自己做事(x2 =4.423,P=0.035),较少体罚儿童(x2=5.432,P=0.02);母亲生育年龄越大,陪伴儿童时间越长(x2=0.150,P=0.002);母亲生育年龄≥30岁者,经常对子女的需求立刻满足(x2=4.948,P=0.026);家庭结构方面:核心家庭经常带子女接触大自然(x2 =7.632,P=0.007)、家庭养育态度(x2=4.557,P=0.033)一致性方面更高.结论 目前北京市东城区婴幼儿家庭中存在一定不利于儿童早期发育的养育态度和行为,需针对性的开展家庭养育教育,以改善儿童家庭养育现状,促进儿童早期发育.

目的 建立一套适用于孕产妇及儿童健康管理信息系统开发的标准化的孕产妇及儿童健康管理统计指标体系,并在国家-省-地市级监管平台应用.方法 第一阶段指标体系研制;第二阶段测试与应用;第三阶段成果产出.结果 依据妇幼保健业务边界、国家及本项目对业务管理的要求,共收录绝对数指标117个,相对数指标72个.结论 《孕产妇及儿童健康管理信息系统》国家级监管平台一期建设中,已将标准化统计指标体系中的79个指标应用于平台建设,其中绝对数指标48个,相对数指标31个.

目的 评价促进亲子教育模式对北京城区婴幼儿家庭养育行为与养育态度的干预效果.方法 2013年12月-2014年3月分层整群抽取北京市海淀、石景山区4所社区卫生服务中心管理的4～11月龄婴幼儿270例,随机分为干预组140例和对照组130例.干预组在常规儿童定期体检中对家长个体化技能指导和咨询,并每月1次对家长进行知识讲座,对照组儿童及家庭仅接受常规儿童健康检查与指导,1年后通过问卷调查比较两组儿童家庭养育行为与养育态度情况.结果 270例儿童中完成研究者194例,失访者基本资料在两组间的比较差异无统计学意义(P＞0.05),因此两组研究结果具有可比性.干预组在家庭养育行为和养育态度方面较对照组有明显改善.干预组的父母经常和孩子一起看书的频率82.7％要高于对照组为66.3％,当孩子对小东西感兴趣时73.5％干预组父母要高于53.1％对照组父母会更多地引导孩子玩,两组差异均有统计学意义(P＜0.01).结论 社区促进亲子教育模式对改善近期北京市城区婴幼儿家庭养育行为和养育态度具有积极意义.

Objective To analyze the impacts of adjusting birth policy on Beijing obstetrics resources through summarizing the data reported by all the health care institutions at various levels that provide maternal health services in Haidian and Chaoyang districts in Beijing. Methods 44 health care institutions at various levels that provided maternal health services were selected from Haidian and Chaoyang districts due to their top two quantities in population and delivery institutions from 2014 to 2015. We extracted the comprehensive information reported to the Department of Information and Statistics of Beijing Obstetrics and Gynecology Hospital,Capital Medical University by these health care institutions,and observed the quarterly number of maternal registrations and of live births in obstetrics,the annual number of live births and obstetrics beds,undertaking number of live births per bed,daily outpatient visits,bed occupancy rate,the proportion of older mothers,the proportion of pregnant women with high risk,the proportion of high risk pregnant women with gestational diabetes and the proportion of high risk pregnant women with uterine scar of the year 2013 to 2015. Results The maternal registrations proportion of those who had met the policy that only - child parents could have a second child and had already had a second child in the total number of maternal registrations was 12. 2% ~ 15. 3% in 2014,and in 2015 was 5. 7% ~ 9. 3% . The number of second child live birth in 2014 to 2015 of those who met the policy that only - child parents could have a second child covered 10. 6% of total live birth numbers in obstetrics in 2014 to 2015. Among the 44 delivery institutions in Chaoyang and Haidian districts,the number of live births in obstetrics was 86 938,1 567 obstetrics beds with the undertaking number of 55 cases per bed in 2013;in 2014 the above three numbers were 112 854,1 867 and 60 separately;and in 2015,the numbers were 74 495,1 881 and 40 respectively. Compared with the undertaking number of live births per bed in obstetrics in 2013,the number in 2014 increased by 9. 1% ,and decreased by 27. 3% in 2015. Compared with 2014,the undertaking number of live births per bed in obstetrics in 2015 was decreased by 33. 3%. The daily outpatient visits in obstetrics of 2013,2014 and 2015 was 4 928,5 746 and 5 214 respectively;Compared with the daily outpatient visits in obstetrics in 2013,the number in 2014 increased by 16. 6% and in 2015 increased by 5. 8%. Compared with the daily outpatient visits in obstetrics in 2014,the number in 2015 decreased by 9. 3% . The rate of obstetrics beds usage in obstetrics was 86. 5% in 2013,91. 5% in 2014 and 71. 9% in 2015. The proportions of older mothers and pregnant women with high risks in 2014 and 2015 were higher than those in 2013( P ﹤ 0. 05);the proportions of older mothers and pregnant women with high risks in 2015 were lower than those in 2014(P ﹤ 0. 05). The proportions of high risk pregnant women with gestational diabetes and uterine scar in 2014 and 2015 were higher than those in 2013(P ﹤ 0. 05). The proportions of high risk pregnant women with gestational diabetes and uterine scar in 2015 were lower than those in 2014(P ﹤0. 05). Conclusion The birth policy adjustment leads to a short - time baby boom,which increases the number of live births undertaking and outpatient visits of the corresponding delivery institutions. Moreover,the dramatically increasing number of pregnant women with high risk generates growing pressures in obstetrics. Therefore,it is necessary to timely establish a perfect and superior maternal and child health service system.

Background Neonatal birth weight is an important index to measure the growth and development of fetus in the uterus, and it plays an important role in predicting the health condition, growth and development of the newborn in childhood.There are many studies exploring the risk factors of low birth weight and macrosomia, however, there are few studies collecting data in large cities like Beijing.Objective To investigate the distribution of neonatal birth weight in Beijing, and analyze the risk factors that affect the incidence of low birth weight and macrosomia.Methods We selected the infants born in 2014 with certificate of live birth from medical birth information database of Beijing maternal and child health information system, and extracted their medical information, including newborn′s gender, birth weight, gestational age at birth, region of birth, and mother′s maternal age, fetal number and place of household registry.Results We collected 269 609 cases of newborns′medical information.The average birth weight of the newborn boys was (3 398 ±489) g, and that of girls was (3 294 ±471) g.There were 10 753 (3.99%) cases of newborns with low birth weight and 21 685 (8.04%) cases with macrosomia.The incidences of low birth weight and macrosomia between different newborn′s gender, gestational age at birth and region of birth were significantly different ( P<0.05 ); the incidences of low birth weight and macrosomia between different mother′s maternal age, fetal number and place of household registry were also significantly different ( P <0.05 ) . The results of multivariate Logistic regression analysis indicated that girl, premature infant, born in urban area, maternal age below 25 years old and multiple fetuses were the risk factors for low birth weight; boy, postmature infant, born in suburb or exurb, maternal age over 34 years old, single fetus and non-Beijing household registrant were the risk factors for macrosomia (P<0.05).Conclusion The incidence of low birth weight is relatively low, whereas that of macrosomia is relatively high in Beijing for the year 2014. Newborn′s gender, gestational age at birth, region of birth, mother′s maternal age and fetal number are the root causes for newborn′s abnormal birth weight.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">多溴联苯醚（PBDEs）因工业生产导致其在环境中广泛存在,并可以通过食物链在生物体内蓄积。妇女儿童通过消化道摄入该物质,可导致癌症、内分泌紊乱、神经损伤等疾病,并且影响妇女生殖健康和儿童生长发育。由于多溴联苯醚在生物体内代谢的复杂性,其在人体内的代谢过程和毒性作用机制尚不明确,还有待于进一步研究证实。</span>

目的 了解各区县在妇幼保健信息管理方面人力的投入情况,对相关工作进行人员备案管理.方法 通过调查表方式于2006年和2014年分别对区级妇幼群体信息管理人员及前一年的工作情况进行调查,对两次调查结果进行分析.结果 与2006年比较,2014年区级妇幼保健机构专职群体信息管理人数增加了3倍,设立独立的信息管理科室的机构数增加了3.5倍;与2006年比较,2014年各区县妇幼信息化应用机构用户数和人员用户数较2006年统计的用户数分别增长了8.64倍和21.22倍;区级妇幼保健机构信息化管理人员人均管理的机构用户数为73个,人均管理的人员用户数为276个.结论 随着北京妇幼信息化工作的不断推进,北京市区级妇幼信息管理人才队伍已初步建立,但仍需进一步加大对信息管理部门与人才队伍的建设.