Objective Studies on the effect of prenatal exposure to magnetic field (MF) on fetal growth is inconclusive and subject to some methodological limitations, particularly in measurement of MF exposure. The present study aimed to examine the association between maternal extremely low frequency MF (ELF-MF) exposure during pregnancy and fetal growth in offspring. Methods A total of 128 pregnant women were recruited at their 3rd trimester and asked to wear an EMDEX Lite meter for 24 h to capture daily ELF-MF exposure. Time-weighted average (TWA), P50, and P75 of personal 24-h measurements were used to evaluate prenatal ELF-MF exposure. The medians of these measurements were used as cut-off points of high and low prenatal ELF-MF exposure. Fetal growth was measured by infant’s birth weight, skinfold thickness of triceps, abdomen, and back, and circumference of head, upper arm, and abdomen. These measures were conducted within 24-h after birth. Generalized Linear Model was used to examine the association between maternal ELF-MF level and fetal growth indices after potential confounders were adjusted for. Results Compared with girls with lower prenatal ELF-MF exposure, girls with higher exposure had a lower birth weight, thinner skinfold of triceps, abdomen and back, and smaller circumference of head, upper arm and abdomen in all three ELF-MF matrices. The differences were statistically significant for birth weight and most other growth measurements ( P < 0.05). These measures had no significant difference between higher and lower prenatal ELF-MF exposure in boys except back skinfold thickness. Conclusion Prenatal exposure to higher ELF-MF levels was associated with decreased fetal growth in girls, but not in boys.

PURPOSE:To examine the association between maternal use of beta-2-adrenergic agonists (β2AAs) and the risk of epilepsy in offspring. METHODS:A nationwide retrospective cohort study was performed based on Danish registries. Children of mothers who used β2AAs during pregnancy were allocated to the exposed group and other children to the unexposed group. The outcome was a diagnosis of epilepsy. Cox regression was performed to estimate the hazard ratios (HRs) of epilepsy after adjusting for parental and children factors. To evaluate confounding by indication, we extended the exposure time window from 2 years before pregnancy and stratified the analyses by maternal asthma, in particular analyses by trimesters. RESULTS:The exposed children had a 1.24-fold risk of epilepsy (HR = 1.24, 95% confidence interval [CI]: 1.12, 1.38). Compared with no prenatal exposure from 2 years before pregnancy through delivery, the HR was 1.11 (95% CI: 1.01, 1.22) in children of mothers with β2AAs use only before pregnancy, 1.28 (95% CI: 1.09, 1.50) only during pregnancy, and 1.23 (95% CI: 1.07, 1.41) both before and during pregnancy. The increased risk was only observed in children of mothers with β2AAs use in the first (HR = 1.33, 95% CI: 1.01, 1.75) or second trimesters (HR = 1.35, 95% CI: 1.05, 1.74), but not the third trimester. CONCLUSIONS:In utero exposure to β2AAs, particularly in the first or second trimesters, may be associated with an increased risk of epilepsy. It may partly be due to the indication of β2AAs use, but a direct effect of β2AAs cannot be ruled out.

OBJECTIVES: It has been shown that maternal prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) may be a risk factor for attention-deficit/hyperactivity disorder (ADHD) in offspring. Our goal was to examine whether paternal SSRI use before conception increases the risk of ADHD in offspring. METHODS: On the basis of Danish national registers, we conducted a cohort study of 781 470 singletons born between 1996 and 2008 with follow-up throughout 2013. The children whose fathers used SSRIs during the last 3 months before conception were identified as the exposed. Cox regression was used to estimate the hazard ratio (HR) of ADHD. RESULTS: A total of 7216 children (0.92%) were born to fathers who had used SSRIs during the last 3 months before conception. There were 12 520 children diagnosed with ADHD. Compared with unexposed children, the exposed had a 26% increased risk of ADHD (HR = 1.26, 95% confidence interval [CI]: 1.06–1.51) after adjusting for potential confounders. When extending the exposure window to 1 year before conception, paternal use of SSRIs only during the period of 12 to 3 months before conception was associated with the HR of 1.35 (95% CI: 1.10–1.66), whereas paternal use of SSRIs only during the last 3 months before conception was associated with a similarly increased risk of ADHD (adjusted HR = 1.31, 95% CI: 0.95–1.82). CONCLUSIONS: The mildly increased risk of ADHD in offspring associated with paternal SSRI use before conception could probably be due to the underlying indications related to SSRI use.

BACKGROUND:There are limited studies on the effects of paternal alcohol consumption, before conception, on the reproductive development of offspring. Anogenital distance (AGD), the distance from the center of the anus to the genitals, is a sensitive biomarker of reproductive hormone abnormalities during the critical developmental window. The relationship between paternal alcohol consumption and AGD of human offspring has not been studied yet.METHODS:This cohort study included 1,292 pregnant women recruited in Shanghai. An in-person interview was conducted to collect information on demographic characteristics of couples, and husbands' lifestyles, including drinking habits. AGD (boys, AGD-AP [anus-penis], AGD-AS [anus-scrotum]; girls, AGD-AC [anus-clitoris], AGD-AF [anus-fourchette]) measurements were performed at birth, and at 6 and 12 months of age. Multiple linear regression analysis was conducted to determine the association between paternal alcohol consumption before conception, and the AGDs of offspring.RESULTS:Data included AGD measurements of infants at birth (N = 980), at 6 months (N = 592, 60.4%), and at 12 months (N = 543, 55.4%). Boys in the paternal alcohol-exposed group had shorter AGDs, irrespective of the areas measured (AGD-AP and AGD-AS) and time of measurements, than those in the unexposed group. However, only the differences in AGD-AP at birth and AGD-AS at 6 months were statistically significant. For girls, the associations were similar at birth; however, the AGD-AC and AGD-AF were longer in the paternal alcohol-exposed group than the unexposed group at 12 months.CONCLUSIONS:Our findings provide first, but preliminary evidence, that paternal alcohol consumption within 3 months before conception may be associated with shorter AGD in the offspring, especially in boys, which indicates that paternal alcohol drinking may have an adverse effect on their reproductive development. Further studies should be conducted to validate these results.

Bisphenol A (BPA) is an extensively used chemical with endocrine disrupting properties. Although animal and in vivo studies have suggested possible effects of BPA on levels of gonadotropic hormones, human studies are limited and inconclusive. The study examined whether environmental BPA exposure was associated with gonadotropic hormones levels in men. A total of 560 men aged 18-55 years were recruited from Sandu County, Guizhou Province, China. We collected urine samples for measurement of BPA, and blood samples for measurement of reproductive hormones. We examined serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and total testosterone (T). Relative risk (RR) was obtained by log-binominal regression to explore the association between urinary BPA level and hormone levels. BPA was detected in 70.4% of urine samples, with a geometric mean of 0.50 μg/gCr. Men with detectable levels of BPA had a 1.52-fold increased risk of having a high LH level (>75th percentile) when compared with men with undetectable levels of BPA, after adjustment for potential confounders (95% confidence interval (CI): 1.04-2.21). The association persisted and slightly intensified among current smokers (adjusted RR (aRR) = 1.76, 95%CI: 1.05-2.95), while it weakened among non-smokers (aRR = 1.17, 95%CI: 0.69-1.96). Urinary BPA level was associated with an increased FSH level among smokers (aRR = 1.64, 95%CI: 1.01-2.67). Urinary BPA level was inversely associated with total T level among males with body max index (BMI) ≥25 kg/m2 although this association was of borderline significance (aRR = 0.52, 95%CI: 0.26-1.05). In conclusion, environmental exposure to BPA was associated with increased serum levels of LH and FSH in male smokers, along with decreased serum levels of total T in men with BMI≥25 kg/m2. These findings suggest that the effects of environmental BPA exposure on hormone levels might be modified by smoking and BMI.

ObjectiveThe present study aimed to examine the association between paternal selective serotonin reuptake inhibitor (SSRI) use before conception and the risk of autism spectrum disorder (ASD) in offspring.DesignA population-based cohort study.MethodsWe conducted a cohort study of 669 922 children born from 1998 to 2008, with follow-up throughout 2013. Based on Danish national registers, we linked information on paternal use of SSRIs, ASD diagnosed in children and a range of potential confounders. The children whose fathers used SSRIs during the last 3 months prior to conception were identified as the exposed. Cox regression model was used to estimate the HR for ASD in children.ResultsCompared with unexposed children, the exposed had a 1.62-fold higher risk of ASD (95% CI 1.33 to 1.96) and the risk attenuated after adjusting for potential confounders, especially fathers’ psychiatric conditions (HR=1.43, 95% CI 1.18 to 1.74). When extending the exposure window to 1 year before conception, the increased risk persisted in children of fathers using SSRIs only from the last year until the last 3 months prior to conception (HR=1.54, 95% CI 1.21 to 1.94) but not in children of fathers using SSRIs only during the last 3 months prior to conception (HR=1.17, 95% CI 0.75 to 1.82). We also performed stratified analyses according to paternal history of affective disorders and observed no increased ASD risk among children whose father had affective disorders. Besides, the sibling analysis showed that the ASD risk did not increase among exposed children compared with their unexposed siblings.ConclusionsThe mildly increased risk of ASD in the offspring associated with paternal SSRI use before conception may be attributable to paternal underlying psychiatric indications related to SSRI use or other unmeasured confounding factors.

Smoking is a well-known risk factor of reproductive health. However, the effect of paternal smoking on fertility has been less extensively examined. We conducted a cross-sectional study in a mountainous area of South-West China to assess the effect of male smoking on couples′ fertility. A total of 8200 couples aged 18-49 years in the study area were invited to participate in the study. An in-person interview was performed to collect demographic characteristics of the couples, and husbands′ life style factors including smoking and drinking habits. Information on time to pregnancy (TTP) was collected retrospectively. Infertility was defined as failure to achieve clinical pregnancy after regular unprotected intercourse for ≥12 months. Logistic regression model was used to estimate the association between male smoking and infertility. A total of 7025 couples were included in the final analysis. After adjusting for potential confounders, the couples were more likely to suffer from infertility if the husbands smoked (adjusted odds ratio [aOR] =1.28, 95% CI: 1.08-1.52) before the first pregnancy. After the analyses were performed according to husbands′ smoking duration, an increased risk started at a relatively longer smoking duration of 5-10 years (aOR = 1.58, 95% CI: 1.26-1.99) and a stronger association (aOR = 3.34, 95% CI: 2.45-4.56) was observed in the group of ≥10 years. Similar patterns were found for the number of cigarettes smoked per day and the total amount of cigarettes smoked. From our findings, we conclude that male smoking may have an adverse impact on couples′ infertility.

We aimed to examine the association between in utero exposure to β2AA and risk of attention-deficit/hyperactivity disorder (ADHD). We established a cohort of 672,265 children born from 1998 to 2008 in Denmark. Children were categorized as exposed if their mothers had redeemed a prescription of β2AA in pregnancy (from 30 days prior to conception until delivery). We identified children diagnosed with ADHD in the Danish National Hospital Register for the first time after his/her third birthday. Log-linear Poisson regression was used to estimate adjusted incidence rate ratio (aIRR) of ADHD. In total, 25,434 children were born to mothers who had redeemed a β2AA prescription in pregnancy. The exposed children had a 1.31-fold increased risk [aIRR = 1.30, 95% confidence interval (CI):1.20–1.42] of ADHD compared to unexposed children after adjusting for potential confounders. However, when extending the exposure window to 2 years prior to conception until delivery, exposure to maternal use of β2AA only before pregnancy, only during pregnancy, and both before and during pregnancy was associated with elevated risks of ADHD in children, with aIRRs of 1.31 (95% CI 1.22–1.40), 1.38 (95% CI 1.22–1.57), and 1.30 (95% CI 1.16–1.45), respectively. In mothers with a history of asthma, no association was observed between maternal use of β2AA during pregnancy and ADHD in offspring (aIRR = 0.92, 95% CI 0.74–1.15). In utero exposure to β2AA was associated with an increased risk of ADHD in children. However, it is more likely that confounding by indication, the underlying disorders or associated pathological conditions, may explain the association.

Male congenital malformations as cryptorchidism may contribute to the development of neurodevelopmental disorders directly or via shared familial genetic and/or environmental factors, but the evidence is sparse. Using population-based health registries, we conducted a cohort study of all liveborn singleton boys in Denmark during 1979-2008. Boys with a diagnosis of cryptorchidism were categorized into the exposed cohort and the other boys into the unexposed comparison cohort. The outcomes were diagnoses of any neurodevelopmental disorders and their subtypes. We used Cox proportional hazards regression to compute hazard ratios (HRs), taking into consideration several potential confounders. Among 884,083 male infants, 27,505 received a diagnosis of cryptorchidism during follow-up. Boys with cryptorchidism were more likely to be diagnosed with intellectual disability (HR = 1.77; 95%confidence interval [CI]:1.59,1.97), autism spectrum disorders (ASD) (HR = 1.24; 95% CI:1.13,1.35), attention-deficit hyperactivity disorder (ADHD) (HR = 1.17; 95% CI: 1.08,1.26), anxiety (HR = 1.09; 95% CI: 1.01,1.17), and other behavioral/emotional disorders (HR = 1.16; 95% CI: 1.08,1.26) compared to boys without cryptorchidism. The observed risks of intellectual disability, ASD, and ADHD were increased further in boys with bilateral cryptorchidism. Except for anxiety, cryptorchid boys had higher risks of neurodevelopmental disorders than their non-cryptorchid full brothers. The observed increased risks were similar among boys who underwent orchiopexy, as well as among those with shorter waiting times for this surgery. Cryptorchidism may be associated with increased risks of intellectual disability, ASD, ADHD, and other behavioral/emotional disorders. Cryptorchidism and neurodevelopmental disorders may have shared genetic or in-utero/early postnatal risk factors, which need to be further investigated.

Background: Bisphenol A (BPA) is an environmental endocrine disruptor and is found in many consumer products. Animal studies suggest that BPA may perturb pubertal development in males, although studies in humans are limited. Objective: This study investigated the association between BPA exposure and pubertal onset and progression among school-aged boys in Shanghai, China. Methods: A total of 671 boys aged 9-18 years from three schools (one elementary, one middle, and one high school) in Shanghai were enrolled in a cross-sectional study. Tanner stages for genital and pubic hair development and testicular volume were assessed by a specifically trained physician. Information concerning spermarche was self-reported. Urine samples were collected to examine peripubertal BPA exposure levels. Associations between BPA exposure and pubertal development, as indicated by the presence of different milestones in early puberty, mid-puberty and late puberty, were assessed using Poisson multivariate regression to derive adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs). Results: Earlier onset of genital and pubic hair development was observed in boys with moderate BPA exposure compared with those exposed to the least BPA; the adjusted PRs were 1.31 (95%CI:1.03, 1.68) and 1.28 (95%CI:1.02, 1.60) for onset of genital maturation and pubic hair development, respectively. A similar trend was seen for onset of testicular development, although the association was not statistically significant. Conversely, compared with the lowest level of BPA exposure, moderate BPA exposure was associated with delayed presence of the late stage of genital development, with an adjusted PR of 0.78 (95%CI: 0.65, 0.92). A suggestive inverse association was also observed between BPA exposure and late progression of testicular development. Conclusions: Our findings indicate an association between peripubertal BPA exposure and earlier pubertal onset, but delayed pubertal progression, in boys. Longitudinal studies of male pubertal development with periodic follow-up are needed to verify these results. (C) 2016 Elsevier GmbH. All rights reserved.

PurposeWe aimed to examine the risk of autism spectrum disorders (ASDs) in the offspring who were exposed to maternal use of 2-adrenoreceptor agonist (2AA) during pregnancy.MethodsThis is a population-based cohort study including all live singleton births in Denmark from 1 January 1997 to 31 December 2008. Children born to mothers who used 2AA during pregnancy were categorized as exposed, and all other children were included in the unexposed group. Cases of ASDs were identified from the Danish Psychiatric Central Register and the Danish Patient Register. Incidence rate ratio (IRR) and 95% confidence interval were estimated by Poisson regression models.ResultsAmong 751888 children in the cohort, 9098 (1.21%) received a diagnosis of ASDs. We observed an increased risk of ASDs in the exposed children (IRR=1.28, 1.11-1.47), especially for those who were exposed during the second trimester period (IRR=1.38, 1.14-1.67). However, when extending the exposure time window to 1year prior to pregnancy, we observed a similar association in children born to women who received 2AA treatment during pregnancy (IRR=1.33, 1.11-1.59) to that in children born to women who received 2AA treatment 1year prior to pregnancy (IRR=1.35, 1.17-1.56).ConclusionOur finding suggested that children born to women who used 2AA during pregnancy have an increased risk of ASDs in later life, which is more likely due to underlying maternal diseases rather than the exposure to 2AA itself. However, further study, which would better differentiate the effects between indication and medicine, is needed to corroborate the finding. Copyright (c) 2017 John Wiley & Sons, Ltd.

The study aimed to examine the relationships between calcium, magnesium, and calcium/magnesium ratio in semen plasma and sperm quality. It was a cross-sectional study based on a program aiming at promoting the reproductive health in less-developed areas. A total of 515 men aged between 18 and 55 years provided semen specimens at family planning clinics in Sandu County, Guizhou Province, China. Total calcium and magnesium concentrations in semen plasma were measured with flame atomic absorption spectrometry. Sperm quality, including sperm motility and concentration, was evaluated by using a computer-assisted sperm analysis method. The medians of seminal plasma calcium, magnesium, and zinc concentrations were 9.61, 4.41, and 2.23 mmol/l, respectively. Calcium concentration and calcium/magnesium ratio were negatively associated with sperm concentrations (β = −0.47, P = 0.0123 for calcium; β = −0.25, P = 0.0393 for calcium/magnesium ratio) after adjusting for zinc and other covariates. In stratified analyses, the association between calcium and sperm concentrations only persisted among subjects with a calcium/magnesium ratio of ≤2.5 (β = −0.71, P = 0.0268). In the same stratum, magnesium was associated with increased sperm concentration (β = 0.73, P = 0.0386). Among subjects with a calcium/magnesium ratio of >2.5, neither calcium nor magnesium was associated with sperm concentration. In conclusion, total calcium and magnesium concentrations were associated with sperm concentration among subjects with a lower calcium/magnesium ratio. The calcium and magnesium ratio had a modifying effect on the associations of calcium and magnesium with sperm concentration.

目的:了解孕期防辐射服的使用情况及其与不良妊娠结局的关系.方法:选取2012年4～8月在上海市闵行区妇幼保健院建档待产的1400名孕妇作为研究对象,于孕中期和孕晚期收集人口学资料,生活方式等信息,并在分娩时记录妊娠结局.结果:本研究中61.43％的妇女在妊娠时穿着防辐射服,其中,大学及以上文化程度、职业为公司职员、初次妊娠者所占比例较高,且使用手机和电脑的时间相对较长.多因素Logistic回归结果显示,是否穿着防辐射服与早产(OR=0.85,95％CI =0.37～ 1.94)、小于胎龄儿(OR=2.02,95％CI =0.73～5.57)、胎盘异常(OR=1.75,95％CI =0.44～ 6.94)和前置胎盘(OR=0.34,95％CI =0.12～ 1.08)之间的关联均无统计学意义.结论:现有结果尚不能说明孕期防辐射服的使用对早产、小于胎龄儿、胎盘异常和前置胎盘的发生有保护作用.

BACKGROUND:Being small for gestational age (SGA), a foetal growth abnormality, has a long-lasting impact on childhood health. Its aetiology and underlying mechanisms are not well understood. Underlying epigenetic changes of imprinted genes have emerged as a potential pathological pathway because they may be associated with growth, including SGA. As a common methyl donor, folic acid (FA) is essential for DNA methylation, synthesis and repair, and FA supplementation is widely recommended for women planning pregnancy. The present study aimed to investigate the inter-relationships among methylation levels of two imprinted genes [H19 differentially methylated regions (DMRs) and MEST DMRs], maternal FA supplementation and SGA.METHODS:We conducted a case-control study. Umbilical cord blood was taken from 39 SGA infants and 49 controls whose birth weights are appropriate for gestational age (AGA). DNA methylation levels of H19 and MEST DMRs were determined by an analysis of mass array quantitative methylation.RESULTS:Statistically significantly higher methylation levels were observed at sites 7.8, 9 and 17.18 of H19 (P = 0.030, 0.016 and 0.050, respectively) in the SGA infants compared to the AGA group. In addition, the association was stronger in male births where the mothers took FA around conception at six H19 sites (P = 0.004, 0.005, 0.048, 0.002, 0.021 and 0.005, respectively).CONCLUSIONS:Methylation levels at H19 DMRs were higher in SGA infants compared to AGA controls. It appears that the association may be influenced by maternal peri-conception FA supplementation and also be sex-specific.

BACKGROUND:Bisphenol A (BPA) is a suspected human endocrine disruptor which is widely used. METHODS:In order to determine whether urine BPA level is associated with serum reproductive hormone levels among male adults, we carried out a cross-sectional study in China. We recruited 592 male workers and collected their urine samples for BPA measurement. We also collected blood samples and examined serum reproductive hormones. We used multiple linear regression and log-binomial model to examine associations between urine BPA level and hormone levels after controlling for age and smoking status. RESULTS:An increased urine BPA level was associated with increased prolactin (p<0.001), estradiol (p<0.001), sex hormone-binding globulin level (p=0.001), and a reduced androstenedione (p<0.001) and free androgen index level (p=0.021). Males, whose urine BPA level was in the 2nd, 3rd and highest quartiles, had respectively 1.58, 1.33 and 3.09-fold increased prevalence of having a high prolactin level (>P75 level). The highest quartile of BPA level was associated with 1.63 and 1.50-fold increased prevalence of having a high estradiol and elevated sex hormone-binding globulin level. Males with higher quartile of BPA level had a lower inhibin B level. CONCLUSION:High BPA exposure is associated with increased prolactin, estradiol and sex hormone-binding globulin level in males, and may contribute to male infertility.

OBJECTIVE:To explore the relationship between age at menarche and infertility.STUDY DESIGN:The cross-sectional study investigated 6906 couples from the communities in Sandu Shui Autonomous County of Guizhou Province, China. Face to face interviews were conducted to collect information on age at menarche and time to first pregnancy, as well as demographic characteristics and lifestyle factors. Infertility was defined as being unable to become pregnant after attempting for ≥12 months. Poisson regression was used to assess the relationship between age at menarche and infertility of first attempt.RESULTS:The prevalence rate of infertility for the first pregnancy attempt of the study population was 11.87%. There is an obvious monotonic, almost linear, trend of prevalence rate of infertility with increasing age at menarche (P for trend: <0.001). Compared with wives with age at menarche of 13 years, the prevalence ratios of infertility were 0.71 (95%CI: 0.42, 1.20), 1.33 (95%CI: 1.05, 1.68), 1.47 (95%CI: 1.17, 1.85), 1.57 (95%CI: 1.20, 2.04), 1.41 (95%CI: 1.00, 1.99) and 1.73 (95%CI: 1.18, 2.52) for wives with age at menarche of ≤12, 14, 15, 16, 17 and ≥18 years, respectively, after adjusting for wife's year at birth, age at marriage, ethnic group, education and occupation, and husband's smoking and drinking habits before marriage.CONCLUSIONS:The present community-based study indicated that increasing age at menarche was associated with an increased risk of infertility in the study population.

目的:了解上海市在婚人群的二胎生育意愿,并探索其潜在的影响因素.方法:随机抽取上海市17个区县8 507名20～50岁在婚户籍人口进行二胎生育意愿调查,收集个人背景、经济状况等资料进行二胎生育意愿的影响因素分析.结果:在不考虑是否有政策约束时,35.16％的对象表示愿意生育二胎.现有孩子数为0个、文化程度高、家庭收入高的对象更倾向于选择生2个孩子,而年龄较大、健康状况较差、出生于上海本地、没有老人提供帮助的对象则不愿意生育二胎.结论:上海市在婚人群的二胎生育意愿不高.除生育政策外,个人背景、经济能力、社会文化等多方面因素制约着在婚人群的二胎生育意愿.

目的:了解围绝经期及绝经后妇女宫内节育器(IUD)的取出情况及实际使用年限.方法:以在黄浦区居住且末次使用避孕方法为IUD的45～60岁妇女为研究对象,于2011.08～12期间开展横断面调查,共调查2 167人,其中2 054人纳入分析.结果:研究对象平均年龄52.4±4.0岁.1 160例已绝经的妇女中,63例(5.4％)使用的IUD仍未取出,其中15例IUD已放置至绝经后5年以上;IUD的平均宫内放置时间为18.9±5.7年,50.2％的IUD使用者宫内放置时间＞20年.732例未绝经的妇女中,IUD的平均使用年限为17.3±5.7年,有51.1％的女性使用IUD已超出建议使用期限.结论:绝经后IUD过期使用情况严重,相当一部分正在使用的IUD已超过了使用期限.

目的:了解贵州省水族地区夫妇的原发不孕率及可能的影响因素.方法:采用随机整群抽样的方法,在贵州省三都水族自治县随机抽取10个乡镇作为研究现场,以在该10个乡镇居住的18～49岁初婚育龄妇女或其丈夫为研究对象,于2011年9月～2012年4月开展横断面调查.结果:共调查7 445位已婚育龄妇女或其丈夫,7 153份问卷合格.该地育龄夫妇的原发不孕率为11.37％.多因素分析显示,妇女计划妊娠年龄小、月经初潮年龄较大、文化程度低、职业为在机关事业单位工作,以及丈夫为以工为主的农民、有饮酒、吸烟习惯是原发不孕的危险因素.结论:贵州水族地区夫妇的原发不孕率为11.37％,夫妇的人口学特征及不良生活习惯是不孕的影响因素.

The aim of this study was to investigate the association between polymorphisms in folic acid metabolism-related genes and idiopathic recurrent early pregnancy loss (REPL). A prospective case-control study was performed on a cohort of 82 REPL patients and 166 healthy controls. Genotyping of methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C was assessed by applying polymerase chain reaction for amplification followed by DNA sequencing, for methionine synthase reductase A66G, solute carrier family 19, member 1 (SLC19A1) G80A and C696T, and genotyping was done by utilizing the Sequenom MassARRAY system. The results revealed a significant association between MTHFR A1298C polymorphism and idiopathic REPL. Haplotype analysis indicated that the MTHFR 677C-MTHFR 1298C allele combination was associated with REPL (P < 0.001). The MTHFR 677C-MTHFR 1298A and SLC19A1 80G-SLC19A1 696C allele combinations had lower frequencies in patients with REPL, but with P > 0.05 (P = 0.093 and P = 0.084, respectively).