Objectives: To analyze the dose-response relationship between maternal Blood pressure (BP) in different trimesters and preterm birth(PTB). Design: A monitoring data (cohort) study. Setting and population: All single-fetus pregnant women who delivered during 2014-2018 in 13 counties of 6 provinces in China. Methods: Through the Maternal and Newborn Health Monitoring System in China, the monitoring data were obtained, including essential maternal information, all previous antenatal examination and pregnancy outcomes of all pregnant women lived in the monitoring area. Main outcome measures: PTB(delivered between 28 and 37 weeks); Hypertensive disorders of pregnancy(HDP)(SBP ≥140mmHg and/or DBP ≥90mmHg once); Hypotension (SBP<90mmHg and/or DBP<60mmHg once). Results: A total of 212,941 single-fetus pregnant women were included. The overall incidences of HDP and PTB were 7.07% and 4.04% respectively. Taking the group of normal BP as reference, the odds ratios(OR) of PTB for the groups of HDP in 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). ORs of PTB had a nonlinearly U-shaped association with SBP and DBP in 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. Funding: Funded by the government of China (No.1311300011301). Key words: Maternal blood pressure, preterm birth, dose-response relationship, restricted cubic spline, hypertensive disorders of pregnancy, hypotension

Objective To analyze the distribution characteristics of the gene polymorphisms of key enzymes related to folate metabolism [5,10-methylenetetrahydrofolate reductase (MTHFR) and methionine synthase reductase (MTRR)] in women of reproductive age of the Han nationality in Jia County, China, and to provide a reference for folate supplementation for pregnant women. Methods A total of 554 women who underwent examinations during pregnancy in Jia County Maternal and Child Health Hospital from 2017 to 2019 were enrolled. Oral mucosal cell samples were collected from them, followed by DNA extraction. PCR was used to examine MTRR (A66G) and MTHFR (A1298C and C677T) polymorphisms. Results The distribution of polymorphisms of all the samples accorded with the law of genetic equilibrium. The proportions of TT, CT, and CC genotypes at the C677T locus of the MTHFR gene were 42.8%, 43.3%, and 13.9%, respectively. The proportions of AA, AC, and CC ge-notypes at MTHFR A1298C were 77.3%, 22.0%, and 0.7%, respectively. The proportions of AA, AG, and GG genotypes at MTRR A66G were 56.7%, 36.6%, and 6.7%, respectively. There were seven combinations of MTHFR C677T and A1298C ge-notypes among the Han women of reproductive age in Jia County. TT/AA was the most frequent combination, which accounted for 42.8%. No TT/AC or TT/CC combination was found. There was a strong linkage disequilibrium between the two loci (D'=0.984,r2=0.233). Conclusion Different from those of Han women in other regions, Han women of reproductive age in Jia County show regional specificity in MTHFR and MTRR polymorphisms. There is a high proportion of the TT genotype at MTHFR C677T, with which genotype women should appropriately increase the dose and duration of folate supplementation according to actual situation during pregnancy.

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).

孕产妇贫血是导致孕产妇死亡和不良妊娠结局的关键因素,目前在全球仍处于较高的流行水平.为降低孕产妇贫血患病率,提高母儿健康水平,各国政府先后出台了多项政策、策略措施,并提出了防控目标.但由于现有国内外很多研究中孕产妇贫血的诊断标准、研究对象等存在差异,导致孕产妇贫血患病率的范围较大,从而对我国制定政策及对现有策略措施的评价带来困扰.本研究对孕产妇贫血的诊断和流行状况进行综述,旨在为后续研究提供参考和新思路.

目的 调查研究白银市汉族女性叶酸代谢关键酶5,10-亚甲基四氢叶酸还原酶(MTHFR)和甲硫氨酸合成酶还原酶(MTRR)的基因多态性分布特征.方法 选取2017-2020年在白银市妇幼保健院进行孕期保健的331例汉族健康女性为研究对象,采集口腔黏膜上皮细胞,提取基因组DNA,通过荧光定量PCR分型检测MTHFRC677T、A1298C及MTRR A66G基因位点情况,并进行分析.结果 入组对象的基因多态性分布符合遗传平衡.汉族女性MTHFR 677CC、CT及TT的基因型频率分别为27.5％、45.0％及27.5％,C、T等位基因频率分别为50.0％、50.0％;MTHFR 1298AA、AC及CC的基因型频率分别为71.0％、26.6％及2.4％,A、C等位基因频率分别为84.3％、15.7％;MTRR 66AA、AG及GG的基因型频率分别为56.5％、38.4％及5.1％,A、G等位基因频率分别为75.7％、24.3％.汉族女性MTHFR C677T和A1298C两位点连锁有6种组合,频率最高的是CT/AA(31.4％),没有CT/CC、TT/AC及TI/CC组合.两位点间存在完全连锁不平衡(D'=1.0,r2=0.186).结论 获取白银市汉族女性MTHFR和MTRR基因多态性的群体遗传学特征,其中关键基因位点MTHFR C677T的高风险TT基因型比例为27.5％,低于已报道的山东淄博、河南新乡等地,高于新疆阿克苏、浙江丽水及广东佛山等地,说明叶酸利用能力中等,对于高风险人群应加强孕期管理,同时此研究也可为白银地区育龄女性进行个体化增补叶酸提供理论依据.

背景 在政府推进基层控费步伐越来越快的背景下,基层医疗卫生机构亟须发展出便捷、好用、通用的管理工具,来覆盖人力成本核算、服务绩效发放、新服务开发、服务对外定价、学科建设和人才培养等方方面面机构经营过程中常见问题的解决.标化工作量作为精确测算某个服务项目人力时消耗的工具,在测算过程中,用到的参数和变量涉及前述的方方面面问题,并可以通过精确的统计将上述问题的解决清晰化、定量化,并形成决策闭环.目的 本研究拟清晰阐述标化工作量的内涵、定义、操作定义、各种应用方式,便于读者理解、把握、应用、用好这一工具,来进行机构的治理与经营,以解决上述问题,加快基层医疗卫生机构的发展,早日实现卓越经营和合理控费.方法 从标化工作量的内涵出发,整理标化工作量的计算公式,得出与之关联的关键变量和参数,将参数进行不同的、有意义的组合和分析,逐一回答标化工作量助力机构经营与发展的各种应用场景.结果 标化工作量可以用来解决人力成本核算、服务绩效发放、新服务开发、服务对外定价、学科建设和人才培养等问题.结论 标化工作量既是用于政府经费拨付、内部绩效发放的计价工具,更是在开发自身特色服务时的定价工具、在开展服务改进和效率提升时的比对工具、在开展新技术和发展新业务时的循证思维工具,用好标化工作量可以加快社区卫生学科建设和人才培养.

目的 对珠海市汉族育龄女性开展分子流行病学调查,研究维生素D受体(VDR)的基因多态性分布.方法 以孕期保健的7983例汉族健康女性为研究对象,采集口腔黏膜上皮脱落细胞,抽提基因组DNA,使用荧光定量PCR方法检测VDR Bsm I和Taq I位点基因多态性,进行统计分析.结果 ①入组对象的基因多态性分布符合遗传平衡.②VDR Bsm I位点GG、GA及AA的基因型频率分别为90.2％、9.7％及0.2％,G、A等位基因频率分别为95.0％、5.0％.VDR Taq I位点TT、TC及CC的基因型频率分别为89.6％、10.2％及0.2％,T、C等位基因频率分别为94.7％、5.3％.③VDR Bsm I和Taq I两位点连锁有8种组合,频率最高的是GG/TT (88.3％),无GG/CC组合.两位点间存在高度连锁不平衡(D '=0.858,r2=0.695).结论 获取珠海市汉族女性VDR Bsm Ⅰ、Taq Ⅰ基因型和等位基因频率分布的群体遗传学特征.

目的:针对潍坊市汉族女性开展分子流行病学调查,研究叶酸代谢关键酶MTHFR和MTRR的基因多态性分布.方法:以孕期保健的670例汉族健康女性为研究对象,采集口腔黏膜上皮脱落细胞,抽提基因组DNA,使用荧光定量PCR方法检测MTH-FR C677T、A1298C和MTRR A66G基因多态性,进行统计分析.结果:1)入组对象的基因多态性分布符合遗传平衡.2)汉族女性MTHFR 677CC、CT、TT的基因型频率分别为13.73％、47.91％、38.36％,C、T等位基因频率分别为37.7％、62.3％;MTHFR 1298AA、AC、CC的基因型频率分别为75.52％、23.28％、1.19％,A、C等位基因频率分别为87.2％、12.8％;MTRR 66AA、AG、GG的基因型频率分别为54.63％、40.44％、4.93％,A、G等位基因频率分别为74.9％、25.1％.3)汉族女性MTHFR C677T和A1298C两位点连锁有7种组合,频率最高的是TT/AA(38.21％),没有CT/CC和TT/CC组合.两位点间存在完全连锁不平衡(D'=0.987,r2=0.237).结论:获取潍坊市汉族女性MTHFR和MTRR基因多态性的群体遗传学特征.

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: 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.

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.

背景 标化工作量作为社区卫生服务机构精确测算某个服务项目人力时消耗的工具,在测算过程中用到的参数和变量涉及社区卫生服务机构发展的方方面面,因此,极具实用性,但如何将标化工作量切实完整地用于整个社区卫生机构的运行和全面考核尚缺乏可指导操作的文献.目的 以北蔡社区为例,全面系统地介绍社区卫生服务机构如何应用标化工作量完成机构全体成员绩效薪酬核算问题,并在此过程中,同时回答如何梳理机构全部服务项目、如何建立不同业务科室之间的薪酬关系、如何完成对新增服务项目进行标化工作量赋值等问题.方法 以在真实世界中进行标化工作量测算时的实施流程为时间轴,分为4个主题6个步骤逐一介绍操作实施细节.结果 整理出了使用标化工作量进行全员绩效测算和新项目服务定价时的实际操作流程、遵照原则和计算公式.结论 整个实施过程操作细节的介绍,可以直接指导社区卫生机构同行标化工作量测算和应用等相关工作的开展,并特别介绍了机构对新增服务项目进行标化工作量赋值的操作办法,以及不同科室应采取何种策略保持在标化工作量思想和框架下进行绩效测算,以维持整个机构经营战略的统一.

目的 了解儿童家长儿童保健知识知晓情况,分析知识知晓的影响因素,为进一步开展针对性健康教育提供依据.方法 选择在东部、中部和西部地区部分县/市妇幼保健机构儿童保健门诊接受健康体检的2975名儿童家长进行问卷调查.结果 调查地区儿童家长儿童保健知识知晓率为25.9％.城市儿童家长知识知晓率(32.6％)高于农村儿童家长(21.5％)(P<0.05).医护人员(59.1％)、母婴健康类APP(50.4％)、微信/百度(38.1％)是儿童家长获取健康教育知识最常见的途径.Logistic回归分析显示,儿童家长儿童保健知识知晓水平与调查者为孩子的父亲(OR=1.602,95％CI:1.196～2.145)、孩子的年龄是0～岁(OR=2.749,95％CI:2.183～3.461)和3～6岁(OR=1.923,95％CI:1.540～2.403)、汉族(OR=2.693,95％CI:2.128～3.409)、城市(OR=1.324,95％CI:1.085～1.615)、东部地区(OR=1.449,95％CI:1.151～1.824)、高中/中专(OR=1.496,95％CI:1.126～1.990)、大专及以上(OR=1.957,95％CI:1.521～2.519)、家庭平均月收入5001～10000元(OR=1.341,95％CI:1.080～1.665)、>10000元(OR=1.630,95％CI:1.258～2.112)以及多种途径获取知识(OR=3.876,95％CI:2.118～7.095)有关.结论 调查的2975名儿童家长儿童保健知识知晓水平较低,应针对不同地区人群特点开展多层次、多渠道的专业性的健康教育服务.

目的:调查贵州省多民族育龄女性叶酸代谢关键酶MTHFR(C677T,A1298C),MTRR A66G基因多态性,获取本地区多民族育龄女性叶酸利用能力情况,同时为叶酸营养增补方案提供分子医学理论依据,更好地指导孕期保健.方法:选取2018年2月至2019年10月在本院产科进行备孕及孕期检查的女性作为研究对象,共计7761例(其中汉族6317例、苗族349例、布依族292例、土家族265例、侗族158例、彝族81例、仡佬族71例、穿青族64例、回族38例、白族35例、壮族35例、满族23例、黎族20例、仫佬族13例).采集并提取研究对象口腔黏膜上皮脱落细胞,抽提DNA,利用荧光定量PCR方法检测并分析受检者MTHFR(C677T,A1298C)和MTRR(A66G)基因分型情况.结果:贵州省汉族育龄女性MTHFR C677T位点基因型和等位基因频率与当地苗族、布依族、侗族育龄女性相比差异有统计学意义(P<0.05),与其他少数民族(土家族、彝族、仡佬族、穿青族、回族、白族、壮族、满族、黎族、仫佬族)相比无显著性差异(P>0.05);贵州省汉族与苗族、布依族育龄女性MTHFR A1298C位点基因型和等位基因频率相比有显著性差异,与其他少数民族(土家族、侗族、彝族、仡佬族、穿青族、回族、白族、壮族、满族、黎族、仫佬族)相比无显著性差异;贵州省汉族育龄女性MTRR A66G位点基因型与当地土家族、穿青族、白族育龄女性比较有统计学意义,汉族育龄女性MTRR A66G位点等位基因频率与当地布依族、土家族相比有显著性差异,与其他民族比较无统计学意义.结论:贵州省多民族育龄女性叶酸代谢关键酶基因位点多态性有其自身特点,部分与当地汉族育龄女性有区别,具有民族特性,可以有针对性地制定符合当地民族特征的个性化叶酸补服方案.

目的 了解并分析中国6省(自治区)孕产妇孕期铁剂补充状况及其影响因素.方法 2019年10月—2020年2月以方便抽样原则在监测地区的6个省(自治区)纳入1714名孕产妇作为调查对象,问卷调查收集其人口学特征、孕期铁剂补充等情况,采用多因素Logistics回归分析相关影响因素.结果 被调查的孕产妇中,孕期从未补充过铁剂、偶尔补充过、一直补充的比例分别为61.9％、23.6％和14.4％.孕期从未补充铁剂最主要的原因是"认为没必要"(53.4％),其次是"医生没有告知"(19.2％)和"总忘记吃"(9.6％).多因素Logistic回归结果显示,东部和西部地区孕产妇孕期铁剂补充率显著高于中部地区,分别是中部地区的1.50倍(OR=1.50,95％CI:1.06～2.11)和1.52倍(OR=1.52,95％CI:1.07～2.16);北方是南方的1.54倍(OR=1.54,95％CI:1.18～2.03);中孕期、晚孕期妇女以及产妇分别是早孕期妇女的1.58倍(OR=1.58,95％CI:1.02～2.44)、2.56倍(OR=2.56,95％CI:1.66～3.97)和3.52倍(OR=3.52,95％CI:2.27～5.46);在孕期进行过铁蛋白检测者是未检测的1.36倍(OR=1.36,95％CI:1.02～1.83);贫血者是不贫血者的1.71倍(OR=1.71,95％CI:1.16～2.52);铁缺乏症者是无铁缺乏者的2.91倍(OR=2.91,95％CI:1.91～4.42).结论 调查地区的孕产妇孕期铁剂补充率较低,不同地区、地域、人群间铁剂补充率存在较大差异,应有针对性地开展健康教育,以促进孕期合理补充铁剂.

目的 针对新疆塔城地区汉族、哈萨克族和回族女性开展分子流行病学调查,研究叶酸代谢关键酶5,10-亚甲基四氢叶酸还原酶(MTHFR)和甲硫氨酸合成酶还原酶(MTRR)的基因多态性分布.方法 以进行围孕期保健的籍贯为新疆的828名育龄女性为研究对象,其中汉族418名、哈萨克族279名、回族131名.采集口腔黏膜上皮脱落细胞,抽提基因组DNA,使用荧光定量PCR方法检测MTHFR C677T、A1298C和MTRR A66G基因多态性,进行统计分析.结果 ①入组对象的基因多态性分布符合遗传平衡.②汉族女性MTHFR 677CC、CT、Tr的基因型频率分别为26.6％、48.3％、25.1％,哈萨克族女性为52.3％、40.5％、7.2％,差异有统计学意义(P＜0.05),回族女性为26.7％、54.2％、19.1％,差异无统计学意义(P＞0.05).汉族女性MTHFR 1298AA、AC、CC的基因型频率分别为72.5％、23.9％、3.6％,哈萨克族女性为47.7％、42.3％、10.0％,差异有统计学意义(P＜0.05),回族女性为65.6％、29.8％、4.6％,差异无统计学意义(P＞0.05).汉族女性MTRR 66AA、AG、GG的基因型频率分别为51.2％、40.4％、8.4％,哈萨克族女性为32.6％、48.4％、19.0％,差异有统计学意义(P＜0.05),回族女性为41.2％、49.6％、9.2％,差异无统计学意义(P＞0.05).③汉族、哈萨克族、回族女性MTHFR C677T和A1298C两位点连锁均有6种组合,没有CT/CC、TT/AC和TT/CC组合.汉族、回族女性频率最高的是CT/AA,哈萨克族女性频率最高的是CC/AC.两位点间存在完全连锁不平衡.结论 获取新疆塔城地区汉族、哈萨克族和回族女性MTHFR与MTRR基因多态性的群体遗传学特征,为指导科学增补叶酸营养、实施个性化孕期保健提供依据.

目的 了解中国不同地区孕产妇健康知识知晓情况,分析孕产妇健康知识知晓的影响因素,为进一步开展针对性的健康教育提供依据.方法 于2019年12月-2020年5月,通过方便抽样方法,选择在东部、中部和西部地区部分县级妇幼保健机构进行产检或分娩的2 599名孕产妇,对其进行问卷调查.结果 调查地区孕产妇健康知识知晓率为31.36％.城市户籍孕产妇知晓率(34.41％)高于农村户籍(29.37％),东部地区孕产妇知晓率(41.57％)高于中部(28.08％)和西部(26.38％),不同地区和城乡之间差异均有统计学意义(均P＜0.05).医护人员咨询(66.67％)、新媒体(57.60％)是最常见的孕产妇获取健康知识的途径.logistic回归分析显示,年龄≥41岁、初产妇、高中及以上学历、通过多种途径获取知识以及居住于东部地区是影响孕产妇健康知识知晓的保护因素,经产妇、初中及以下学历、无业、通过单一途径获取知识、居住于中部和西部地区为孕产妇健康知识知晓的危险因素.结论 调查地区孕产妇健康知识知晓水平较低,孕产妇的年龄、生育情况、文化程度、职业、所在地区以及知识获取途径是其主要影响因素;应针对不同人群特点开展多层次、多渠道的专业性健康教育服务.

目的 针对山东省海阳市汉族女性开展分子流行病学调查,研究叶酸代谢关键酶5,10-亚甲基四氢叶酸还原酶(MTHFR)和甲硫氨酸合成酶还原酶(MTRR)的基因多态性分布情况.方法 选取2017年12月-2020年1月在海阳市妇幼保健服务中心进行围孕期检查的370名汉族健康女性为研究对象,采集所有研究对象口腔黏膜上皮脱落细胞,抽提基因组DNA,使用荧光定量PCR方法检测MTHFR C677T、A1298C和MTRRA66G基因多态性,并进行统计学分析.结果 入组对象的基因多态性分布符合遗传平衡.汉族女性MTHFR 677CC、CT、TT的基因型频率分别为15.7％、47.8％、36.5％,C、T等位基因频率分别为39.6％、60.4％;MTHFR 1298AA、AC、CC的基因型频率分别为77.6％、21.4％、1.08％,A、C等位基因频率分别为88.2％、11.8％;MTRR 66AA、AG、GG的基因型频率分别为53.5％、40.0％、6.49％,A、G等位基因频率分别为73.5％、26.5％.汉族女性MTHFRC677T和A1298C两位点连锁有6种组合,频率最高的是TI/AA (36.5％),无CT/CC、TT/AC和TT/CC组合.两位点间存在完全连锁不平衡(D'=1.0,r2=0.203).结论 获取海阳市汉族女性MTHFR和MTRR基因多态性的群体遗传学特征,为围孕期保健指导科学增补叶酸提供依据.

背景 标化工作量的计算公式中包含人力时、技术难度和风险程度三个变量,其中技术难度和风险程度是一种主观的度量,不同部门和工种的业务人员会有自己的度量衡,一般来说,相同工种的业务人员度量衡相对一致,但不同部门和工种的人员之间则难以获得相同的度量衡,这使得不同部门之间的技术难度和风险程度度量值不可比.目的 本研究拟在测算社区卫生服务项目标化工作量背景下解决跨部门的技术难度和风险程度主观度量衡均一化问题.方法 从标化工作量的内涵出发,选择专业的、有代表性的业务人员,获取其对所在科室各项目人力时、技术难度和风险程度的原始赋值,按照最小值和平均值原则进行转换,再将转换后的技术难度和风险程度取值乘以使用串联法得到的科室间转换系数,得到不同科室间可比的技术难度和风险程度最终取值,并使用排序法解决确定最终取值前的争议.结果 选择的专家权威程度基本大于0.7,结果科学可信,得到了各科室间的技术难度和风险程度转换系数,得到了各个科室所有项目可比的技术难度和风险程度最终取值.结论 标化工作量的技术难度和风险程度等参数的测量取值,需要选择有代表性的业务人员,获得其赋值结果,测得各人的原始赋值后,通过最小值及平均值原则、串联法、排序法,可以顺利地获得各个项目在全院范围内可比的技术难度和风险程度最终取值.