To explore the relationship between different conception time and gestational weight gain or abnormal birth weight. Methods: From October 2013 to September 2015, 29711 maternal and newborn who recorded in 12 counties of 6 provinces joining the health care systerm of national center for women and children’s health, China CDC were selected. The multiple logistic regression analysis was used to survey the correlation between different conception time and gestational weight gain or abnormal birth weight. Adjustment factors included maternal age, education, prepregnant BMI, district, and fetal sex. Results: The incidence of macrosomia was 5.9%, while incidence of small for gestational age of infants was 1.3%. During the autumn, the onset of pregnancy decreased the risk of macrosomia, when compared to that during the spring, the adjusted OR (95% CI) of incidence of macrosomia during the autumn was 0.76 and 0.660.88. The onset of pregnancy during the autumn and winter reduced the risk of weight gain too much of pregnant women. When compared to that during the spring, the adjusted OR (95% CI) of incidence of weight gain of pregnant women during the summer, the autumn, and the winter were 0.84 (0.760.91), 0.46 (0.420.50) and 0.42 (0.510.61), respectively. Conclusion: The seasonal pattern in abnormal birth weight was related to seasonality of gestational weight gain. Both the rate of gestational weight gain and the incidence of macrosomia were lower when women who become to pregnancy in autumn, which has suggested that pregnant women with high risk factors of macrosomia maybe choose to conception in fall.

2018 Vol. 26　(4):　244- [Abstract]（ 465 ） HTML (0 KB)  PDF  (0 KB)  ( 75 )

Objective: To investigate the reproductive health (RH) knowledge, attitude and behavior of tibetan reproductive women from pastoral area and urban area of Gansu province, and to provide evidence for government to strengthen the reproductive health technology service system of minority regions. Methods: A questionnaire survey on RH knowledge, attitude and behavior was conducted among 200 Tibetan women from pastoral area ( Nima town of Maqu county) and 200 Tibetan women from urban area (Huazangsi town of Tianzhu county). Results: The rate of known RH significance, the access to RH knowledge, and the awareness rate of sexually transmitted diseases (STDs) and their transmitted ways of Tibetan women from urban were significantly better than those of Tibetan women from pastoral (P<0.001). There were significant differences in visited doctors frequency for examining gynecological diseases, reasons of refusing visited doctors, type of sickness, the frequency of intercourse, and rate of reproductive hygiene between the two groups (P<0.001). As for the demands of RH, Tibetan women from urban would like to accept maternal and children health care, eugenics service, contraception service, sexual physiology and psychology knowledge, and STDs/ AIDS preventing. On the contrary, Tibetan women from pastoral women would like to accept the knowledge of maternal and children health care, contraception service, STDs/AIDS preventing, sexual physiology and psychology knowledge, just married couple care, the knowledge and prevention of artificial abortion, and the knowledge relation to twochild policy, which had significant differences between Tibetan women from urban and from pastoral（χ2=20.2，P=0.009）. As for the ways of accessing RH knowledge, from hospital doctor and family planning servicing personnel were the first choice of Tibetan women. Tibetan women from urban would liked to know RH information by newspaper and magazines (41% ), friends communication(11.5%), Wechat and blogging (9%), but Tibetan women from pastoral women intended to know RH information by Wechat and blogging (20.5%) , friends communication(18%), school education ( 11.5%), which had significant differences between the two groups (χ2=33.1，P＜0.001). Conclusion: There are significant differences in RH knowledge, attitude and behavior between Tibetan reproductive women from pastoral and from urban. The targeted and sustainable development plan on long time training programs and reproductive health education and propaganda in Chinese and Tibetan language should be conducted by multiple departments collaboration for improving health service system of childbearing age women from ethnic minority areas.

2018 Vol. 26　(4):　254- [Abstract]（ 441 ） HTML (0 KB)  PDF  (0 KB)  ( 46 )

Objective: To investigate the effect of different doses of levothyroxine tablets on thyroid function and pregnancy outcome of pregnant women with hypothyroidism. Methods: 120 pregnant women with hypothyroidism were selected in this study, and among them, 80 pregnant women were randomized divided into high dose group and low dose group (doses of levothyroxine tablets: 75ug/d vs. 50ug/d，100ug/d vs.75ug/d，125ug/d 100ug/d) by random number table. Other 40 pregnant women without given any drug except given diet treatment were in control group. The changes of thyroid function indexes of women before and after treatment in three groups were detected, and rate of complications and pregnancy outcome were compared among the three groups. The neonatal development scale (BSID) was used to assess neonatal development at 6 months after birth, which included intelligence development index (MDI) and motor development index (PDI). Results: After treatment, the level of TSH and TPOAb of women in the three groups decreased significantly (P<0.05). The decreased degree of TSH, TPOAb level of women in high dose group was significantly better than that of women in low dose group, and the decreased degree of TSH, TPOAb level of women in low dose group was significantly better than that of women in control group (P<0.05). The score of BSID, MDI and PDI of newborns in high dose group were significantly higher than those of newborns in low dose group, and the score of BSID, MDI and PDI of newborns in low dose group were significantly higher than those of newborns in control group (P<0.05). The rate of hypertension and cholestasis of women in the high dose group and low dose group were similar to those of women in control group (P>0.05), but the rate of abnormal glucose metabolism of women in high dose group and low dose group was significantly lower than that of women in control group (P>0.05). The rate of cesarean section, neonatal asphyxia, neonatal malformation and fetal death in high dose group and low dose group had no significant difference when compared to those of women in control group (P>0.05). The rate of extremely low body weight of infants in high dose group and low dose group was significantly lower than that in control group (P<0.05), and the rate of extremely low body weight of infants in high dose group was also significantly lower than that in low dose group(P<0.05). Conclusion: levothyroxine tablet can significantly improve the thyroid function and pregnancy outcome of pregnant women with hypothyroidism, and the effect of high dose of levothyroxine is better than that of low dose of levothyroxine.

2018 Vol. 26　(4):　270- [Abstract]（ 487 ） HTML (0 KB)  PDF  (0 KB)  ( 101 )

Objective: To explore the correlation of the pregnant outcome with the changes of electrocardiogram（ECG）of older pregnant women during late stage pregnancy. Methods：From February 2015 to February 2017, 378 older pregnant women( equal to or over 35 years old) who admitted in people's hospital of Wuyi county for prenatal examination and labor were selected in observation group, and during the same period, 370 pregnant women (less than 35 years old) were in control group. Women in both groups were examined by electrocardiogram during late stage pregnancy. The rate of abnormal ECG, cardiac arrhythmia, and pregnant outcome were compared between the two groups. Results：The incidence of abnormal ECG of women in observation group was 30.4%, and that of women in control group was 12.6%, which had statistical significance different (P< 0.05). The incidence of arrhythmia, short PR interphase, ST segment depression, left bias of electric axis, and low voltage of conduction of women in observation group were significant higher than those of women in control group. The rate of sinus tachycardia, sinus arrhythmia and room premature beat of women in observation group were significantly higher than those of women in control group (P<0.05)，but there were no differences in the incidence of sinus bradycardia, indoor conduction block and ventricular premature beats between the two groups (P > 0.05). In pregnant women with normal ECG, there were no significant difference in pregnant outcomes and neonatal birth weight between the two groups (P > 0.05), the incidence of premature infants in observation group was significant higher than that in control groups (P< 0.05). The incidence of abortion, premature birth, and low birth weight in observation group were significant higher than those in control groups (P< 0.05). Conclusion：The incidence of abnormal ECG of older women during late pregnancy increases. And the incidence of abortion, premature delivery and low birth weight of newborns of older pregnant women are also higher than those of pregnant women at the right age. Prenatal ECG monitoring for older pregnant women should be strengthened to ensure the safety of maternal and child.

2018 Vol. 26　(4):　279- [Abstract]（ 430 ） HTML (0 KB)  PDF  (0 KB)  ( 97 )

Objective: To investigate the clinical efficacy of palacelaparoscopy combined with GnRHa (Gonadotropinreleasing hormone agonist) for treating of endometriosis (EM) complicated with infertility, and to analyze influencing factors of postoperative pregnancy. Methods: 58 cases of EM patients with infertility treated by palacelaparoscopy surgery in Zhengzhou shenma maternity hospital were selected as research objects. 30 cases of patients were treated by GnRHa after operation were in observation group, and 28 cases of patients were treated by gestrinone after operation were in control group. The therapeutic effect and adverse reaction of drugs were compared between the two groups, and factors affecting postoperative pregnant rate of all included patients were analyzed. Results: The rate of symptom relief of patients in observation group was significantly higher than that of patients in control group, and the recurrence rate of patients in observation group was significantly lower than that of patients in control group (P<0.05). The incidence of vaginal bleeding and rate of aminotransferase elevated of patients in observation group were significantly lower than those of patients in control group (P<0.05). There was no significant difference in clinical pregnant rate between the two groups (P>0.05). In observation group, there was no significant difference in the age, the duration of infertility, and the history of pelvic surgery between the postoperative pregnant women and postoperative nonpregnant women (P>0.05). There were significant different in rAFS staging and tubal patency between the two groups (P<005). Multivariate analysis showed that rAFS staging and tubal patency were the key factors that affected the postoperative pregnant rate of observation group. Conclusion: The palacelaparoscopy combined with GnRHa to treat EM complicated with infertility can effectively increase the pregnant rate and reduce the risk of EM recurrence, decrease the adverse reactions, and improve the security. Tubal patency and rAFS staging are the main factors that affecting thepregnant rate of women with EM post operation, so women with EM postoperative should accept related examinations and IVF actively for improving pregnant rate.

2018 Vol. 26　(4):　286- [Abstract]（ 417 ） HTML (0 KB)  PDF  (0 KB)  ( 37 )

Objective: To observe the clinical effect of Shenqi Jiangtang granule combined with insulin aspart injection for treating women with gestational diabetes. Methods: 190 women with gestational diabetes mellitus(GDM) in department of gynecology and obstetrics of Zhoushan hospital were selected as research subjects from September 2014 to September 2016, and all the pregnant women were randomized divided into study group (95 cases) and control group (95 cases) according to the random number table. The pregnant women in control group were treated by insulin aspart injection only, and the pregnant women in study group were given oral administration of shenqi jiangtang granule except insulin aspart injection. The occurrence of adverse reactions of drugs during the treatment, the average dosage of insulin aspartate and the period of blood glucose up to standard of pregnant women in both groups were observed, and the blood glucose and glycosylated hemoglobin level after treatment were compared between the two groups. And the curative effect, rate of adverse pregnant outcomes, and rate of perinatal complications were evaluated between the two groups. Results: During the treatment, the average amount of insulin aspart used of women in study group(38.6±4.4) IU/d was significant lower than that of women in control group (52.7±6.3) IU/d, and the time of blood glucose up to standard of women in study group (4.5±1.1) d was significantly shorter than that of women(7.6±1.8) d in control group (P<0.05). There was no significant different in the incidence of adverse reactions of drugs between study group (8.4%) and control group (12.6%) (P=0.12). After treatment, the levels of preprandial and postprandial 2h blood sugar and glycated hemoglobin of women were significant lower than those of women before the treatment in the both groups (P<0.05), but there was no significant different in levels of preprandial blood glucose, postprandial 2h blood glucose and glycated hemoglobin of women between the two groups (P>0.05). The total effective rate of gestational diabetes in study group (96.8%) was significantly higher than that in control group (85.3%) (P<0.05). The incidence of cesarean section, premature birth and abortion of women in study group (30.5%, 2.1% and 3.2%, respectively) were significantly lower than those of women in control group (44.2%, 13.7% and 11.6%, respectively) (P<0.05), and the incidence of perinatal complications of women in study group (7.4%) was significantly lower than that of women in control group (26.3%) (P<0.05). Conclusion: Insulin injection combined Shenqi jiangtang granule for treating women with GDM can significantly improve the overall effect, decrease the dosage of insulin injection, shorten the time of blood glucose up to standard, improve pregnancy outcomes, reduce rate of perinatal complications, and don’t increase rate of adverse reactions of drugs.

2018 Vol. 26　(4):　294- [Abstract]（ 461 ） HTML (0 KB)  PDF  (0 KB)  ( 82 )