Preventive effect of one-day outpatient health management on adverse pregnancy outcomes in patients with gestational diabetes mellitus: a retrospective cohort study.

Background: One-day outpatient health management has been applied to treat gestational diabetes mellitus (GDM) and prevent further complications. However, the relationships between one-day outpatient health management and adverse pregnancy outcomes remain ambiguous, because of limited evidence. We analyzed the effects of one-day outpatient health management on premature birth, macrosomia and low-birth-weight infants in patients with GDM. Methods: We retrospectively enrolled pregnant women with GDM who delivered at Guiyang Maternal and Child Health Hospital between 2019 and 2021. Patients could voluntarily choose to participate in either the general outpatient health education or a one-day outpatient health management. Data on demographic and clinical characteristics were collected and pregnancy outcomes ascertained. Logistic regression analysis was used to detect the potential relationship between one-day outpatient health management and adverse pregnancy outcomes including preterm birth, macrosomia, and low-birth-weight infants. GDM, preterm birth, low birth weight and macrosomia was diagnosed according to the criteria established by Obstetrics and Gynecology (9th edition). Results: A total of 3,249 patients with GDM were included, and 798 (24.56%) patients participated in the one-day outpatient health management. Statistically significant differences were observed in the maternal age (P<0.05) and gravidity (P<0.001) between the study and control groups. The incidences of premature birth, low-birth-weight infant, and macrosomia in patients attending the one-day outpatient service were 9.6%, 8.1%, and 4.5%, while the incidences of those who did not attend the one-day outpatient service were 12.4%, 11.1%, and 7.5%. After adjusting for maternal age, ethnic groups, body mass index (BMI) before pregnancy, family history of diabetes, history of abnormal pregnancy, history of polycystic ovary syndrome, gravidity, hyperthyroidism and hypothyroidism, multivariate logistic regression analyses showed that this one-day outpatient health management was a protective factor for premature birth [odds ratio (OR) 0.751, 95% confidence interval (CI): 0.576-0.981], macrosomia (OR 0.567, 95% CI: 0.385-0.834) and low-birth-weight infants (OR 0.699, 95% CI: 0.522-0.937). Conclusions: The degree of acceptance of patients with GDM to a one-day outpatient health management is still low. This one-day outpatient health management may reduce the incidence of adverse pregnancy outcomes in women with GDM to a certain extent.

Factors influencing parents' willingness to vaccinate their preschool children against COVID-19: Results from the mixed-method study in China.

During the COVID-19 pandemic, little is known about parental hesitancy to receive the COVID-19 vaccine for preschool children who are the potential vaccinated population in the future. The purpose of this mixed-method study was to explore the factors influencing Chinese parents' decision to vaccinate their children aged 3-6 years old against COVID-19. In July 2021, we conducted semi-structured interviews (n = 19) and a cross-sectional survey (n = 2605) with parents of kindergarten children in an urban-rural combination pilot area in China. According to the qualitative study, most parents were hesitant to vaccinate their children with the COVID-19 vaccine. In the quantitative study, we found that three-fifths of 2605 participants were unwilling to vaccinate their children against COVID-19. Furthermore, the main predictors of parents' intention to vaccinate their children were fathers, lower level of education, and positive attitudes toward vaccination. Based on our findings, targeted health education techniques may be able to boost childhood COVID-19 immunization rates.

Molecular epidemiology and clinical features of hand, foot and mouth disease requiring hospitalization after the use of enterovirus A71 inactivated vaccine in chengdu, China, 2017-2022: a descriptive study.

Three inactivated enterovirus A71 (EV-A71) vaccines have been widely vaccinated among children in the targeted age group in mainland China since mid-2016. However, comprehensive virological surveillance of hand, foot and mouth disease (HFMD) over multiple years after the use of EV-A71 vaccines has rarely been conducted. Using long-term data extracted from the Public Health and Clinical Center of Chengdu, we described the clinical, aetiological, and epidemiological characteristics of HFMD inpatients after the use of EV-A71 vaccines from 2017 through 2022. A total of 5115 patients were selected for analysis with a male-to-female ratio of 1.63:1 and were mostly under 5 years of age (97.6%). Among these cases, 4.3% presented with severe symptoms, and 4.1% of severe cases experienced significant complications. EV-A71 was no longer the major serotype for laboratory-confirmed HFMD, responsible for 15.6% of severe cases and 1.2% of mild cases. A significant downwards trend of EV-A71 infections was observed after the use of EV-A71 vaccines (P for trend < 0.001). Coxsackievirus A6 was the predominant pathogen, accounting for 63.5% of mild cases and 36.2% of severe cases. Coxsackievirus A10 (CV-A10) and A16 were sporadically detected, and an upwards trend was observed in the proportion of CV-A10 infections. This study provides baseline molecular epidemiology for the evaluation of EV-A71 vaccination impact and potential serotype replacement based on HFMD inpatients. Additional nationwide and population-based epidemiologic and serologic studies are essential to elucidate HFMD dynamics after the use of EV-A71 vaccines, and to inform public health authorities to introduce optimized intervention strategies.