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【Objective】 To evaluate the dietary quality with the dietary balance index (DBI_16) and the association between dietary quality and bone mass among middle-aged and elderly people in Gansu Province so as to provide evidence for improving dietary quality and bone health status of Gansu population. 【Methods】 Based on the information of the type and quantity of food intake and the bone mass of middle-aged and elderly people aged 35 years and above collected by the Gansu Project in the Regional Ethnic Cohort Study in Northwest China, DBI_16 was used to evaluate the intake level of cereals, vegetables, fruits, milk, beans, fish and shrimp, eggs and other foods, and the degree of inadequate, excessive and unbalanced dietary intake of the participants. Multiple linear regression was used to evaluate the associations of three component indexes of DBI_16, high bound score (DBI_HBS), low bound score (DBI_LBS), diet quality distance (DBI_DQD), and seven single indexes of DBI_16 with bone mass. 【Results】 Analyses of the dietary and bone mass data of 11,840 participants showed that 44.8% of participants consumed excessive amounts of cereals compared to the dietary recommendation. 96.3%, 90.6%, 90.1%, 71.9%, 95.1% and 60.3% of participants’ intake of vegetables, fruits, milk, soybeans, fish and shrimp, and eggs, respectively, were inadequate. 47.7% participants consumed less than 10 types of food. 2.3% participants’ DBI_LBS levels were appropriate. 54.7% participants’ DBI_HBS levels were appropriate. Only 1.2% participants’ DBI_DQD reached a balanced level. The bone mass level in the study population was (2.5±0.6) kg [(2.8±0.5) kg for men and (2.3±0.5) kg for women]. After adjusting for sociodemographic characteristics, lifestyle, total dietary energy intake and body mass index, DBI_LBS and DBI_DQD were negatively associated with bone mass [β and 95% CI was -0.002 01 (-0.003 62--0.000 40) and -0.001 76 (-0.003 09--0.000 43), respectively]. 【Conclusion】 Dietary intake imbalance is common among middle-aged and elderly people in Gansu Province, and the more severe the dietary intake imbalance, the lower the bone mass level.
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【Objective】 To estimate the prevalence, associated factors and patterns of multimorbidity of non-communicable diseases among adults in Shaanxi Province so as to provide evidence for the prevention and control of non-communicable diseases. 【Methods】 We used the data of adults aged 18 years and older collected in the baseline survey of Shaanxi Project in the Regional Ethnic Cohort Study in Northwest China. Multinomial logistic regression was used to explore the associated factors for multimorbidity. Exploratory factor analysis was used to extract patterns of multimorbidity. 【Results】 The prevalence of multimorbidity was 10.7% among the 44 442 participants. Age increase, being males, urban residence, and being overweight or obesity were positively associated with multimorbidity. Compared with women, men had a higher risk of multimorbidity. The OR and 95% CI was 1.25 (1.12-1.39). The risk of multimorbidity increased with age among adults. Compared with participants aged 18.0-34.9 years, the ORs and 95% CIs of those aged 35.0-44.9, 45.0-54.9, 55.0-64.9, and ≥65.0 years were 4.73 (3.47-6.46), 15.61 (11.60-21.00), 41.39 (30.76-55.70) and 90.04 (66.58-121.77), respectively. The primary multimorbidity patterns among adults in Shaanxi were cardiovascular-metabolic multimorbidity (5.4%), viscero-articular multimorbidity (1.0%), and respiratory multimorbidity (0.3%). 【Conclusion】 More than one in ten adults in Shaanxi Province had multimorbidity, and the predominant pattern of multimorbidity was cardiovascular-metabolic multimorbidity. The prevention and control of non-communicable diseases should be reinforced in middle-aged and older people, males, people living in the urban, and overweight or obese people. More attention should be paid to the prevention and control of cardiovascular-metabolic diseases.
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Objective@#To explore the association between the frequency of prenatal care in childbearing aged women and risk of small for gestational age (SGA) among neonatal twins in Shaanxi Province.@*Methods@#From July to December 2013, a total of 30 027 childbearing aged women, who were pregnant from January 2010 to November 2013 and had definite outcomes, were selected from 30 districts (counties) of Shaanxi Province by using the multi-stage random sampling method. The questionnaires with a face-to-face survey method were used to retrospectively collect demographic information, pregnancy history, lifestyle during pregnancy, disease history, nutritional supplements, and health care during pregnancy. Information on the gestational age and birth weight of the newborn were obtained by consulting the medical certificate of birth and were registered as twin A and twin B by birth order. Finally, 356 childbearing aged women and their twin babies with complete data were included in the analysis. A generalized estimation equation model was used to analyze the association between the frequency of prenatal care and the risk of SGA among neonatal twins.@*Results@#The age of childbearing aged women was (27.44±4.68) years old, of which 79.49% (283 women) were rural residents and 44.38% (158 women) had seven or more times prenatal care. The gestational age and birth weight were (37.64±2.51) weeks and (2 510±497) g, respectively. The prevalence of SGA was 51.40% (183/356) for twin A and 53.37% (190/356) for twin B, respectively. The prevalence of SGA was 44.30% (70/158) for twin A with seven or more times prenatal care and 42.41% (67/158) for twin B with seven or more times prenatal care, which was lower than that for twins with less than seven times prenatal care, respectively [57.07% (113/198) and 62.12% (123/198)] (P values were 0.017 and <0.001). The results of generalized estimation equation model suggested that compared to those with less than seven times prenatal care, after adjusting for parity, birth order, place of residence, maternal age, occupation, education, family wealth index, passive smoking, pregnancy-induced hypertension syndrome, folic acid, and iron supplement during perinatal period, and gender of the newborn, the OR (95%CI) of risk of SGA among childbearing aged women with seven or more times prenatal care was 0.60 (0.40-0.91).@*Conclusion@#Seven or more times prenatal care could reduce the risk of SGA among neonatal twins in Shanxi Province.
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Objective@#To analyze the types of dietary patterns of women during pregnancy in Shaanxi and their association with adverse pregnancy outcomes.@*Methods@#Data were derived from a cross-sectional program named "The prevalence and risk factors of birth defects in Shaanxi Province" from July to November in 2013. A multi-stage stratified random sampling method was used to extract 15 980 women of childbearing age who met the inclusion exclusion criteria from Shaanxi Province. The questionnaire obtained information such as the pregnancy outcome and the food intake of the study subjects during pregnancy. The dietary pattern was extracted by factor analysis, and the each dietary pattern of subjects were divided into T1-T3 groups according to the factor score. The effects of each dietary pattern on major adverse pregnancy outcomes were estimated by unconditional logistic regression model.@*Results@#Four dietary patterns were established:vegetarian pattern, balanced pattern, traditional pattern, and processing pattern. The multivariate logistic regression model results showed that compared with the vegetarian pattern T2 group, the T1 group had lower risk of low birth weight (OR=0.56, 95%CI: 0.41-0.83), and the T3 group had higher risk of low birth weight in offspring (OR=2.32, 95%CI: 1.59-3.89); compared with the traditional pattern T2 group, the T3 group had higher risk of premature (OR=2.62, 95%CI: 1.58-5.01); compared with the balanced pattern T2 group, the T3 group had a lower risk of spontaneous abortion (OR=0.73, 95%CI: 0.36-0.89); compared with the processing pattern T2 group, the T3 group had a higher risk of spontaneous abortion (OR=1.97, 95%CI: 1.36-3.34) and higher risk of stillbirth (OR=2.96, 95%CI: 1.49-6.26), and the T1 group had a lower risk of stillbirths in offspring (OR=0.52, 95%CI: 0.33-0.83).@*Conclusion@#The women of childbearing age in Shaanxi have different dietary patterns, and there may be a correlation between dietary patterns and adverse pregnancy outcomes.
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Objective@#To investigate the interaction of pregnancy-induced hypertension and history of preterm birth on the risk of small for gestational age.@*Methods@#Stratified multistage random sampling method was used to choose samples from 30 districts and counties of Shaanxi province. Information on childbearing-age women with their children between January 2010 and November 2013 was retrospectively collected through face-to-face questionnaire survey. The childbearing-aged women were in pregnancy or having had definite outcomes of pregnancy. Enumeration data were described by percentage, and measurement data were described by Mean±SD, and χ2 test was used to compare the rates. Unconditional logistic regression analysis was performed to estimate the interaction between pregnancy-induced hypertension and history of preterm birth on the risk of small for gestational age, and by using small for gestational age as dependent variables, pregnancy-induced hypertension and history of preterm birth as independent variables. Confounding factors were under control. Firstly, the association between pregnancy-induced hypertension and small for gestational age has been analyzed in primiparas, secondly, interaction of pregnancy-induced hypertension and history of preterm birth on the risk of small for gestational age has been analyzed in multiparas.@*Results@#A total of 25 751 women of childbearing age and their children were recruited. 60.55% (15 592/25 751) were primiparas, 39.45% (10 159/25 751) were multiparas, the rate of history of preterm birth was 1.89% (192/10 159) for multiparas. The incidence rates of pregnancy-induced hypertension and small for gestational age were 1.55% and 15.49% in pregnant woman (400/25 751) and their newborns (3 990/25 751). Unconditioned logistic regression analysis showed that compared with woman without pregnancy-induced hypertension, primiparas with pregnancy-induced hypertension had increased risk of small for gestational age (OR=1.43, 95%CI: 1.02-2.00, P=0.041). Regarding multiparas, the main effect of pregnancy-induced hypertension had a positive correlation with small for gestational age (OR=1.34, 95%CI: 0.91-1.96), but there was no statistical significance (P=0.138). The main effect of history of preterm birth was positively correlated with small for gestational age (OR=1.61, 95%CI: 1.13-2.31, P=0.009). The interaction term "pregnancy-induced hypertension×history of preterm birth" was positively associated with risk of small for gestational age (OR=5.93, 95%CI: 1.19-29.61, P=0.030).@*Conclusions@#Pregnancy-induced hypertension was associated with increased risk for small for gestational age in both primiparas and multiparas, and history of preterm birth further increased risk for small for gestational age in pregnant women with pregnancy-induced hypertension, indicating that there was multiplication interaction between pregnancy-induced hypertension and history of preterm birth.
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Objective@#To understand the relationship between medication during pregnancy and single live preterm birth of infant in women of childbearing age in Shaanxi province.@*Methods@#A cross-sectional design was used in this study and stratified multistage random sampling method was used. A questionnaire survey was conducted in the childbearing-aged women selected through multi stage stratified random sampling in Shaanxi during 2010 to 2013. Qualitative datum was described by percentage and measurement datum was described by mean±standard deviation. Logistic regression analysis was done to evaluate the relationship between medication during pregnancy and preterm birth of infant.@*Results@#The overall incidence rate of premature birth was 2.7% in Shaanxi. Among the 28 841 mothers participating in this study, the proportion of medication use at any time during pregnancy was 15.8%, and the most commonly used drug was cold medicine (5.9%). After adjusting all confounding factors, the multivariable logistic regression analysis results showed that taking hormone medicine (OR=2.23, 95%CI: 1.19-4.18), antihypertensive medicine (OR=7.74, 95%CI: 4.28-13.95) and other medicines (OR=2.15, 95%CI: 1.60-2.89) during early pregnancy were the risk factors for preterm delivery, the risk was 2.23 times, 7.74 times and 2.15 times higher compared with those taking no these medicines.@*Conclusion@#Using hormone medicine, antihypertensive medicine and other medicines during pregnancy increased the risk for preterm delivery in women of childbearing age in Shaanxi.
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Objective@#To explore the prevalence of chronic diseases and related risk factors in Shaanxi province.@*Methods@#Multi-stage stratified cluster random sampling was used to collect the sample from permanent residents in 10 national surveillance points in Shaanxi province in 2015. Behavioral risk factors (smoking, drinking, diet and physical activity) were investigated by face-to-face interviews and biological risk factors (BMI, blood pressure, blood glucose and blood lipid) were collected by physical measurements and laboratory tests. Designed weight, no response weight and post hierarchical weight were taken into account in the data analysis. Binary logistic regression models were used to examine the pair-wise associations among 8 risk factors.@*Results@#A total of 6 174 persons were included in the analysis. The following weighted prevalence were noticed in Shaanxi province in 2015, that including current smoking as 28.19%, harmful use of alcohol as 6.20%, inadequate intake of vegetables and fruits as 55.62%, physical inactivity as 19.56%, overweight and obesity as 46.82%, hypertension as 31.12%, raised fasting blood glucose as 4.27%, and raised total cholesterol as 20.96%. Eight risk factors were found to be associated with each other. The mean numbers of risk factors were 2.41 per male and 1.85 per female, 1.94 per urban resident and 2.28 per rural resident.@*Conclusions@#Risk factors for chronic diseases among adults aged 18 or older were more than the national levels in Shaanxi province in 2015. Male and rural residents presented more risk factors than their counterparts. Correlations between risk factors implied that a combined package of interventions was needed to reduce these risk factors.
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Objective@#To investigate the relationship between maternal disease in early pregnancy of women of childbearing age and congenital heart disease of neonates.@*Methods@#A cross-sectional design was used in this study and stratified multistage random sampling method was used. A questionnaire survey was conducted in the childbearing-aged women during 2010-2013 in Shaanxi province. Propensity score (PS) matched (1∶1) analysis was used to match participants with diseases to those without disease in early pregnancy. Through the control of the confounders step by step, a logistic regression model was established to evaluate the ORs of congenital heart disease according to the independent variable of maternal disease.@*Results@#A total of 28 680 pairs of mothers and infants were included in this study, the proportion of the women with disease in early pregnancy was 20.25% (5 807). After PS matching, 5 436 pairs were matched. After adjusting all confounding factors, the multivariable logistic regression analysis results showed that maternal disease (OR=1.86, 95%CI: 1.23-2.81), especially cold (OR=2.19, 95%CI: 1.46-3.28), gynecological disease (OR=4.74, 95%CI: 2.03-11.09) and diabetes (OR=14.00, 95%CI: 1.64-119.21), in early pregnancy were the risk factors for congenital heart disease of neonate.@*Conclusion@#In women of childbearing age, disease in early pregnancy, especially cold, gynecological disease and diabetes, can increase the risk of congenital heart disease in neonates.
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Objective To analyze the relationship between medication taken during pregnancy and congenital heart disease of the newborns.Methods A large cross-sectional survey was conducted between August and November 2013.A questionnaire survey was conducted among the childbearing aged women,selected through multistage stratified random sampling in Shaanxi from 2010 to 2013.All of the childbearing aged women under study were in pregnancy and with definite pregnancy outcomes.Multivariable Poisson regression was conducted for data analyses.Results A total of 28 680 cases were included in this study.The proportion of medication taken at any time during pregnancy was 16.0％,and the prevalence of congenital heart disease among the newborns was 67.9/10 000.After adjustment for factors as general demographic characteristic,history of heart disease and drug allergy and the situation of disease during pregnancy of these women,results from the multivariable Poisson regression showed that,factors as taking drugs (RR=1.95,95％ CI:1.42-2.68),cold medicine (RR=l.68,95％ CI:1.07-2.64),antibiotics (RR=1.90,95％ CI:1.25-2.90),salicylates (RR=5.01,95％CI:1.84-13.64) and antifungal drugs (RR=10.22,95％CI:3.25-32.19)during pregnancy were all related to congenital heart disease,and with the history of taking cold medicine (RR =1.90,95 ％ CI:1.01-3.61),antibiotics (RR =2.18,95 ％ CI:1.17-4.06),salicylates (RR =6.07,95％CI:1.45-25.41),antifungal drugs (RR=21.01,95％CI:4.17-105.87) and other drugs (RR=2.31,95％CI:1.19-4.47) during early pregnancy.These factors were with higher risks for congenital heart disease.Conclusion Women of childbearing age who took cold medicine,antibiotics,salicylic acid drugs,antifungal drugs and other drugs during early pregnancy would increase the risks related to congenital heart diseases.
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Objective To explore the association between maternal respiratory infection in early pregnancy and gestational age of single live birth.Methods A face to face questionnaire survey was conducted among child bearing aged women in 30 counties (district) of Shaanxi province selected through stratified multistage sampling.Propensity score (PS) matched (1 ∶ 1) analysis was used to match participants with respiratory infections to those without respiratory infections.A multilevel linear model was used to investigate the association between respiratory infections and gestational age.Through the control of the confounders step by step,three models were established in this study:model 1 for the variable of respiratory infections before PS matching,model 2 was adjusted for variables in model 1 plus some other individual differences of mother and baby,and model 3 for the variable of respiratory infections after PS matching.Results Of 28 848 child bearing aged women surveyed,3 676 (12.74％) had respiratory infections in early pregnancy.After PS matching,2 762 pairs were matched.Analysis with model 1 indicated that a decrease of 0.111 week (P＜0.001) in gestational age was associated with a respiratory infection during the first trimester.Analysis with model 2 and model 3 indicated that a decrease of 0.058 week (P=0.025) and a decrease of 0.076 week (P=0.036) were associated with respiratory infection during the fast trimester,respectively.Conclusion The respiratory infection during the first trimester was associated with the decrease of the gestational age of newborn.
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Objective To understand the effect of interpregnancy interval (IPI) of childbearing aged women on the birth weight of single live birth neonates in Shaanxi province.Methods A questionnaire survey was conducted among the childbearing aged women selected through multistage stratified random sampling in Shaanxi during 2010-2013,all the childbearing aged women had definite pregnancy outcomes.The interpregnancy interval of the childbearing aged women and the birth weight of the newborns were used as the independent variables and dependent variables respectively in multiple linear regression model and quantile regression model,and confounding factors were controlled.Results A total of 13 063 women at childbearing age and their infants were investigated.The incidence of low birth weight and macrosomia was 3.54％ and 7.62％ respectively.Multiple linear regression analysis showed that there was no significant difference in birth weight among different IPI group and control group.Quantile regression analysis showed when birth weight was at 5 percentiles,the difference in birth weight between newborns whose mothers had short interpregnancy interval (＜12 months) and those in control group was significant,when the birth weight was ≥90 percentiles,the birth weights of newborns whose mothers had long interpregnancy interval (60-119 months) were higher than those in control group,the difference was significant.As the increase of the percentiles of birth weight,the extent of changes gradually increased.Conclusion The analysis indicated that both short (＜12 months) and long (60-119 months) interpregnancy interval would had negative effects on birth weights of newborns.Therefore,planning for pregnancy is important for having a good perinatal outcome.
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Objective To analyze the relationship between medication taken during pregnancy and congenital heart disease of the newborns.Methods A large cross-sectional survey was conducted between August and November 2013.A questionnaire survey was conducted among the childbearing aged women,selected through multistage stratified random sampling in Shaanxi from 2010 to 2013.All of the childbearing aged women under study were in pregnancy and with definite pregnancy outcomes.Multivariable Poisson regression was conducted for data analyses.Results A total of 28 680 cases were included in this study.The proportion of medication taken at any time during pregnancy was 16.0％,and the prevalence of congenital heart disease among the newborns was 67.9/10 000.After adjustment for factors as general demographic characteristic,history of heart disease and drug allergy and the situation of disease during pregnancy of these women,results from the multivariable Poisson regression showed that,factors as taking drugs (RR=1.95,95％ CI:1.42-2.68),cold medicine (RR=l.68,95％ CI:1.07-2.64),antibiotics (RR=1.90,95％ CI:1.25-2.90),salicylates (RR=5.01,95％CI:1.84-13.64) and antifungal drugs (RR=10.22,95％CI:3.25-32.19)during pregnancy were all related to congenital heart disease,and with the history of taking cold medicine (RR =1.90,95 ％ CI:1.01-3.61),antibiotics (RR =2.18,95 ％ CI:1.17-4.06),salicylates (RR =6.07,95％CI:1.45-25.41),antifungal drugs (RR=21.01,95％CI:4.17-105.87) and other drugs (RR=2.31,95％CI:1.19-4.47) during early pregnancy.These factors were with higher risks for congenital heart disease.Conclusion Women of childbearing age who took cold medicine,antibiotics,salicylic acid drugs,antifungal drugs and other drugs during early pregnancy would increase the risks related to congenital heart diseases.
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Objective To explore the association between maternal respiratory infection in early pregnancy and gestational age of single live birth.Methods A face to face questionnaire survey was conducted among child bearing aged women in 30 counties (district) of Shaanxi province selected through stratified multistage sampling.Propensity score (PS) matched (1 ∶ 1) analysis was used to match participants with respiratory infections to those without respiratory infections.A multilevel linear model was used to investigate the association between respiratory infections and gestational age.Through the control of the confounders step by step,three models were established in this study:model 1 for the variable of respiratory infections before PS matching,model 2 was adjusted for variables in model 1 plus some other individual differences of mother and baby,and model 3 for the variable of respiratory infections after PS matching.Results Of 28 848 child bearing aged women surveyed,3 676 (12.74％) had respiratory infections in early pregnancy.After PS matching,2 762 pairs were matched.Analysis with model 1 indicated that a decrease of 0.111 week (P＜0.001) in gestational age was associated with a respiratory infection during the first trimester.Analysis with model 2 and model 3 indicated that a decrease of 0.058 week (P=0.025) and a decrease of 0.076 week (P=0.036) were associated with respiratory infection during the fast trimester,respectively.Conclusion The respiratory infection during the first trimester was associated with the decrease of the gestational age of newborn.
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Objective To understand the effect of interpregnancy interval (IPI) of childbearing aged women on the birth weight of single live birth neonates in Shaanxi province.Methods A questionnaire survey was conducted among the childbearing aged women selected through multistage stratified random sampling in Shaanxi during 2010-2013,all the childbearing aged women had definite pregnancy outcomes.The interpregnancy interval of the childbearing aged women and the birth weight of the newborns were used as the independent variables and dependent variables respectively in multiple linear regression model and quantile regression model,and confounding factors were controlled.Results A total of 13 063 women at childbearing age and their infants were investigated.The incidence of low birth weight and macrosomia was 3.54％ and 7.62％ respectively.Multiple linear regression analysis showed that there was no significant difference in birth weight among different IPI group and control group.Quantile regression analysis showed when birth weight was at 5 percentiles,the difference in birth weight between newborns whose mothers had short interpregnancy interval (＜12 months) and those in control group was significant,when the birth weight was ≥90 percentiles,the birth weights of newborns whose mothers had long interpregnancy interval (60-119 months) were higher than those in control group,the difference was significant.As the increase of the percentiles of birth weight,the extent of changes gradually increased.Conclusion The analysis indicated that both short (＜12 months) and long (60-119 months) interpregnancy interval would had negative effects on birth weights of newborns.Therefore,planning for pregnancy is important for having a good perinatal outcome.
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Objective To understand the levels of exposure to traffic-related air pollutants including nitrogen dioxide (NO2),PM10 and PM2.5,and the relationship between the exposure to air pollutants during pre-pregnancy or early pregnancy and birth defects.Methods Data on air pollution and birth defects from 2013 to 2015 was collected.A case-crossover design was employed to analyze the exposure-response relationship between traffic-related air pollutants and birth defects.Results A total of 4 235 pregnant women were studied.During the study period,the daily average concentrations of ambient NO2,PM10 and PM25 appeared as 60.83 μg/m3,104.94 μg/m3 and 103.88 μ.tg/m3,respectively,with the concentration of PM2.5 larger than the 2nd version of Standard National Ambient Air Quality Standard.In addition,there were strong correlations seen between each of the pollutants (P＜0.01).After adjustment for the influence of meteorological factors,it was found that the exposure to high level of NO2 and PM10 during pre-pregnancy or early pregnancy increased the risk on birth defects (P＜0.05).Conclusion Levels of exposure to adverse environmental factors during pre-pregnancy or early pregnancy could increase the risk of birth defects,suggesting that in these sensitive periods,women should try to avoid being exposed to high concentration of traffic-related air pollutants as NO2,PM10 etc.in order to reduce the risk of birth defects.
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Objective To understand the prevalence of prenatal supplementations of iron, iron-containing multi-micronutrients (IMMN) and antianemic Chinese patent medicines (ACPM) and associated factors in women in Shaanxi province. Methods A sample of 28367 childbearing-age women who gave birth during 2010-2013 and had specific information of the prenatal nutrients supplementation were recruited using stratified multistage cluster random sampling in Shaanxi province. The information about their basic characteristics and prenatal supplementation of nutrients were collected by a questionnaire survey. Descriptive analysis method was used to analyze the intake rate of iron, IMMN and ACPM during each period of pregnancy, and logistic regression model was used to identify associated factors. Results The overall prevalence of prenatal iron, IMMN and ACPM supplementation was low (28.99%), and the intake rate of iron was the lowest (5.33%). The prevalence of prenatal supplementation of iron, IMMN and ACPM were lower before pregnancy and in the first trimester than in the second and third trimester. The intake rates for consecutive 2 periods were very low (all were lower than 2.00%). The intake rates of iron, IMMN and ACPM significantly increased year by year. Women living in central Shaanxi had relatively high intake rates of iron (7.22%) and IMMN (16.55%), and women in southern Shaanxi had relatively high intake rate of ACPM (18.50%). The results of logistic regression analysis showed that higher educational level(OR=1.920, 95%CI: 1.617-2.279), antenatal care times≥6 (OR=1.832, 95%CI: 1.604-2.091), etc. were the positive factors for iron intake, and these positive factors were similar to those for IMMN intake. Additionally, rural residence was the negative factor for IMMN intake (compared with urban residence, OR=0.872, 95%CI:0.788-0.966). Conversely, higher educational level (OR=0.855, 95%CI:0.746-0.979), higher household income (OR=0.864, 95%CI: 0.796-0.938) were negative factors for ACPM intake, and rural residence was its positive factor (OR=1.285, 95% CI: 1.141-1.447). Conclusions The prevalence of prenatal supplementation of iron, IMMN and ACPM were low in women in Shaanxi, especially the intake rate of iron was the lowest. The prophylactic iron supplementation before pregnancy or in the first trimester was rare. Measures should be taken to improve the prenatal supplementation of iron in Shaanxi and to standardize the clinical use of ACPM.
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Objective To understand the prevalence of birth defects, related diseases and mental status of women during pregnancy in Shaanxi province and to analyse the major risk factors on birth defects and congenital heart disease. Possible association between maternal diseases or mental status and the risk of birth defects, was also explored. Methods A cross-sectional design was used in this study and stratified multistage random sampling method was used. The whole survey was from Jury 2013 to November 2013. Logistic regression method was used to analyze the association between maternal diseases, mental status during pregnancy and birth defects. Results The overall prevalence of birth defects was 195.04 per 10000 in Shaanxi. Among the 29121 mothers participating in this study, 51.1% developed illness and 6.8%"changed their mental status during pregnancy. After adjusting all the confounding factors, results showed that, histories of cold", fever, and intrahepatic cholestasis were (OR=1.33, 95%CI:1.10-1.61, OR=1.54, 95%CI:1.09-2.16, and OR=32.77, 95%CI:4.08-263.04) respectively, during pregnancy that related to birth defects. Self-reported unstable mental status (OR=1.60, 95%CI: 1.19-2.15) and family friction (OR=2.07, 95%CI: 1.12-3.79) were both related to the birth rates. Histories of cold and fever (OR=1.59, 95%CI:1.28-1.98;OR=1.43, 95%CI:1.48-4.00), during early pregnancy, unstable mental status during mid-pregnant period (OR=1.52, 95%CI:1.05-2.19), unstable mental status during late-pregnant period (OR=1.63, 95%CI:1.05-2.19) and family friction during late-pregnant period (OR=2.89, 95%CI:1.16-7.20) were found to be related to birth defects. Compared with those without history of cold, those with the history of cold during first (OR=1.24, 95%CI: 1.02-1.52) and second stages (OR=2.06, 95%CI: 1.30-3.26) of pregnancy were more likely to bear fetus with birth defects. Compared with those without these histories, those with histories of fever (OR=1.49, 95%CI:1.04-2.13), emotional problem (OR=1.71, 95%CI:1.19-2.45) and related diseases (OR=2.67, 95%CI: 1.32-5.39) during the first period of pregnancy were more likely to bear fetus with birth defects. Conclusion The incidence of birth defects in Shaanxi was high. Histories of cold, fever, unstable mental status and family friction during pregnancy, seemed to have increased the risks of bearing child with birth defects.
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Objective This study explored the association between air pollution exposure and birth weight by using the multilevel linear model,after controlling related meteorological factors and individual differences of both mothers and babies.Methods Women of childbearing age who were pregnant in Xi'an from 2010 to 2013,were selected as objects of this study.Multistage random sampling method was used to select 4 631 subjects followed by a self-designed questionnaire survey.Data related to quality of air and meteorology were gathered from routine monitoring system.Gestational age and date of birth,together with the average levels of air pollution were calculated for each trimester on each mother,and then the impact of air pollution on birth weight was assessed.A multilevel linear model was employed to investigate the association between the levels of exposure to air pollution by birth weight.Confounding factors were under control.We established three models in this study:Model 1 which involving the variable of air pollution exposure.Model 2 was adjusted for variables in Model 1 plus some other individual differences of both mother and baby.Model 3 was adjusted for variables in Model 2 plus meteorological factors.Results There were significant differences seen in birth weight within the subgroups of gender,gestational age,mother's reproductive age,maternal education,residential areas and family incomes (P＜0.01) of the infants.However,there was no difference found in Model 1 (P＞0.05).Data from Model 3 indicated that a decrease of 13.3 g (10.9 g in Model 2) and 6.6 g (5.9 g in Model 2) in birth weight that were associated with an increase of 10 μg/m3 in the average level of NO2 and PM10 during the second trimester;A decrease of 13.7 g (9.8 g in Model 2) in birth weight was associated with an increase of 10 μg/m3 in the average level of NO2 during the third trimester.Conclusion After controlling for meteorological factors,the levels of exposure to NO2 and PM10 during the second trimester and NO2 during the third trimester were negatively associated with birth weight.
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Objective To explore the association between exposure to ambient air pollution during pregnancy and congenital heart disease so as to provide evidence for primary prevention of congenital heart disease.Methods Epidemiologic studies on ambient air pollution and congenital heart diseases were reviewed.Summary risk estimates were calculated at high versus low exposure levels and risk per-unit-increase in continuous pollutant concentration.Meta-analysis was conducted with Stata 12.0 software.Results A total of 20 articles in English were qualified for inclusion.Results from Meta-analysis showed that CO exposures were related to the increase on the risk of tetralogy of fallot (high versus low exposure level OR=1.22,95％CI:1.03-1.44),while the exposures to NO2 were related to the increase on risk of coarctation of aorta (per 10 mm3/m3 OR=1.01,95％CI:1.01-1.20).Exposures to O3 were related to the increase on risk of atrial septal defect (per 10 mm3/m3 OR=1.14,95％CI:1.03-1.26),and PM10 exposures were related to the increase on risk of atrial septal defect (per 10 μg/m3 OR=1.10,95％CI:1.03-1.19).In addition,there were inverse associations between CO and atrial septal defect and between PM10 and ventricular septal defect.Conclusion Exposures to CO,NO2,O3,PM10 during pregnancy seemed to be associated with congenital heart diseases.
ABSTRACT
Objective To explore the effect of maternal animal sourced food intake during pregnancy on neonate birth weight and provide scientific basis for guiding the reasonable diet intake in pregnant women and increasing neonate birth weight.Methods Data were derived from a cross-sectional project of "the prevalence and risk factors of birth defects in Shaanxi province",which were conducted in 30 counties in Shaanxi province from July to November in 2013.A stratified multistage random sampling method was used to select women who were pregnant between January 2010 and December 2013 for a random semi-quantitative food frequency questionnaire survey to collect the data on the frequency and amount of food consumption on animal protein sources and the data of newborns.Children aged 0-1 years and their mothers were selected as the study subjects.The generalized linear model was used to analyze the relationship between the neonate birth weight and maternal animal sourced food intake during pregnancy,and by using neonate birth weight as dependent variable,food intake frequency as independent variable,three adjustment models were established for stratified analysis.Results Totally 11 459 participants were involved in this study.The average birth weight of newborn was (3 279.9 ± 454.6) g,the average weekly intake of animal sourced foods was 4.00 times for egg,1.50 times for meat,3.00 times for dairy foods,0.50 times for fish and 5.00 times for overall animal sourced foods in pregnant women.Without stratification,three models shown that meat and overall animal sourced food intake had effects on neonate birth weight.After adjustment for gestational weeks,maternal age,social and demographic factors and others,meat intake increased by 1 time a week,the increase of neonate birth weight was about 5.26 (95％ CI:1.32-9.20) g,and the overall animal food increased by 1 times a week,the average neonate birth weight increased by 3.24 (95％ CI:1.09-5.39) g.Stratified analysis showed that meat and overall animal sourced food always had more influences on baby girls and those living in rural area.In the region classification,the overall animal sourced food intake had more influences on women living in northern area and Guanzhong area of Shaanxi,and meat intake had greater influence on women living in southern Shaanxi.And the influences were positive,the more animal sourced foods were taken,the greater the birth weight increased.Conclusion Animal sourced food intake during pregnancy would benefit the increase of neonate birth weight.It suggests that pregnant women should pay more attention to the intake of animal sourced food.