RESUMO
Objective: To analyze the incidence and causes of stillbirth in 11 hospitals of Guangdong province, and to explore the appropriate interventions. Methods: Clinical data of stillbirth in 11 hospitals of Guangdong province were collected from January 2014 to December 2016. The gestational weeks, causes, maternal conditions and other factors were analyzed. Results: (1) From 2014 to 2016, 103 472 newborns were delivered in the 11 hospitals, and the number of stillbirth was 2 204, with the incidence of 2.13%. Among them, 0.71%(738/103 472) was therapeutic induction, 1.42%(1 066/103 472) was natural stillbirth. At different gestational age (<28 weeks, 28-<37 weeks and ≥37 weeks), the incidence of stillbirth was 55.63% (1 226/2 204), 28.45% (627/2 204) and 15.92% (351/2 204), respectively, with statistically significant difference (P<0.01). (2) For stillbirth<28 weeks, the first reason was therapeutic induction, accounting for 53.34% (654/1 226). For stillbirth during 28-37 weeks, pre-eclampsia was the major cause, accounting for 40.67% (255/627). And for full-term stillbirth, the causes were umbilical cord factors (19.37%, 68/351), abnormal labor (17.09%, 60/351). (3) In all the stillbirth cases, the incidence of fetal growth restriction (FGR) <28 weeks was significantly higher than that during 28-37 weeks [23.49% (288/1 226) vs 18.02% (113/627) , P<0.01]. (4) The stillbirth rate during labor was significantly higher in women ≥35 years old than in younger women [63.88% (191/299) vs 36.12% (108/299) ; χ(2)=9.346, P=0.000]. For the causes of stillbirth during labor, the incidence of severe maternal obstetrical complications [61.11% (33/54) vs 38.89% (21/54) ; χ(2)=3.323, P=0.002], abnormal labor [65.82% (52/79) vs 34.18% (27/79) ; χ(2)=4.067, P=0.001] and abnormal fetal position [66.63% (26/39) vs 33.37% (13/39) ; χ(2)=3.002, P=0.013] were higher in women ≥35 years old than in younger women. (5) Cesarean section during labor accounted for 33.77% (101/299) of stillbirth, including 76 cases of emergency cesarean section or converted to cesarean section during labor. Conclusions: (1) The incidence of stillbirth in the 11 hospitals is high, and the causes are different at different gestational ages, therefore, different interventions are needed to reduce the incidence in different gestational weeks. Supervision of therapeutic induction should be strengthened <28 gestational weeks; standard management of pregnancy might decrease the occurrence of natural death ≥28 weeks. (2) Attention should be paid to fetal body weight during pregnancy, especially FGR. (3) The stillbirth rate is high in elderly pregnant women, so it is important to strengthen the management of the elderly pregnant women.
Assuntos
Distocia/epidemiologia , Retardo do Crescimento Fetal/epidemiologia , Pré-Eclâmpsia/epidemiologia , Natimorto/epidemiologia , Adulto , Cesárea , China/epidemiologia , Feminino , Retardo do Crescimento Fetal/etiologia , Idade Gestacional , Hospitais , Humanos , Incidência , Recém-Nascido , Trabalho de Parto , Gravidez , Cuidado Pré-Natal , Natimorto/etnologiaRESUMO
UNLABELLED: Chemical composition and antioxidant, antimicrobial activities of the essential oils from Thymus marschallianus Will. and Thymus proximus Serg. growing in the wild in Xinjiang were studied. Samples were collected from the aerial parts of the plants with simultaneous distillation-extraction apparatus. The yields ranged between 1.22%+/- 0.01 and 0.16%+/- 0.01 (weight/dry weight), respectively, 53 and 60 kinds of volatiles, representing 99.6% and 99.7% of the essential oils, respectively, were identified in extracts from T. marschallianus and T. proximus by GC/MS analysis. The main components were Thymol (28.0% to 32.9%), p-Cymene (7.7% to 25.4%), and gamma-Terpinene (18.0% to 22.4%). Antioxidant activities of the oils were evaluated using metal chelating, reductive potential, 2,2-diphenyl-1-picrylhydrazyl, hydroxyl radical, and modified thiobarbituric acid reactive substances assay. Antimicrobial activities of the oils were investigated on Escherichia coli, Staphylococcus aureus, Bacillus subtilis, yeast, Rhizopus, and Penicillium. The inhibition zones (IZ) and minimum inhibitory concentration (MIC) values were 5.0 to 35.7 mm in diameter and 1.81 to 4.52 microL/mL, respectively. PRACTICAL APPLICATION: Due to the economical impacts of spoiled foods and the consumer's concerns over the safety of foods, a lot of attention has been paid to naturally derived compounds. Fresh and dried Thymus species as well as their processed products have been widely used as flavorings since ancient times; however, during the last few decades, they also have become a subject for a search of natural antioxidants and antimicrobial agents. Biological activities of Thymus essential oils depend on their chemical composition, which is determined by the genotype and influenced by environmental conditions. Recent studies have showed that Thymus species have strong antimicrobial and antioxidant activities. To the best of our knowledge, the properties of Thymus species growing wild in the Xinjiang have not been reported before.