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Objective@#To investigate the health-seeking intention for urinary incontinence among adult women in Gansu Province, so as to provide insights into the management of female urinary incontinence.@*Methods @#Women at ages of 20 years and older who lived in 8 communities and 8 villages of Gansu Province for at least one year were recruited using the multi-stage stratified cluster random sampling method. A face-to-face questionnaire survey was conducted from October 2019 to February 2020, and the demographic features, urinary incontinence status and health-seeking intention were collected and descriptively analyzed.@*Results@#A total of 3 580 questionnaires were allocated and 3 485 were recovered, with a recovery rate of 97.35%. The respondents had a mean age of ( 51.18±17.13 ) years, with 1 759 respondents ( 50.47% ) that lived in urban areas, and 1 726 ( 49.53% ) that lived in rural areas. There were 1 150 respondents with self-reported urinary incontinence ( 33.00% prevalence ), including 340 cases with stress urinary incontinence ( 29.57% ), 78 cases with urge urinary incontinence ( 6.78% ) and 732 cases with mixed urinary incontinence ( 63.65% ). The overall proportion of health-seeking intention for urinary incontinence was 41.57%, and the proportions of health-seeking intention were 51.76%, 39.74% and 37.02% for stress, urge and mixed urinary incontinence, respectively. The proportion of health-seeking intention for urinary incontinence appeared a tendency towards a decline with the increase in household monthly income per capita and frequency of urinary leakage, and appeared a tendency towards a rise with the increase in educational levels ( P<0.05 ). In addition, a higher proportion of health-seeking intention for urinary incontinence was seen in women living in urban areas than in rural areas (5 3.63% vs. 31.98%, P<0.05 ), and a higher proportion was found in women with mental labors than in those with physical labors ( 60.81% vs. 40.24%, P<0.05 ), while a higher proportion was found in married women than in divorced or widowed women ( 44.33% vs. 23.53%, P<0.05 ).@*Conclusions@#There is a low proportion of health-seeking intention for urinary incontinence among adult women in Gansu Province. Age, occupation, place of residence, educational level, income, marital status, and frequency of urine leakage may affect the intention to seek medical care for urinary incontinence among adult women.
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Background Zinc is a trace element essential for normal fetal heart development, and excess zinc can be toxic. The relationship between maternal and fetal zinc levels and the development of congenital heart disease (CHD) in the offspring is unclear. Objective To study the effects of maternal and neonatal zinc exposure levels on the risk of developing CHD in the offspring. Methods The data and biological samples of the study subjects were derived from the birth cohort established by Gansu Provincial Maternity and Child Care Hospital in Lanzhou from 2010 to 2012. Questionnaire surveys were conducted at baseline in the first trimester and at follow-up visits in the second trimester, the third trimester, and 42 d after delivery. Maternal venous blood during the third trimester and neonatal umbilical venous blood at delivery were collected, and information on their birth outcomes was extracted from medical records. Ninety-seven children with CHD diagnosed by echocardiography at birth and confirmed at the follow-up after 42 d were selected as the case group, and 194 healthy full-term infants were selected as the control group, 1∶2 matched for maternal age and geographical location from the database. The zinc concentrations in whole blood of pregnant mothers and umbilical cord blood of fetuses in both groups were measured by inductively coupled plasma mass spectrometry. According to the quartiles P25 and P75 of zinc levels in the whole blood of pregnant mothers and neonatal cord blood in the control group, zinc exposure was divided into three groups: low, medium, and high. After adjusting for maternal vaginal bleeding in early pregnancy, pre-pregnancy folic acid and vitamin supplementation, birth weight, and umbilical cerclage confounders, a multiple conditional logistic regression model was applied to analyze the associations between maternal whole blood and fetal umbilical cord blood zinc levels and the risk of CHD in the offspring, and a further subgroup analysis was performed by disease classification. Results The medians (P25, P75) of maternal whole blood zinc levels in the case group and the control group were 5.034 (3.456, 6.644) and 4.693 (3.411, 5.646) mg·L−1, respectively, with significant differences between the two groups (P=0.029). The medians (P25, P75) of neonatal cord blood zinc level was 2.153 (1.479, 2.405) mg·L−1 in the case group and 1.636 (1.304, 1.979) mg·L−1 in the control group, with significant differences between the two groups (P<0.001). The zinc levels of maternal whole blood and neonatal cord blood in the simple CHD group were significantly higher than those in the control group (P<0.05). The multiple conditional logistic regression model showed that compared with the maternal medium zinc exposure level group (3.41-5.65 mg·L−1), the risk of offspring CHD was 2.225 times of the high exposure level group (>5.65 mg·L−1) (OR=2.225, 95%CI: 1.017-4.868). Compared with the neonatal medium zinc exposure level group (1.30-1.98 mg·L−1), the neonatal high exposure level group (>1.98 mg·L−1) also had an increased risk of CHD (OR=4.132, 95%CI: 1.801-9.480). The subgroup analysis results showed that compared with corresponding medium exposure level groups, the risk of simple CHD in the offspring of the maternal high zinc exposure level group was increased (OR=4.081, 95%CI: 1.427-11.669), and the risks of simple CHD (OR=7.122, 95%CI: 2.126-23.854) and complex CHD (OR=5.165, 95%CI: 1.859-14.346) of neonates of the neonatal high zinc exposure level group were increased. Conclusion Under the exposure levels of the study population, high concentrations of zinc exposure in pregnant mothers and neonates may be associated with the incidence of CHD.
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Objective To investigate the relationship between maternal body composition in first trimester and gestational diabetes mellitus (GDM). Methods In this nested case-control study based on a prospective cohort study, we enrolled gravidas between 8 and 14 weeks of gestation, who received prenatal care and voluntary nutrition evaluation in Gansu Provincial Maternity and Children Health Care Hospital, from July 2016 to January 2017. Body mass index (BMI) of each gravida was recorded and the maternal body composition including body fat, body fat percentage and fat-free mass was measured by bioelectrical impedance analysis. Pregnancy outcomes were followed up. A total of 70 patients diagnosed with GDM were allocated to the GDM group and 140 healthy gravidas matching for age and pre-pregnancy BMI were selected as the control group. Differences in body composition between two groups and their relationships with GDM were analyzed by Chi-square test and multivariate logistic regression. ResuLts Maternal BMI ≥ 30 kg/m2 (OR=1.973, 95%CI:1.095-7.664, P=0.024) and body fat percentage≥30%,≥35% and≥40% in first trimester (OR=1.261, 95%CI:1.021-2.982, P=0.010; OR=4.020, 95%CI: 1.341-7.950, P<0.001; OR=8.311, 95%CI: 5.018-42.771, P<0.001) were the risk factors of GDM. ConcLusions BMI ≥ 30 kg/m2 and body fat percentage ≥ 30% in first trimester are risk factors for GDM and excessive adipose tissue may play an important role in the development of GDM.
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Objective@#To investigate the influence of occupational stress on recurrent spontaneous abortion (RSA) in women of childbearing age.@*Methods@#From January to December, 2017, 75 working women of childbearing age (25-35 years) who were admitted to a provisional hospital in Lanzhou, China and diagnosed with RSA were assigned into patient group. At a 1∶4 ratio, 300 age-matched working women who had normal first pregnancy were randomly selected as controls. A case-control study was conducted by a self-made questionnaire and the effort-reward imbalance scale. The impact of occupational stress on RSA in women of childbearing age was analyzed by evaluation of occupational harmful factors, regularity, effort-reward ratio, and sleep quality.@*Results@#There were significant differences in the distribution of sleep, daily exercise, night shift, extrinsic-effort/low-reward score, and effort/low-reward score between the patient group and the control group (χ2=7.867, P<0.05; χ2=7.377, P<0.05; χ2=3.714, P<0.05; χ2=6.651, P<0.05; χ2=8.556, P<0.05) . With controlled factors such as general conditions and living habits, logistic regression analysis showed that poor sleep quality and high-effort/low-reward were risk factors for RSA (odds ratio[OR]=1.462, 95% confidence interval[CI]: 1.032~2.073; OR=3.253, 95%CI: 1.169~9.053) . A regular work was a protective factor against RSA (OR=0.644, 95%CI: 0.438-0.946) .@*Conclusion@#In occupational stress, irregular working hours, lack of sleep, and high-effort/low-reward are risk factors for RSA. Working women of childbearing age should ensure adequate sleep, pay attention to effort-reward balance, and make a regular work schedule.
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Objective To study the prevalence and the main risk factors of neonatal asphyxia in southern Gansu province high-altitude area.Method From October 2016 to December 2016,clinical data of neonates born in eight hospitals of the region were analyzed.A uniform questionnaire was used to survey the maternal condition and family background.Univariate and multivariate Logistic regression analysis were used to determine the risk factors of neonatal asphyxia.Result A total of 183 newborns were born with asphyxia (mild 157 cases,severe 26 cases),and the incidence of neonatal asphyxia was 15.3％ (183/1 197).The multivariate Logistic regression analysis indicated that the risk factors included altitude less than 3 000 meters (OR =2.693,95％ CI 1.275 ～5.689),maternal fever (OR =2.986,95％ CI 1.163 ～7.666),prolonged labor (OR =2.925,95％ CI 1.112 ～ 7.691),fetal distress (OR =7.000,95％ CI 3.254 ～ 15.056),uterine inertia (OR =2.737,95％ CI 1.484 ～ 5.047),umbilical cord abnormality (OR =3.094,95％ CI 2.051 ～4.668),amniotic fluid abnormality (OR =2.033,95％ CI 1.230 ～3.361)and placental abnormality (OR =2.753,95％ CI 1.016 ～ 7.464).Annual household income more than 30 000 yuan (OR =0.452,95％ CI 0.297 ～0.687) was protective factor of neonatal asphyxia.Conclusion The incidence of neonatal asphyxia was high in the region,which was related to intrauterine and intrapartum factors.Antepartum monitoring and timely treatment should be strengthened to reduce the incidence of newborn asphyxia.
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Objective To study the association of maternal calcium supplementation and dietary calcium intake with the preterm birth so that to provide scientific basis for effective intervention of preterm birth. Methods Normal pregnant women who were followed up all through to childbirth in Gansu Provincial Maternity and Child Care Hospital were selected. Multivariate logistic regression was used to evaluate the associ-ation of calcium supplementation and intake with preterm birth. Results After confounding factors were adjus-ted, pregnant women who took calcium supplement for more than 3 months before and/or during pregnancy had the risk of preterm birth reduced by 14% which was dose-responding ( OR=0. 86, 95% CI=0. 77-0. 96, P<0. 05). Through stratifying by trimesters of pregnancy, it was found that calcium supplement in the third trimes-ter was a protective factor for preterm birth and especially significant in early and very early pregnancy ( OR=0. 75, 95% CI=0. 62-0. 92, P<0. 05). Through stratifying by dietary calcium intake, pregnant women who took dietary calcium more than 465. 55 mg/d had the risk of preterm birth significantly reduced which was shown by the reduction of preterm birth of different degrees, controlled preterm labor and spontaneous premature dilivery (OR=0. 66, 95% CI=0. 53-0. 82, P<0. 05). Conclusion Appropriate calcium supplementation or dietary calcium intake before and during pregnancy can reduce the risk of preterm birth, which is especially sig-nificant in late pregnancy.