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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 establish interactive online survey system for monitoring hypertension risk factors during pregnancy using the research electronic data capture (REDCap) system. Methods Based on the actual requirements of monitoring hypertension risk factors during pregnancy, an interactive online survey system was designed using the REDCap clinical research data collection system provided by the Open Research Data Platform of Xi'an Jiaotong University. Then, the online designer, data dictionary, branch logic, calculated fields and other module functions were used to create variables and set logical jumps to implement the questionnaire tool form creation. Finally, project management functions such as user rights and permission modules and group management, adding data quality verification rules, were applied to implement the implementation of quality control of survey data. Results The design of the above-mentioned survey system was achieved and put into clinical use according to the predetermined goals, and good feedback and high evaluation were received from researchers. Conclusion Application of research electronic data capture in an interactive online survey system for monitoring hypertension risk factors during pregnancy that was accompanied by friendly interface, convenient access, secure data storage, complete investigation functions, perfect quality control, and easy follow-up management and maintenance, providing a convenient, efficient, secure and standardized data management tool for medical researchers to conduct relevant research.
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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 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 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.