A pre-conception cohort study of fertility and its related factors among couples with the intention of conception / 中华预防医学杂志

Objective: To describe fertility and explore factors associated with it among pre-conception couples of childbearing age. Methods: Based on the pre-conceptional offspring trajectory study of the School of Public Health of Fudan University, couples of childbearing age who participated in the pre-conception physical examination in Shanghai Jiading District from 2016 to 2021 were recruited and followed up. Couples' time to pregnancy (TTP) was analyzed and Cox proportional hazards regression model was used to explore the factors associated with TTP. Kaplan-Meier was used to calculate each menstrual cycle's cumulative pregnancy rate. Results: A total of 1 095 preconception couples were included in the analysis, the M(Q1,Q3)of TTP was 4.33 (2.41, 9.78) menstrual cycles. Age of women (FR=0.90, 95%CI: 0.85-0.95, P<0.001), women who were overweight or obese before pregnancy (FR=0.36, 95%CI: 0.24-0.55, P<0.001), women who were exposed to second-hand smoking (FR=0.63, 95%CI: 0.44-0.92, P=0.016), women whose home or office had been renovated in the past 2 years and had a particular smell (FR=0.46, 95%CI: 0.26-0.81, P=0.008) were risk factors for impaired fertility. Regular menstrual cycles (FR=1.64, 95%CI: 1.16-2.31, P=0.005), females who often drank tea/coffee (FR=1.55, 95%CI: 1.11-2.17, P=0.011) and males who took folic acid before conception (FR=2.35, 95%CI: 1.38-4.23, P=0.002) were associated with better fertility. The cumulative pregnancy rate of 3, 6, and 12 menstrual cycles was 37.6%, 64.4%, and 78.4%, respectively. Conclusion: Older couples, overweight or obesity before pregnancy, irregular menstruation, exposure to secondhand smoke and decoration pollutants in females are associated with impaired fertility. Frequent tea/coffee drinking before pregnancy in females and taking folic acid before pregnancy in males are associated with shortened conception time.

Relationship between breastfeeding knowledge， self-efficacy and exclusive breastfeeding behavior among postpartum mothers / 上海预防医学

Objective:To explore the relationship between breastfeeding knowledge， self-efficacy and exclusive breastfeeding behavior among mothers of one-month old babies. Methods:Random sampling method was conducted for choosing 5 out of 13 community service health centers in Jiading district of Shanghai. A cross-sectional online survey was conducted among the mothers. Results:A total of 456 valid questionnaires were received， the full score of breastfeeding knowledge was set at 60， with an average of 47.17±5.65， ranging from 12 to 60. The full score of self-efficacy was set at 70， with an average of 47.70±14.48， ranging from 14 to 70. The exclusive breastfeeding rate of one-month old infants was 55.3%（252/456）. Multivariate logistic analysis showed that mothers with higher scores of breastfeeding knowledge had significantly higher rate of exclusive breastfeeding （OR=1.717， 95%CI 1.034-2.851， P=0.037）. Those with higher scores of breastfeeding self-efficacy also had significantly higher rate of exclusive breastfeeding （OR=5.736， 95%CI 3.455-9.522， P=0.001）. Conclusions:The breastfeeding knowledge and self-efficacy of mothers of one-month old babies were significantly associated with the rate of exclusive breastfeeding. Medical staff should strengthen the delivery and cultivation of breastfeeding knowledge and skills for mothers to improve breastfeeding self-efficacy， and ultimately promote the rate of exclusive breastfeeding.