ABSTRACT
Objective:To identify problems and demands for antenatal care (ANC) among pregnant women in different trimesters of pregnancy in Shanghai for optimizing ANC service during the epidemic of COVID-19.Method:s Organized by maternal and child health care institute in the 16 districts of Shanghai, a cross sectional study was conducted among pregnant women who came to pregnancy registration in the community health centers or attended ANC in midwifery hospitals from February 7 to February 12, 2020. Consented participating women completed a semi-structured online questionnaire voluntarily. Data was analyzed using frequency,chi-square test and scoring.Result:s A total of 2 002 valid questionnaires were collected from 183 community health centers and 67 midwifery hospitals. About 94.6%(1 894/2 002) of the pregnant women worried about being infected during the COVID-19 epidemic, and 14.7% (294/2 002) demanded for psychological consultation. Time-lapse appointments for ANC were requested by 87.7% (1 756/2 002) of the participants for avoiding presenting themselves in people-density places. Compared with other pregnancy trimesters, pregnant women in the second trimester were more willing to reduce the frequency of ANC (35.2% versus 39.5% versus 48.1%, P<0.01). Compared with multiparas, primiparas were more willing to have online consultation and guidance (49.2% versus 63.8%, P<0.01). Regarding the needs for health knowledge on COVID-19, personal protection against 2019 novel coronavirus (2019-nCoV) was the most concerned for pregnant women, and 71.0% (1 421/2 002) of them preferred to obtain knowledge through health applications, official Weibo and WeChat. Conclusions:Pregnant women in Shanghai critically concern about the risk of 2019-nCoV infections, and highly demand knowledge and measures on prevention and protection from COVID-19. They ask for having time-lapse appointments for ANC and online access to health information and services. Maternal and child care institutes should understand the demands of pregnant women, optimize the means of ANC service, and provide tailored and accessible health education and service for the safety of mother and child.
ABSTRACT
Objective@#To identify problems and demands for antenatal care (ANC) among pregnant women in different trimesters of pregnancy in Shanghai for optimizing ANC service during the epidemic of coronavirus disease 2019 (COVID-19).@*Methods@#Organized by Maternal and Child Health Care institute in the 16 districts of Shanghai, a cross sectional study was conducted among pregnant women who came to pregnancy registration in the community health centers or attended ANC in maternity hospitals from February 7 to February 12, 2020. Consented participating women completed a semi-structured online questionnaire voluntarily. Data was analyzed using frequency and scoring, chi-square test.@*Results@#A total of 2 002 valid questionnaires were collected from 183 community health centers and 67 midwifery hospitals. About 94.6% of the pregnant women worried about being infected during the COVID-19 epidemic, and 14.7% demanded for psychological consultation. Appointment ANC services were requested by 87.7% of the participants for avoiding presenting themselves in people-density places. Compared with other pregnancy trimesters, pregnant women in the second trimester were more willing to reduce the frequency of ANC (48.1% VS. 39.5% VS. 35.2%, P<0.01). Compared with multiparas, primiparas were more willing to have online consultation and guidance (63.8% VS. 49.2%, P<0.01). Regarding the needs for health knowledge on COVID-19, personal protection against 2019-nCoV was the most concerned for pregnant women, and 71.0% of them preferred to obtain knowledge through health applications, official Weibo and WeChat.@*Conclusions@#Pregnant women in Shanghai critically concern about the risk of 2019-nCoV infections, and highly demand knowledge and measures on prevention and protection from COVID-19. They ask for having time-lapse appointments for ANC and online access to health information and services. Maternal and Child Care institutes should understand the demands of pregnant women, optimize the means of ANC service, and provide tailored and accessible health education and service for the safety of mother and child.
ABSTRACT
Objective To analyze the factors associated with syphilis treatment compliance and adverse pregnant outcomes among pregnant women with syphilis in Shanghai.Methods The prospective cohort was established based on maternal syphilis monitoring system of Shanghai,which included all the pregnant women diagnosed with syphilis during Jan 2013 to Dec 2015.A total of 1 717 pregnant women with syphilis were recruited at the baseline,and 1 147 of them were followed up during treatment and their pregnancy,and the delivery outcomes were recorded.The information of testing/treatment of pregnant women with syphilis and health outcomes of infants were collected.Chi-square test was used for univariate analysis and logistic regression model was used to identify the factors associated with syphilis treatment and adverse pregnant outcomes.Results A total of 685 participants received syphilis treatment during pregnancy,with the treatment rate of 59.7％.Among them,397 (34.6％) patients underwent two courses of complete treatment.The poor educated,unemployed/job-waiting or multipara population had poor compliance to treatment.Only 34.9％ (142/407) of cases diagnosed at last trimester received syphilis treatment and 10.1％ (41/407) completed the treatment.The proportion of non-treponemal conversion were higher in subjects who received syphilis treatment during pregnancy than those who did not (39.1％ [268/285] vs 3.7％ [17/462]).Complete syphilis treatment during pregnancy was protective factor to decrease neonatal death adjusted relative risk ([aRR] =0.05,95％ CI:0.01-0.37,P =0.003) and prematurity/low birth weight (aRR =0.44,95％ CI:0.27-0.70,P =0.001).Strong positive non-treponemal result before delivery increased the risks of neonatal death (aRR =12.89,95％ CI:1.70-100.43,P =0.014) and prematurity/low birth weight (aRR =12.78,95％ CI:152-5.06,P =0.001).Conclusions Factors such as educational level,employment status,and maternal history will affect the compliance of syphilis treatment during pregnancy.Early diagnosis and complete treatment course of syphilis could improve the pregnant outcomes and the health status of infants.
ABSTRACT
Objective:To carry out the large sample research of the importance of medical ethics in the stand-ardized resident doctor training. Methods:Randomly selected 100 graduated resident doctors from Jiangsu province, Zhejiang province,Shanghai and Jiangxi province of standardization training. Using the questionnaire survey form to investigate the doctor-patient relationship and carry out correlation analysis. Results:Two groups of subjects after research statistics, the analysis found the doctor-patient relationship in the model show the current mutual partici-pation pattern of the more advanced undergraduate group was 22%, 16% in the graduate student degree group has significant difference;While 66% of bachelor's degree group and 70% graduated degrees performance as the guide-cooperation mode. Conclusion:It should strengthen medical ethics in the stage of standardized training, this study further strengthen standardized training for the future stage of low qualification resident ethics application guide the importance and the influence on the doctor-patient relationship in the future physician has provided the basis, at the same time, also provides certain theoretical guidance for doctor-patient relationship training methodology.