Relationship of occupational stress and negative life events with low birth weight / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the influence of occupational stress and negative life events on low birth weight (LBW).</p><p><b>METHODS</b>1:1 matched case-control study was employed, in which 438 singleton LBW infants with birth weight less than 2500 g (their pregnancy term being 28 to 42 weeks) served as case group while 438 with singleton term normal birth weight served as control group matched by sex, delivery time and hospital. All of their mothers were inquired by well trained investigators about their socio-demographic characteristics, occupational stress, and negative life events occurring in different pregnancy term. After controlling for mother's age, occupation, education level and family income, conditional logistic regression was employed to asses the influence of occupational stress and negative life events on LBW.</p><p><b>RESULTS</b>Compared with those with low technical skill utilization and low job decision, mothers with high technical skill utilization (OR=0.62; 95% CI=0.43 approximately 0.91) and high job decision (OR=0.67; 95% CI=0.46 approximately 0.97) significantly decreased the risk of laboring LBW. Compared with those not exposed to negative life events, mothers with negative life event score being=3 in the middle three months of pregnancy (OR=18.85; 95% CI=1.58 approximately 225.02), with negative life event score being 1 in the later three months of pregnancy (OR=2.67; 95% CI=1.14 approximately 6.28), with negative life event score being 2 (OR=2.80; 95% CI=1.04 approximately 7.52) and=3 in the whole time of pregnancy (OR=2.94; 95% CI=1.22 approximately 7.09) were the risk factors of LBW.</p><p><b>CONCLUSION</b>Negative life events might affect LBW and negative life events occurring in the different term of pregnancy impact LBW differently.</p>

Influence of stress from work and negative life events during pregnancy on different types of low birth weight / 中华流行病学杂志

Objective To explore the influence of occupational stress and negative life events that occur during pregnancy on different types of low birth weight (LBW). Methods 438 singleton LBW infants (birth weight of less than 2500 g and their pregnancy term from 28 to 42 weeks) were selected as case group, and they were further divided into symmetric LBW infants (337 cases) and asymmetric LBW infants (101 cases). According to situation of each LBW infant, a singleton with full term and normal birth weight was selected as control group matched by sex, pregnancy term, time during delivery and types of hospital.All of their mothers were inquired by well trained investigators on their socio-demographic characteristics, occupational stress, and negative life events that occurred in different pregnancy term. After controlling for mother's age, occupation,education level and family income, multinomial logistic regression was employed to asses the influence of occupational stress and negative life events on symmetric LBW and asymmetric LBW. Results Compared with those using low technical skills, mothers with high technical skill utilization significantly decreased the risk of laboring both symmetric LBW ( OR = 0.69, 95 ％ CI:0.49-0.98) and asymmetric LBW (OR = 0.53,95％CI: 0.31-0.89). Compared with those without exposure to negative life events, mothers with negative life event score ≥ 3 in the whole duration of pregnancy had significantly increased the risk of delivering symmetric LBW ( OR = 2.30, 95％ CI : 1.08-4.88), mothers with negative life event score ≥3 in the middle three months of pregnancy, ≥3 in the last three months of pregnancy, = 2 and ≥3 in the whole duration of pregnancy had significantly increased the risk of delivering asymmetric LBW, and their OR (95 ％ CI ) was 8.85 (1.97-39.68), 3.80 ( 1.40-10.29 ),3.58(1.33-9.66) and 3.48 (1.32-9.13), respectively. Conclusion Occupational stress and negative life events might produce different influence on symmetric LBW and negative life events that occurr in the different terms of pregnancy had different impact on symmetric LBW and asymmetric LBW.

Surveillance of antimicrobial susceptibility of Streptococcus pneumoniae and Hemophilus influenzae isolated from children in Guangzhou area between 2003 and 2004 / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the situation of antibiotic resistance of Streptococcus pneumoniae (Sp) and Hemophilus influenzae (Hi) clinical isolates from children in Guangzhou area.</p><p><b>METHODS</b>The authors cultured, isolated and identified the Sp and Hi strains from nasopharyngeal secretion of patients who visited Guangzhou Children's Hospital for upper respiratory tract infection between 2003 and 2004. K-B disc diffusion and E-test for antibiotic susceptibility were performed for these clinical isolates.</p><p><b>RESULTS</b>Totally 172 and 484 strains of Sp and Hi were respectively isolated from nasopharyngeal secretions in the hospital. For Sp strains, the rates of resistance to penicillin, amoxicillin/clavulanic acid, ceftriaxone, cefuroxime, cefaclor, erythromycin, tetracycline, chloramphenicol, sulfamethoxazole/trimethoprim (SMZ/TMP), clindamycin and ofloxacin were 32.0%, 11.1%, 32.6%, 18.1%, 39.5%, 82.6%, 78.5%, 24.4%, 87.2%, 69.2% and 3.1%, respectively. The penicillin non-susceptible Sp (PNSSP) isolates showed higher rates of resistance to other antimicrobial agents such as other beta-lactam antimicrobial agents, erythromycin, and SMZ/TMP than those of penicillin susceptible Sp (PSSP) isolates. More than 90% of PNSSP were multidrug resistant strains. The average rate of beta-lactamase production among 484 strains of Hi was 29.5% (143/484). For Hi isolates, the rates of resistance to ampicillin, amoxicillin/clavulanic acid, ceftriaxone, cefuroxime, cefaclor, SMZ/TMP, tetracycline, chloramphenicol, azithromycin, and ofloxacin were 40.1%, 3.4%, 4.1%, 1.9%, 5.6%, 56.2%, 52.1%, 17.4%, 2.1%, and 0.6%, respectively.</p><p><b>CONCLUSION</b>The antimicrobials resistant Sp and Hi isolated from children with respiratory tract infection in the area have become a severe problem. The rate of resistance to penicillin of Sp had been decreased compared with the last three years, but the rate of resistance to ceftriaxone of Sp increased, and the multidrug resistance rates of PNSSP was rather high. PNSSP was characterized by a multidrug-resistance to erythromycin, tetracycline and SMZ/TMP. beta-lactamase production and ampicillin resistance among the Hi isolates from children in the area had increased generally during the period 2003 - 2004. The Hi isolates were more susceptible to the second and the third generation cephalosporins, amoxicillin/clavulanic acid and azithromycin.</p>

Validation study on the criteria for clinical classification of small for gestational age infants / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the validity of criteria currently used in China for the classification of symmetric small for gestational age infants (SGA) as compared with its definition.</p><p><b>METHODS</b>This study included 417 inpatients diagnosed as SGA in authors' hospital from January 1998 to June 2002. Symmetric SGA was diagnosed by the following three criteria: (1) the Ponderal Index (PI), (2) the crown-heel length-to-head circumference ratio (BL/HC) issued in Chin J Pediatr (1988;26:164 - 165), as well as (3) the SGA definition. The definition criterion was considered as the "gold standard". The sensitivity, specificity, false positive and negative values, positive and negative predictive values, exact agreement ratio, diagnosis index, and Cohen's Kappa value were used to evaluate the validity and agreement of the methods of PI and BL/HC. Receiver Operating Characteristic (ROC) analysis was used to evaluate the validity of the diagnosis.</p><p><b>RESULTS</b>Of 417 SGA infants, 376 (90.17%), 376 (90.17%) and 187 (44.84%) subjects were diagnosed as symmetric type with PI, BL/HC and the definition criteria, respectively. (2) The agreement rate and Kappa value between PI and BL/HC was 80.82% and -0.093 (SEM 0.026), respectively. And the agreement rates between PI or BL/HC and the definition criterion were 49.88% and 50.84%, respectively. As compared with the definition criterion, the PI and BL/HC methods had sensitivities of 91.8% - 96.4%, specificities of 9.3% - 25.9%, positive predictive values of 45.8% - 51.1%, negative predictive values of 72.7% - 82.8%, diagnosis indices of 4.9% - 17.7% and Kappa values of 0.070 - 0.167. (3) The areas under the ROC curves in full-term and preterm infants by PI method were 0.635 (95% CI, 0.573 - 0.697) and 0.698 (95% CI, 0.622 - 0.725), respectively. PI cutoffs at 2.47 in full-term SGA, at 2.43 in preterm SGA, and BL/HC cutoff at 1.43 produced the maximum diagnosis indices that were 24.7%, 39.6% and 33.7%, respectively. When the PI at 2.50 (full-term), PI at 2.31 (preterm) and BL/HC values at 1.46, the sensitivity closed mostly to the specificity. The sensitivities and specificities in full-term and preterm infants were 59.4% and 59.3%, 65.3% and 65.5%, and 66.3% and 65.5%, respectively.</p><p><b>CONCLUSION</b>In the classification of SGA, the results showed a poor agreement between PI or BL/HC and the definition criterion. The results suggested that the current cutoffs of PI and BL/HC might not be appropriate for the diagnosis of symmetric SGA. Low AUC suggested that PI and BL/HC could not give a valid diagnosis at any cutoffs.</p>