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Objective:To evaluate the effect of implementation of prevention from mother-to-child transmission of syphilis in Minhang district of Shanghai from 2013 to 2019.Methods:The data of 284 pregnant women with syphilis infection diagnosed by 6 midwifery medical institutions in Minhang District from January 2013 to December 2019, were collected from the database of national management information system for prevention of mother to child transmission of AIDS, syphilis and hepatitis B. Among them there were 1 case of spontaneous abortion, 4 cases of ectopic pregnancy, 42 cases of lost follow-up; the remaining 237 parturients were included in this study. The Implementation Program of prevention of mother-to-child transmission of AIDS, syphilis and hepatitis B (2015 edition) has been implemented since 2015 in Minhang district. The maternal and neonatal outcomes between the period of 2013-2015 (before program implemented, 123 cases) and the period of 2016-2019 (after program implemented, 114 cases) were compared. Results:Between 2013 and 2019, the syphilis detection rate of pregnant women remained 100.00% (100 761/100 761). The detection rates during pregnancy before and after program implementation were 95.92% (51 855/54 288) and 98.87% (45 949/46 473); the prevalence rate of syphilis was 2.93‰ (159/54 288) and 2.69‰ (125/46 473), respectively. The rate of anti-syphilis treatment was 62.60% (77/123) and 85.96% (98/114), the standard treatment rate was 20.33% (25/123) and 49.12% (56/114), the neonatal preventive treatment proportion/rate was 1/12 and 94.74% (72/76). The detection rate during pregnancy, anti-syphilis treatment rate, standardized treatment rate and neonatal preventive treatment rate after program implementation were significantly higher than those of before implementation (χ 2=988.88, 16.72, 21.81, 54.72, all P<0.01). The rate of non- Treponema pallidum antigen titer ≥ 1∶8 was 36.89% (38/103) and 17.48% (18/103), respectively in two periods; the incidence of neonatal adverse health problems was 21.49% (26/121) and 6.03% (7/116); congenital syphilis report incidence rate was 152.12/100 000 live births (83/54 562) and 23.46/100 000 live births (11/46 890), respectively. All these indicators showed a significant reduction (χ 2=9.81, 11.80, 45.10, all P<0.01). The treatment rate of pregnant women with previously diagnosed syphilis infection was 63.27% (62/98), which was lower than that of those with initially diagnosed (81.29%, 113/139) ( cOR=2.52, 95 %CI: 1.40-4.56, χ 2=9.672, P<0.01). Among whose with lost follow-up, the floating pregnant women accounted for 92.86% (39/42), 57.14% (24/42) of whom were unable to contact and 30.95% (13/42) refused to be followed up. Conclusions:After the implementation of prevention program, the rates of detection and diagnosis, standardized treatment, neonatal preventive treatment, as well as the maternal and neonatal outcomes of pregnant women with syphilis infection have been significantly improved in Minhang district of Shanghai.
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Objective To survey the contraceptive knowledge and service ability of postpartum visitors in Shanghai Minhang district.Methods A questionnaire survey on the contraceptive knowledge and contraceptive services was conducted in May 2018 among postpartum visitors from 13 community health service centers in Shanghai Minhang district.Results One hundred and forty-eight valid questionnaires were collected.All the participants were women,among whom 6.8％ (10/148) were obstetricians and gynecologists,8.1％ (12/148) were general practitioners and public health doctors,52.7％ (78/148) were nurses and 32.4％ (48/148) were village doctors.One hundred and ten participants were married women of childbearing age,among whom 18.2％(20/110) did not take contraceptive measures,43.6％(48/110) used condom,10.9％ (12/110) used in vitro ejaculation or safe period or combination of two methods,and only 27.3％(30/1 10) used IUD or tubal ligation.The overall correct rate of contraceptive knowledge was 65.9％ (1 755/2 664).The correct rates of knowledge about postpartum intrauterine device,the placement time of subcutaneous implantation of contraceptives,the correct use of condoms were particularly low.During the visits,postpartum lactating mothers,condom and safe period were recommended for contraception;and condom was recommended most (93.2％,138/148),however,only 24.3％(36/148) of them carried free contraceptive condom when visiting home.Conclusions The general levels of contraception-related knowledge and ability of community postpartum visitors are less satisfactory.It is necessary to strengthen the training and assessment of contraceptive knowledge for them.
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The status of human papillomavirus (HPV) infection and cervical lesions was analyzed among 20 420 postmenopausal women who participated in gynecological disease screening in Shanghai Minhang district 2017.The infection rate of HPV in postmenopausal women was 8.37％(1 710/20 420),and the infection of high-risk HPV 52,58,16,18 accounted for 95.26％(2 029/2 130).The HPV infection rate was 7.37％ in women aged ≥65 years,and that was 8.62％ in women aged＜65 years(x2=6.640,P=0.010).Among 552 cases with pathological results there were 133 cases of cervical lesions.The top 4 HPV infections in patients with cervical lesions were HPV16,52,58 and 33.The rate of cervical lesions was 22.35％ in ≥65 age group,and 24.93％ in ＜65 age group (P＞0.05).The study suggests that HPV genotyping should be taken into account in gynecological disease screening,and the subjects with high-risk HPV infection should be closely followed up;meanwhile,the age limits of screening population should be appropriately extended.
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Objective To explore the associations between maternal and prenatal depressive symptoms and children's behavioral problems at 2 years old.Methods In the present study,a total of 491 mother-child pairs were selected from the Shanghai-Minhang Birth Cohort Study (S-MBCS) which was conducted in Maternal and Child Health Hospital of Minhang District in Shanghai between April and December,2012.Data from the Center for Epidemiologic Studies on Depression was gathered to assess the maternal depressive symptoms in the second and third trimester of pregnancy,as well as at 6 months and 12 months postpartum.Neurodevelopment at 2 years was assessed,using the Child Behavior Checklist.We used generalized linear models with a log-link function and a Binomial distribution to estimate the risk ratios (RRs) and 95％CIs,on children's behavioral problems at 2 years of age.Sensitivity analyses were performed among participants without postpartum depressive symptoms.Results After adjustment on factors as maternal age,gestation week,average monthly income per person,parental education and children's gender etc.,maternal depression in second trimester of pregnancy was found associated with higher risk of both developing emotional (RR =2.61,95％ CI:1.36-4.99) and internalizing problems (RR=1.94,95％ CI:1.22-3.08).However,maternal depression in third trimester was found to be associated with higher risks of developing emotional (RR=6.46,95％CI:3.09-13.53),withdrawn (RR=2.42,95％CI:1.16-5.02),aggressive (RR=2.93,95 ％CI:1.45-5.94),internalizing (RR =1.79,95 ％CI:1.01-3.16) or externalizing problems (RR =2.56,95％ CI:1.49-4.42).In sensitivity analysis,antenatal maternal depression was found positively associated with children's emotional,internalizing and externalizing problems and the differences all statistically significant.Conclusions Maternal depression during pregnancy might increase the risks of children's behavioral problems.In order to decrease the incidence of children's behavioral problems and promoting both maternal and child health status,monitoring program regarding maternal mental health care should be strengthened.
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Objective To explore the associations between maternal and prenatal depressive symptoms and children's behavioral problems at 2 years old.Methods In the present study,a total of 491 mother-child pairs were selected from the Shanghai-Minhang Birth Cohort Study (S-MBCS) which was conducted in Maternal and Child Health Hospital of Minhang District in Shanghai between April and December,2012.Data from the Center for Epidemiologic Studies on Depression was gathered to assess the maternal depressive symptoms in the second and third trimester of pregnancy,as well as at 6 months and 12 months postpartum.Neurodevelopment at 2 years was assessed,using the Child Behavior Checklist.We used generalized linear models with a log-link function and a Binomial distribution to estimate the risk ratios (RRs) and 95％CIs,on children's behavioral problems at 2 years of age.Sensitivity analyses were performed among participants without postpartum depressive symptoms.Results After adjustment on factors as maternal age,gestation week,average monthly income per person,parental education and children's gender etc.,maternal depression in second trimester of pregnancy was found associated with higher risk of both developing emotional (RR =2.61,95％ CI:1.36-4.99) and internalizing problems (RR=1.94,95％ CI:1.22-3.08).However,maternal depression in third trimester was found to be associated with higher risks of developing emotional (RR=6.46,95％CI:3.09-13.53),withdrawn (RR=2.42,95％CI:1.16-5.02),aggressive (RR=2.93,95 ％CI:1.45-5.94),internalizing (RR =1.79,95 ％CI:1.01-3.16) or externalizing problems (RR =2.56,95％ CI:1.49-4.42).In sensitivity analysis,antenatal maternal depression was found positively associated with children's emotional,internalizing and externalizing problems and the differences all statistically significant.Conclusions Maternal depression during pregnancy might increase the risks of children's behavioral problems.In order to decrease the incidence of children's behavioral problems and promoting both maternal and child health status,monitoring program regarding maternal mental health care should be strengthened.