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ObjectiveTo explore the effect of incentive spouse collaborative psychological intervention on delivery outcomes of primipara. MethodsFrom July 2019 to July 2020， 300 primiparas with an uneventful pregnancy were recruited and divided into the control group and the intervention group， with 150 cases in each group. The control group was managed by routine nursing care， and the intervention group was managed by incentive spouse collaborative psychological intervention. The delivery outcomes in two groups， including delivery route， postpartum blood loss， and perineal laceration were compared. ResultsAfter intervention， the cesarean section rate， the 2-hour postpartum blood loss and perineal laceration in the intervention group were less common than those in the control group and the difference was statistically significant （P<0.05）. The first， second and total stages of labor duration in the intervention group were shorter than those in the control group and the difference was statistically significant （P<0.05）. There was no significant difference in the incidence of neonatal asphyxia between these two groups （P>0.05）. In terms of vaginal delivery experience scores of the two groups， the intervention group was better than the control group and the difference was statistically significant （P<0.05）. ConclusionThe mode of incentive spouse collaborative psychological intervention can reduce the rate of cesarean section， the amount of bleeding 2 hours after delivery， and perineum injury. It can shorten the labor process， and effectively improve the delivery outcome of primiparas.
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ObjectiveTo explore the effect of incentive spouse collaborative psychological intervention on delivery outcomes of primipara. MethodsFrom July 2019 to July 2020， 300 primiparas with an uneventful pregnancy were recruited and divided into the control group and the intervention group， with 150 cases in each group. The control group was managed by routine nursing care， and the intervention group was managed by incentive spouse collaborative psychological intervention. The delivery outcomes in two groups， including delivery route， postpartum blood loss， and perineal laceration were compared. ResultsAfter intervention， the cesarean section rate， the 2-hour postpartum blood loss and perineal laceration in the intervention group were less common than those in the control group and the difference was statistically significant （P<0.05）. The first， second and total stages of labor duration in the intervention group were shorter than those in the control group and the difference was statistically significant （P<0.05）. There was no significant difference in the incidence of neonatal asphyxia between these two groups （P>0.05）. In terms of vaginal delivery experience scores of the two groups， the intervention group was better than the control group and the difference was statistically significant （P<0.05）. ConclusionThe mode of incentive spouse collaborative psychological intervention can reduce the rate of cesarean section， the amount of bleeding 2 hours after delivery， and perineum injury. It can shorten the labor process， and effectively improve the delivery outcome of primiparas.
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Objective To investigate the status of hepatitis B virus (HBV) infection and hepatitis B vaccination in junior middle school children of migrant workers in Pudong New Area of Shanghai, so as to provide evidence for prevention and treatment of hepatitis B. Methods A total of 298 children of migrant workers were recruited from junior middle schools of five communities in Pudong New Area, where migrant workers gathered. Questionnaire survey and HBV serological test were conducted. Results The 298 students had a hepatitis B vaccination coverage rate of 70.8% (211/298) and the whole-course vaccination coverage rate of 48.3% (144/298). The vaccination coverage rate of ethnic minority students was significantly lower than that of Han students (P<0.01). The vaccination coverage rate of children whose fathers were private business owners was the highest (P<0.001). The vaccination coverage rate of children whose fathers had junior college or above education background was significantly higher than those whose fathers had a lower one (P<0.01). The positive rates of hepatitis B virus surface antigen (HBsAg) and hepatitis B virus core antibody (HBcAb) in these children were 2.3% (7/298) and 4.7% (14/298), respectively. HBV infected family member was the independent influencing factors for positive HBsAg or HBcAb (P<0.01). HBsAb positive rate was 36.6% (109/298) in these children, with that of ethnic minority students being significantly higher than that of Han students (P<0.05). The proportion of low hepatitis B virus surface antibody (HBsAb) titer (10 mU/mL≤HBsAb<100 mU/mL) in Han students was higher than that of ethnic minority students, while the proportions of normal level (100 mU/mL≤HBsAb<1 000 mU/mL) and high level (HBsAb≥1 000 mU/mL) of ethnic minority students were significantly higher than those of Han students (P<0.05). Conclusion The hepatitis B vaccination coverage rate is relatively low in junior middle school children of migrant workers, and the positive rates of HBsAg and HBcAb are slightly higher, and these children are important targets for hepatitis B prevention and treatment in Shanghai and other megacities in the future. Health management and education of hepatitis B prevention and treatment should be strengthened for migrant workers and their children.
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Objective To explore the infection status of hepatitis B virus (HBV) in families of hepatitis B surface antigen (HbsAg) positive students and the mutations of HBV related to hepatocellular carcinoma, so as to provide theoretic evidence for the prevention and control of HBV infection and hepatocellular carcinoma. Methods A total of 1 611 students were investigated; they were from 60 classes of 15 schools and kindergartens in Pudong New Area, Shanghai, China, and 8 HBsAg positive students were found. These 8 students and their 18 first-degree relatives were enrolled in this study. Venous blood samples were collected to test the 5 markers of hepatitis B using enzyme linked immunosorbent assay. HBV DNA was detected by fluorescent PCR. HBV genome, basic core promoter (BCP) region and PreS region were detected using multiplex-PCR and nested PCR combined with cloning and sequencing. Results The positive rates of HBsAg and HBcAb in the first-degree relatives were 33.3% (6/18) and 38.9% (7/18), respectively. Both HBsAg and HBcAb positive rates in the mothers were 71.4% (5/7), which were significantly higher than those of the other first-degree relatives (P0.05). Seven of 8 families (87.5%) had 2 or more members infected or had ever infected with HBV. Fourteen of 26 members in 8 families had positive HBsAg, with a positive rate of 53.8%. A total of 4 groups of mothers and children received gene detection. Three groups of them had type C HBV gene, and 1 group had type C in mother and type B in child. Among the hepatocellular carcinoma-related HBV mutations, the mutation frequency of hot spots in BCP region was lower in the children than that in the mothers. Eight HBV mutation sites of type C in PreS region were found in both the mothers and children, and none of the remaining key sites were found in the children. Conclusion There is obvious family clustering of HBV infection, suggesting that HBV infection of students is more likely to be transmitted through mother-to-child transmission, but there are other ways of infection, such as acquired blood. The evolution degree of HBV gene in children is lower than that in mothers, which conforms to the rule of HBV evolution.
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Objective To investigate the statuses of hepatitis B virus (HBV) prevalence and hepatitisB vaccination coverage in children of the migrant workers, so as to provide the evidence for HBV control and prevention in Shanghi Methods An epidemiological survey was conducted with 1 071 children of the migrant workers; the children were from the kindergartens, primary and secondary schools in five urban-rural fringe communities in Pudong New Area of Shanghi Fasting bloods samples were collected to detect the biomarkers and DNA titer of HBV. Results The hepatitis B vaccination coverage rate was 87.1% (933/1 071); the coverage rate of students under the age of tenwas significantly higher than those at 10 years of age or older (P<0. 01); the coverage rate in children of the Han nationality was significantly higher than that of the other minorities (P< 0. 001), and the coverage rate in children whose parents with the college education background and above was higher than that of children whose parents with a lower education background (P<0. 001). The positive rate of HBsAg was 0. 7% (7/1 071) in this study. We found that age and HBV infected relatives in the family were the main risk factors of HBV infection in children (P<0. 05). The positive rate of HBcAb was 1. 7% (18/1 071) in the present study, which was positively correlatedwith the age of children (P<0. 01). The positive rate of HBsAb was 33. 9% (363/1 071), and the rate decreased with the age increase between 3 to 14 years old and increased with the age increase after 15 years old (P<0. 001). The positive rate of HBsAbwas significantly higher in other minorities than that in the Han nationality (P<0. 001). The proportion of children with low level of HBsAb titer decreased with the increase of age, while the proportion of children with normal and high level of HBsAb increased with the increase of age (P<0. 01). Conclusion The hepatitis B vaccination coverage rate in the children of migrant workers is lower than that in the local children of permanent residents. The positive rates of HBsAg and HBcAb witness a great decrease compared with those in 2006. More efforts should be made to strengthen the hepatitis B vaccination for the children of migrant workers.
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Objective To explore the mutations of hepatocellular carcinoma (HCC)-related hepatitis B virus (HBV) during mother-to-child transmission. so as to provide theoretic evidence for prophylaxis of HCC from the very beginning. Methods A total of 413 HBsAg-positive mothers and their newborns were enrolled in this study. Serum HBV DNA levels in maternal peripheral blood and cord blood of the newborns were measured using real-time quantitative PCR. Nested PCR together with cloning and sequencing methods were applied to examine the HCC-related HBV mutations in the preS and basal core promoter regions of HBV genome. All the newborns received standard HBV vaccination. Of the 413 newborns. 104 were successfully followed-up 7 months after birth. and the HBV mutations were examined if their circulating HBV DNA was detectable. Results Of the 413 newborns. 41 (9. 9%) had HBV DNA level >103 copies/mL in their cord blood. Four (3. 8%) of the 104 newborns who were successfully followed up had circulating HBV DNA level >103 copies/mL 7 months after birth. Compared to mothers without HBV trans-placental transmission. those with HBV trans-placental transmission had no increase in HBV mutations in the basal core promoter region. However. the viral mutations containing T2898G/C. C3000T. C3116T. T31C • and T52C in the preS region of HBV subgenotype C2 significantly increased the risk of HBV trans-placental transmission 8<0. 05). The frequencies of the HCC-related mutations in the preS and basal core promoter regions of HBV genome were not significantly different between maternal peripheral blood and the cord blood of the newborns. Importantly. the HCC-related mutations were rarely found in the HBV-positive infants at 7 months after birth. Conclusion The HBV mutations in the preS region of HBV subgenotype C2 may affect the trans-placental transmission of HBV. However, the quasispecies of HCC-related HBV mutants have no advantage in causing chronic HBV infection in infants. The HBV mutants which can promote HCC are selected during the long term chronic infection.
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Objective: To study the transmission of hepatitis B virus (HBV) from mother to child and the related influencing factors, so as to provide evidence for HBV control. Methods: An epidemiological survey was conducted on 445 mother-infant pair participants with positive maternal HBsAg from 4 hospitals in Pudong New area of Shanghai. Peripheral blood samples of mothers and the umbilical cord blood samples of the infants were collected to detect the markers and DNA titer of HBV. HBsAg positive and HBV DNA positive in umbilical cord blood were defined as HBV positive in the infants. All the newborns received vaccination after birth according to the national regulation. Of the 445 participants, 104 newborns were followed for 7 months after birth, and the blood samples were collected and the markers and DNA titer of HBV were examined. HBsAg positive after 7 months was defined as immune failure. Results: The positive rate of HBV in the newborns was 8. 0% for mothers with positive HBsAg in our study. The HBV positive rate of newborns whose mothers were positive for both HBsAg and HBeAg was significantly higher than whose mothers were only HBsAg positive (26. 7% vs 1.8%, P106 copies/mL compared with those with HBV DNA <106 copies/mL (23. 6% vs 2. 3%, P<0. 05). The immune failure rate of hepatitis B vaccine was 3. 8% 7 months after birth in our study, with all their mothers being positive for both HBsAg and HBeAg. Conclusion: The maternal HBeAg positivity and the high concentration of HBV DNA are the main risk factors of neonatal infection, and they may lead to non-response to hepatitis B vaccine.