prenatal care

产前护理
  • 文章类型: Letter
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  • 文章类型: Journal Article
    我们回顾了儿童产前暴露于重金属的过敏性疾病的患病率。
    此系统综述和荟萃分析已在PROSPERO数据库(CRD42023478471)中注册。全面搜索PubMed,WebofScience,Medline和Cochrane图书馆从数据库开始到2023年10月31日进行。采用纽卡斯尔-渥太华质量评估量表(NOS)对纳入研究进行质量评估。我们使用随机效应模型来总结研究的效果。
    共纳入16项研究,120,065对母子登记。NOS评分表明纳入研究的文献质量较高。
    最终结果表明,产前暴露于Pb会增加婴儿喘息和湿疹的发生率,暴露于Ni和CD会增加婴儿AD的发生率。
    UNASSIGNED: We review the prevalence of allergic diseases in children across prenatal exposures to heavy metals.
    UNASSIGNED: This systematic review and meta-analysis is registered in the PROSPERO database (CRD42023478471). A comprehensive search of PubMed, Web of Science, Medline and Cochrane library was conducted from the database inception until 31 October 2023. The Newcastle-Ottawa Quality Assessment Scale (NOS) was used to assess the quality of included studies. We used a random-effects model to summarize the effects from the studies.
    UNASSIGNED: A total of 16 studies were included, 120,065 mother-child pairs enrolled. The NOS scores indicated that the quality of the literature included in the study was of a high standard.
    UNASSIGNED: The final results indicate that prenatal exposure to Pb increased the incidence of wheeze and Eczema in infants, and exposure to Ni and CD increased the incidence of AD in infants.
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  • 文章类型: Journal Article
    目的:本研究的目的是描述中国东南部夫妇参与“集中妊娠”模式的经历和感知障碍,并了解智能手机是否可以在该模式中发挥潜在作用。
    方法:本研究采用描述性现象学定性研究,使用对女性及其伴侣的半结构化二元访谈。采访被录音了,逐字转录并进行主题分析。
    方法:本研究在中国南方的两个试点产前诊所进行。
    方法:招募了13对接受智能手机辅助中心妊娠的夫妇的目的样本。数据是通过2022年12月至2023年3月之间的半结构化二元访谈收集的,直到饱和。
    结果:该研究产生了四个主要主题:(1)参与动机,(2)接受盘根妊娠,(3)障碍和建议;(4)支持智能手机使用CenteringPregnance。
    结论:合并妊娠受到夫妇的欢迎。夫妻可以获得额外的医疗服务,并参与智能手机辅助的密集社交互动。然而,需要承认某些客观挑战,包括活动空间不足,夫妻对知识的需求很高,雇佣伴侣的时间不灵活。此外,需要注意的是,智能手机可能会导致夫妻之间的错误期望。
    OBJECTIVE: The objectives of this study are to describe couples\' experiences and perceived barriers to participation in the CenteringPregnancy model in southeast of China and to understand whether smartphones could play a potential role in this model.
    METHODS: This study employed a descriptive phenomenological qualitative study using semistructured dyadic interviews with women and their partners. The interviews were audiotaped, transcribed verbatim and subjected to thematic analysis.
    METHODS: This study was conducted in two pilot prenatal clinics in southern China.
    METHODS: A purposive sample of 13 couples who underwent smartphone-assisted CenteringPregnancy were recruited. Data were collected until saturation through semistructured dyadic interviews between December 2022 and March 2023.
    RESULTS: The study yielded four primary themes: (1) motivation for participation, (2) acceptance of CenteringPregnancy, (3) barriers and suggestions and (4) support for smartphone use of CenteringPregnancy.
    CONCLUSIONS: CenteringPregnancy was well received by couples. Couples can access additional medical care and engage in intensive social interactions assisted by smartphones. However, certain objective challenges need to be acknowledged, including inadequate activity space, high demand for knowledge by couples and inflexible time for employed partners. Moreover, the risk that smartphones can lead to false expectations among couples needs to be noted.
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  • 文章类型: Journal Article
    目的:本研究旨在评估基于Fogg行为模型的在线和离线混合体重管理方法对妊娠总体重增加和围产期结局的影响。
    方法:海南孕妇,中国最南端的省份,被招募到一项随机对照试验中,旨在开发一个怀孕体重管理的微信平台,并在Fogg行为模式的指导下对孕妇实施个体化、连续性的孕期体重管理服务。所有参与研究的孕妇均纳入完整分析集(FAS)进行分析。完成干预并提供所有结局指标的孕妇被纳入每个方案集(PPS)以进行结局评估。
    结果:58名孕妇被纳入FAS分析,52名孕妇最终纳入PPS分析。两组基线比较差异无统计学意义(P>0.05)。干预组的孕期体重增长明显低于对照组(P<0.05)。在对照组中,孕期适当增重率为48.26%,干预组孕期适当增重率为93.30%,差异具有统计学意义(P<0.05)。在交付结果中,干预组剖宫产率明显低于对照组,差异均有统计学意义(P<0.05)。干预组妊娠期糖尿病和妊娠期高血压的发生率低于对照组,差异均有统计学意义(P<0.05)。干预组新生儿体重、巨大儿发生率低于对照组,差异有统计学意义(P<0.05)。
    结论:本研究结合线上微信平台和基于Fogg行为模型的线下咨询的个体化连续孕期体重管理,在改善母婴结局方面显示出巨大潜力。
    背景:该研究已在www上注册。chictr.org.cn/index。aspx,中国临床试验注册中心(ChiCTR2200066707,2022-12-14,回顾性注册)。
    OBJECTIVE: This study aimed at evaluating the effects of online and offline hybrid weight management approach based on the Fogg behavior model on total gestational weight gain and perinatal outcomes.
    METHODS: Pregnant women in Hainan, the southernmost province of China, were recruited into a randomized controlled trial, which was designed to develop a WeChat platform for pregnancy weight management, and implement individualized and continuous pregnancy weight management services for pregnant women under the guidance of the Fogg behavior model. All pregnant women participating in the study were included in the full analysis set (FAS) for analysis. The pregnant women who completed the intervention and provided all outcome indicators were included in the per protocol set (PPS) for outcome evaluation.
    RESULTS: Fifty-eight pregnant women were included in FAS analysis, and 52 pregnant women were finally included in PPS analysis. There was no statistically significant difference (P > 0.05) between the two groups at baseline. The gestational weight gain of the intervention group was significantly lower than that of the control group (P < 0.05). In the control group, the rate of appropriate weight gain during pregnancy was 48.26%, the rate of appropriate weight gain during pregnancy was 93.30% in the intervention group, with a statistically significant difference (P < 0.05). In the delivery outcomes, the cesarean section rate in the intervention group was significantly lower than that in the control group, and the differences were statistically significant (P < 0.05). The incidence of gestational diabetes mellitus and gestational hypertension in the intervention group was lower than those in the control group, and the differences were statistically significant (P < 0.05). The neonatal weight and incidence of macrosomia of the intervention group were lower than that of the control group, and the difference was statistically significant (P < 0.05).
    CONCLUSIONS: This study combined the individualized and continuous pregnancy weight management of the online WeChat platform and offline consultation based on the Fogg behavior model, showing great potential in improving maternal and infant outcomes.
    BACKGROUND: The study was registered with www.chictr.org.cn/index.aspx , Chinese Clinical Trial Registry (ChiCTR2200066707, 2022-12-14, retrospectively registered).
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  • 文章类型: Journal Article
    目的:探讨盆腹力学锻炼在降低初产妇剖宫产率和预防盆底功能障碍中的作用。
    方法:随机对照试验。
    方法:在2022年6月1日至2023年6月30日期间,对200名初产妇参与者(年龄18-38岁)进行了正式的产证检查。采用随机数字表法将参与者分为运动(干预)组和对照组。干预组的参与者每周至少进行1小时的骨盆-腹部力学锻炼,持续三个月。对照组的参与者在怀孕期间没有进行任何骨盆-腹部力学运动。本研究从三个角度进行了综合评价,包括分娩期间的孕产妇和新生儿健康结果,产后42天盆底肌肉恢复状况,以及妊娠晚期(36-38周)和产后42天的生活质量。
    结果:分娩结果存在显著差异。对照组的剖宫产率(36%)明显高于运动组(19%)(p<0.05)。产后42天,盆底评估显示运动组盆底肌力明显优于对照组,具有统计学意义(p<0.05)。
    结论:盆腹力学锻炼可降低剖宫产率,改善产后盆底功能。
    OBJECTIVE: To examine the effectiveness of pelvic-abdominal mechanics exercise in reducing cesarean section rates and preventing pelvic floor dysfunction in primiparous women.
    METHODS: Randomized controlled trial.
    METHODS: A single-center prospective study was conducted among 200 primiparous participants (aged 18-38 years) who undertook formal card-issuing maternity tests between June 1, 2022, and June 30, 2023. Participants were divided into two groups: exercise (intervention) and control using the random number table method. Participants of the intervention group performed pelvic-abdominal mechanics exercise at least 1 h each time per week for three months. Participants of the control group did not perform any pelvic-abdominal mechanics exercise during pregnancy. This study conducted a comprehensive evaluation from three perspectives, including maternal and neonatal health outcomes during delivery, the recovery status of pelvic floor muscles at 42 days postpartum, and the quality of life during late pregnancy (36-38 weeks) and 42 days postpartum.
    RESULTS: A significant difference was found in delivery outcomes. The cesarean section rates are significantly higher (p < 0.05) in the control group (36 %) than in the exercise group (19 %). At 42 days postpartum, pelvic floor assessment showed that the exercise group had significantly better results in pelvic floor muscle strength compared to the control group, with statistical significance (p < 0.05).
    CONCLUSIONS: Pelvic-abdominal mechanics exercise lowers the rate of cesarean section and improves postpartum pelvic floor function.
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  • 文章类型: English Abstract
    Objective:To explore the effect of prenatal glucocorticoids therapy on hearing screening in premature infants Methods:Data of 693 preterm infants with gestational age of 24-34+6weeks admitted to theJiangxi Maternal and Child Health Hospital within 24 h after birth from June 2022 to June 2023 were retrospectively analyzed. The infants were divided into the DXM group (544 cases) and the non-DXM group (149 cases) based on whether dexamethasone (DXM) was administered prenatally. General data of preterm infants and parturients in two groups were compared, and the effects of different doses and timing of DXM on hearing screening were analyzed. Results:In the terms of preliminary hearing screening. the pass rate of initial hearing screening in DXM group was significantly higher than that in non-DXM group(53.9% vs 35.6%), with statistical significance(P<0.05). Further subgroup analysis showed that the passing rate of preliminary hearing screening in adequate prenatal dose(=4 doses) DXM group(58.1%) was significantly higher than that in insufficient group(48.0%) and excessive group(42.4%), with statistical significance(P<0.05). Administering DXM 48 hours to 7 days before birth resulted in a higher pass rate for initial hearing screening compared to administration <48 hours or >7 days before birth (56.4% vs. 48.6%), with a statistically significant difference (P < 0.05). In terms of re-hearing screening, the pass rate of secondary hearing screening was not significantly correlated with DXM treatment(P>0.05), but was significantly correlated with gestational age, birth weight, hospital stays, invasive mechanical ventilation, and common neonatal diseases(bronchopulmonary dysplasia, respiratory distress syndrome)(P<0.05). Among them, bronchopulmonary dysplasia was an independent risk factor forsecondary hearing screening referral(P<0.05). Conclusion:A single course of adequate dexamethasone use within 48 h-7 d of prenatal has a positive effect on the preliminary hearing screening of preterm infants.
    目的:探讨产前糖皮质激素治疗对早产儿听力筛查的影响,为预防早产儿听力损伤提供科学依据。 方法:回顾性分析2022年6月至2023年6月出生后24 h内在江西省妇幼保健院住院的693例胎龄24~34+6周早产儿病例资料。根据产前是否使用地塞米松(dexamethasone,DXM)分为DXM组544例和非DXM组149例。对2组早产儿及产妇的一般资料进行比较,分析产前DXM不同剂量和不同给药时机对早产儿听力筛查结果的影响。 结果:听力初筛方面,DXM组听力初筛通过率显著高于非DXM组(53.9% vs 35.6%),差异有统计学意义(P<0.05);进一步亚组分析,产前足量(=4剂)DXM组听力初筛通过率(58.1%)显著高于不足组(48.0%)和过量组(42.4%),差异有统计学意义(P<0.05);产前48 h~7 d给予DXM,听力初筛通过率高于产前<48 h或>7 d给予DXM(56.4% vs 48.6%),差异有统计学意义(P<0.05)。听力复筛方面,听力复筛通过率与产前DXM治疗无显著相关(P>0.05),但与患儿胎龄、出生体重、住院天数、是否使用有创机械通气及新生儿常见疾病(支气管肺发育不良、呼吸窘迫综合征)显著相关(P<0.05),其中支气管肺发育不良是听力复筛转诊的独立危险因素(P<0.05)。 结论:孕妇产前48 h~7 d内单疗程足量DXM使用对其早产儿听力初筛结果显示出积极影响。.
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  • 文章类型: Journal Article
    探讨追踪联动自我管理模式对初产妇产前检查依从性及分娩方式的影响。选取2021年1月至2022年1月在石家庄市妇产科医院进行产前检查的270例初产妇进行前瞻性研究。分为对照组和观察组,每组135例。对照组给予常规管理模式,观察组给予追踪联动自我管理模式。所有人都进行了干预,直到出院。依从性(产前检查的时间和频率),对产前检查的认知,自我护理能力量表的锻炼得分,焦虑自评量表和抑郁自评量表,比较两组分娩方式及新生儿不良结局的发生情况。干预后,观察组产前检查总达标率(84.44%vs72.59%)高于对照组(P<0.05)。怀孕护理的分数,遗传病咨询,观察组预防出生缺陷和孕期合理营养水平均高于对照组(P<0.05),健康认知得分,自我护理技能,自我护理责任感和自我概念高于对照组(P<0.05),焦虑自评量表、抑郁自评量表评分均低于对照组(P<0.05),自然分娩率高于对照组(85.93%vs74.81%)(P<0.05),新生儿不良结局发生率低于对照组(0.74%vs5.93%)(Fisher确切概率=0.036)。跟踪联动自我管理模式的应用能显著提高对产前检查的认知,提高产前检查的依从性和自我护理能力,缓解焦虑和抑郁,提高初产妇自然分娩率,降低新生儿不良结局发生率。
    To explore the effects of tracking linkage self-management mode on the compliance of prenatal examinations and delivery modes in primiparas. A total of 270 primiparas undergoing prenatal examinations in Shijiazhuang Obstetrics and Gynecology Hospital were enrolled for prospective study between January 2021 and January 2022. They were divided into control group and observation group, 135 cases in each group. The control group was given routine management mode, while observation group was given tracking linkage self-management mode. All were intervened till discharge. The compliance (time and frequency of prenatal examinations), cognition of prenatal examinations, score of exercise of self-care agency scale, self-rating anxiety scale and self-rating depression scale, delivery modes and the occurrence of neonatal adverse outcomes were compared between the 2 groups. After intervention, total compliance rate of prenatal examinations in observation group was higher than that in control group (84.44% vs 72.59%) (P < .05). The scores of pregnancy care, genetic diseases counseling, prevention of birth defects and reasonable nutrition during pregnancy in observation group were higher than those in control group (P < .05), scores of health cognition, self-care skills, self-care responsibility and self-concept were higher than those in control group (P < .05), scores of self-rating anxiety scale and self-rating depression scale were lower than those in control group (P < .05), natural delivery rate was higher than that in control group (85.93% vs 74.81%) (P < .05), and incidence of neonatal adverse outcomes was lower than that in control group (0.74% vs 5.93%) (Fisher exact probability = 0.036). The application of tracking linkage self-management mode can significantly improve cognition to prenatal examinations, improve compliance of prenatal examinations and self-care ability, relieve anxiety and depression, increase natural delivery rate and reduce the incidence of neonatal adverse outcomes in primiparas.
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  • 文章类型: Journal Article
    怀孕期间的疟疾感染与产妇死亡风险增加有关。以及不良的分娩结果。已知在妊娠中使用磺胺多辛-乙胺嘧啶(IPTp-SP)进行间歇性预防性治疗可改善妊娠结局。然而,撒哈拉以南非洲产前保健(ANC)中IPTp-SP的覆盖率仍远低于目标。这项研究旨在估计在撒哈拉以南非洲国家的ANC访问期间,疟疾服务准备在多大程度上影响IPTp-SP的吸收。
    这项研究包括六个撒哈拉以南非洲国家的3267名首次参加ANC的孕妇和一个多月前参加ANC的2797名孕妇。每个机构的疟疾服务准备情况包括四个指标:IPTp-SP准则的存在,SP可用性,将IPTp-SP服务集成到ANC中,以及IPTp-SP的提供者培训。结果变量指示孕妇在其当前的ANC就诊时是否接受IPTp-SP。改良的Poisson回归模型估计了有资格接受首次和后续剂量的妇女的疟疾服务准备与IPTp-SP摄取之间的关联。
    对于有资格接受首次剂量的女性,访问SP可用的机构与接受IPTp-SP的概率增加相关(风险比(RR)=1.43;95%置信区间(CI)=1.22~1.67,P<0.001).对于有资格接受下一次剂量的女性,机构中SP的可用性(RR=1.17;95%CI=1.04~1.32,P=0.008)和IPTp-SP服务与ANC的整合(RR=1.82;95%CI=1.21~2.74,P=0.004)与IPTp-SP摄取的可能性增加相关.反事实预测表明,加强提供者培训可以促进高吸收国家的IPTp-SP吸收,而更好的SP可用性和IPTp-SP整合到ANC将对低吸收国家产生重大影响。
    为了更好的IPTp-SP覆盖率,策略应该是定制的。高吸收国家应侧重于提供者培训,而低吸收的应确保IPTp-SP的可用性和服务集成。
    UNASSIGNED: Malaria infection during pregnancy is associated with an increased risk of maternal death, as well as adverse birth outcomes. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is known to improve pregnancy outcomes. However, the coverage of IPTp-SP in antenatal care (ANC) in sub-Saharan Africa remains well below the target. This study aims to estimate to what extent malaria service readiness affects the uptake of IPTp-SP during ANC visits in sub-Saharan African countries.
    UNASSIGNED: This study included 3267 pregnant women attending ANC for the first time and 2797 pregnant women who had attended ANC more than a month ago in six sub-Saharan African countries. The readiness of malaria services at each institution includes four indicators: the presence of IPTp-SP guidelines, SP availability, integration of IPTp-SP service into ANC, and provider training on IPTp-SP. The outcome variable indicates whether a pregnant woman received IPTp-SP at her current ANC visit. A modified Poisson regression model estimated the associations between malaria service readiness and IPTp-SP uptake for women eligible for the first and subsequent doses.
    UNASSIGNED: For women eligible for their first dose, visiting an institution with available SP was associated with an increased probability of receiving IPTp-SP (risk ratio (RR) = 1.43; 95% confidence interval (CI) = 1.22 to 1.67, P < 0.001). For women who were eligible for their next dose, the availability of SP (RR = 1.17; 95% CI = 1.04 to 1.32, P = 0.008) and integration of IPTp-SP service into ANC (RR = 1.82; 95% CI = 1.21 to 2.74, P = 0.004) in the institution were associated with increased likelihood of IPTp-SP uptake. Counterfactual predictions indicated that enhanced provider training could boost IPTp-SP uptake in high-uptake countries, while better SP availability and IPTp-SP integration into ANC would significantly impact low-uptake countries.
    UNASSIGNED: For better IPTp-SP coverage, strategies should be customised. High uptake countries should focus on provider training, while low uptake ones should ensure IPTp-SP availability and service integration.
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  • 文章类型: Journal Article
    这项研究旨在评估孕妇接受流感疫苗的态度和意愿以及影响其决定的因素。对闵行区各医疗机构接受产前保健的孕妇进行抽样调查,上海,2023年3月至6月。调查包括对人口统计信息的询问,知识,以及对流感疾病和流感疫苗的认识。采用Logistic回归模型和卡方检验对数据进行分析。6.9%(78/1125)的参与者考虑在怀孕期间接种流感疫苗。研究生以上学历的参与者(OR=4.632,95CI:1.046-20.517),非上班族(OR=2.784,95CI:1.560-4.970),配偶不是办公室工作人员的参与者(OR=0.518,95%CI:0.294-0.913)与高意愿接种疫苗显著相关.具有优越知识(>30分)的参与者表现出更大的意愿(p<.001)。将流感后症状视为轻度的参与者在怀孕期间接种疫苗的意愿明显较低(2.3%),与不同意的人相比(p=0.015)。相反,那些认识到孕妇流感后因呼吸道疾病导致住院风险增加的人更倾向于在怀孕期间接种疫苗(8.8%)(p=.007).认识到益处的参与者一致表示愿意在怀孕期间接种流感疫苗(p<.001),而那些感知障碍的人一致拒绝接种疫苗(p<.001)。高等教育,非办公室工作人员身份,并且有一个上班族配偶与怀孕期间接受流感疫苗的更大意愿相关。增强对流感及其疫苗的知识和准确认识影响了意愿。积累有关流感及其疫苗的知识可以促进准确的认识。值得注意的是,怀孕期间接种疫苗的总体意愿仍然很低,可能是出于安全考虑,缺乏准确的认知。有针对性的健康教育,改善医疗保健提供者和孕妇之间的沟通,强调疫苗对母亲和儿童的益处的运动至关重要。
    This study aimed to assess the attitudes and willingness of pregnant women to receive the influenza vaccine and the factors influencing their decisions. A sample survey was conducted among pregnant women receiving prenatal care at various medical institutions in Minhang District, Shanghai, from March to June 2023. The survey included inquiries about demographic information, knowledge, and perception of influenza disease and influenza vaccine. Logistic regression models and chi-square tests were used to analyze the data. 6.9% (78/1125) of participants considered receiving the influenza vaccine during pregnancy. Participants with graduate education or above (OR = 4.632, 95%CI: 1.046-20.517), non-office workers (OR = 2.784, 95%CI: 1.560-4.970), and participants whose spouses were not office workers (OR = 0.518, 95% CI: 0.294-0.913) were significantly associated with high intent to vaccinate. Participants with superior knowledge (>30 points) exhibited greater willingness (p < .001). Participants who viewed post-influenza symptoms as mild had a significantly lower willingness to vaccinate during pregnancy (2.3%), compared to those who disagreed (p = .015). Conversely, those recognizing a heightened risk of hospitalization due to respiratory diseases in pregnant women post-influenza were significantly more inclined to vaccinate during pregnancy (8.8%) (p = .007). Participants recognizing benefits uniformly expressed willingness to receive the influenza vaccine during pregnancy (p < .001), while those perceiving barriers uniformly rejected vaccination (p < .001). Higher education, non-office worker status, and having an office worker spouse correlate with greater willingness to receive the influenza vaccine during pregnancy. Enhanced knowledge and accurate perceptions of influenza and its vaccine influenced willingness. Accumulating knowledge about influenza and its vaccine fosters accurate perceptions. Notably, overall willingness to vaccinate during pregnancy remains low, likely due to safety concerns, and lack of accurate perceptions. Targeted health education, improved communication between healthcare providers and pregnant women, and campaigns highlighting vaccine benefits for mothers and children are essential.
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  • 文章类型: Journal Article
    妊娠期糖尿病仍然是妊娠期最常见的医学疾病,对母亲和后代有短期和长期的影响。对病理生理学和管理的新见解表明,当前的妊娠糖尿病治疗方法应从晚期妊娠糖尿病扩展到个性化,从孕前到产后及以后的综合生命历程方法。早孕生活方式干预可预防晚期妊娠糖尿病。早期妊娠糖尿病的诊断和治疗已被证明是有益的,特别是在妊娠14周之前被发现。现在,早期妊娠糖尿病筛查需要将策略整合到常规的产前护理中。除了努力减少妊娠期糖尿病护理的变化,跨不同的设置,在内部,国家。妊娠糖尿病后,应在产后6~12周进行口服葡萄糖耐量试验,以评估血糖状态.建议随后定期筛查血糖异常和心脏代谢疾病,可以与其他家庭健康活动一起纳入。可能会使用共享决策和精准医学来加强以前患有妊娠糖尿病的妇女的糖尿病预防计划。在这种生命历程方法的所有阶段,在高资源和低资源环境中,需要一个更系统的过程来识别和克服预防护理和治疗的障碍,以减轻当前全球妊娠糖尿病的负担.
    Gestational diabetes remains the most common medical disorder in pregnancy, with short-term and long-term consequences for mothers and offspring. New insights into pathophysiology and management suggest that the current gestational diabetes treatment approach should expand from a focus on late gestational diabetes to a personalised, integrated life course approach from preconception to postpartum and beyond. Early pregnancy lifestyle intervention could prevent late gestational diabetes. Early gestational diabetes diagnosis and treatment has been shown to be beneficial, especially when identified before 14 weeks of gestation. Early gestational diabetes screening now requires strategies for integration into routine antenatal care, alongside efforts to reduce variation in gestational diabetes care, across settings that differ between, and within, countries. Following gestational diabetes, an oral glucose tolerance test should be performed 6-12 weeks postpartum to assess the glycaemic state. Subsequent regular screening for both dysglycaemia and cardiometabolic disease is recommended, which can be incorporated alongside other family health activities. Diabetes prevention programmes for women with previous gestational diabetes might be enhanced using shared decision making and precision medicine. At all stages in this life course approach, across both high-resource and low-resource settings, a more systematic process for identifying and overcoming barriers to preventative care and treatment is needed to reduce the current global burden of gestational diabetes.
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