Postpartum Period

产后期间
  • 文章类型: Journal Article
    相当比例的妇女在怀孕或产后期经历心理健康挑战。常见的精神障碍(CMD),包括抑郁症,焦虑,强迫症,是普遍的。确定原因和相关的危险因素对于早期干预和预防心理健康问题至关重要。
    这项研究利用了2018年基础卫生研究的数据,在印度尼西亚全国范围内进行,使用横截面的方法。我们关注的是目前或以前结婚的13-49岁女性,经历过怀孕,包括8,889名孕妇和77,012名在2013年1月1日至2018年8月31日期间分娩的妇女。采用自我报告问卷-20评估CMD。进行多因素logistic回归分析。
    孕妇中CMD的患病率为12.6%,而产后母亲的患病率为10.1%。在两次怀孕期间(调整后的赔率比[AOR]:12.23,95%置信区间[CI]:9.06-16.60)和产后期间(AOR:16.72,95%CI:14.85-18.82),对CMD的影响最大。两组的其他重要因素包括年轻的母亲年龄,缺乏教育,失业,高血压的故事,和吸烟状况。在孕妇中,CMD也与孕早期妊娠有关,既往妊娠并发症,和小的上臂周长。对于产后母亲来说,重要因素包括流产史,意外怀孕,妊娠并发症,缺乏产前护理,自发分娩,产后并发症和避孕药的使用。
    CMD会影响孕妇和产后妇女。早期诊断和管理必须无缝集成到初级医疗保健实践中。
    UNASSIGNED: A substantial proportion of women experience mental health challenges during pregnancy or the postpartum period. Common mental disorders (CMDs), including depression, anxiety, and obsessive-compulsive disorder, are prevalent. Identifying causes and associated risk factors is imperative for early intervention and the prevention of mental health issues.
    UNASSIGNED: This study utilized data from the 2018 Basic Health Research, which was conducted nationwide in Indonesia, using a cross-sectional approach. We focused on women aged 13-49 years who were currently or previously married, and had experienced pregnancy, including 8,889 pregnant women and 77,012 women who had delivered between January 1, 2013, and August 31, 2018. The Self-Reporting Questionnaire-20 was employed to assess CMDs. Multivariate logistic regression was performed.
    UNASSIGNED: The prevalence of CMDs in pregnant women was 12.6%, while postpartum mothers exhibited a prevalence of 10.1%. Poor health status displayed the strongest impact on CMDs during both pregnancy (Adjusted Odds Ratio [AOR]: 12.23, 95% Confidence Interval [CI]: 9.06-16.60) and the postpartum period (AOR: 16.72, 95% CI: 14.85-18.82). Additional significant factors for both group include young maternal age, lack of education, unemployment, hystory of hypertension, and smoking status. Among pregnant women, CMDs was also associated with first-trimester pregnancy, previous pregnancy complications, and small upper arm circumference. For postpartum mothers, significant factors include history of abortion, unwanted pregnancy, pregnancy complications, lack of antenatal care, spontaneous delivery, postpartum complications and contraceptive use.
    UNASSIGNED: CMDs can impact in pregnant and postpartum women. Early diagnosis and management must be seamlessly integrated into primary healthcare practices.
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  • 文章类型: Journal Article
    背景:对日常生活活动的干扰会对产妇的生理和心理行为产生负面影响。这项研究旨在探讨日本女性产后1个月前对日常生活活动和会阴疼痛的干扰模式。此外,我们旨在描述会阴疼痛和分娩相关因素与日常生活活动干扰之间的关系.
    方法:本研究是在日本五家妇产医院进行的更大的前瞻性纵向研究的一部分。参与者是293名女性,她们有足月阴道分娩和单胎婴儿。参与者在产后第1天,第5天和第1个月使用100mm视觉模拟量表和“干扰日常生活量表”的行为自我评估了会阴疼痛和对日常生活活动的干扰。我们使用线性混合模型来计算固定效应参数估计及其95%置信区间。干扰日常生活活动,其中包括坐着困难,移动困难,排泄和清洁方面的困难,被设置为因变量。
    结果:最终分析包括184名参与者,平均年龄为31.5±4.5岁。从产后第1天到第5天,会阴疼痛和干扰日常生活活动的三个子量表减少,并进一步从第5天到产后1个月(会阴疼痛,p<0.01,p<0.01;难以坐着,p<0.01,p<0.01;移动困难,p<0.01,p<0.01;排泄和清洁困难,p<0.01,p<0.01)。这些趋势没有改变,甚至使用混合模型对自变量进行了调整。在后续数据的混合模型中,会阴疼痛与干扰日常生活活动的三个子量表显着正相关,即使调整了会阴损伤和会阴切开术。
    结论:在产后1个月之前,会阴疼痛与日常生活活动干扰之间存在正相关关系,虽然两者都减少了。从产后早期开始,通过育儿促进母亲角色的实现,助产士应额外注意母亲的会阴疼痛,因为这可能会对她们的日常生活和育儿产生负面影响。
    BACKGROUND: Interference with activities of daily living can negatively impact maternal practices both physically and psychologically. This study aimed to explore the patterns of interference with activities of daily living and perineal pain among Japanese women until 1 month postpartum. Furthermore, we aimed to describe how both perineal pain and delivery-related factors were associated with interference with activities of daily living.
    METHODS: This study was part of a larger prospective longitudinal study conducted at five maternity hospitals in Japan. The participants were 293 women who had full-term vaginal deliveries and singleton infants. Participants self-evaluated their perineal pain and interference with activities of daily living using a 100 mm visual analogue scale and \'behaviour that interferes with daily life scale\' at day 1, day 5, and 1 month postpartum. We used a linear mixed model to calculate the fixed-effects parameter estimates and their 95% confidence intervals. Interference with activities of daily living, which included difficulty sitting, difficulty moving, and difficulties with excretion and cleanliness, were set as the dependent variables.
    RESULTS: The final analysis included 184 participants with a mean age of 31.5±4.5 years. Perineal pain and the three sub-scales of interference with activities of daily living reduced from day 1 to 5 postpartum, and further from day 5 to 1 month postpartum (perineal pain, p<0.01, p<0.01; difficulty sitting, p<0.01, p<0.01; difficulty moving, p<0.01, p<0.01; difficulties with excretion and cleanliness, p<0.01, p<0.01). These tendencies did not change, even adjusted for independent variables using a mixed model. In the mixed model for follow-up data, perineal pain was a significantly and positively associated with three sub-scales of interference with activities of daily living, even after adjusted for perineal injury and episiotomy.
    CONCLUSIONS: Positive relationships were observed between perineal pain and interference with activities of daily living until 1 month postpartum, although both reduced. To promote maternal role attainment through child-rearing since early postpartum, midwives should pay additional attention to mothers\' perineal pain as it could negatively affect their daily life and child-rearing.
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  • 文章类型: Journal Article
    产后心脏逆向重构(RR)与尿蛋白质组的关系,尤其是在有心血管(CV)危险因素的孕妇中,心血管疾病和死亡率长期升高的风险尚不清楚.我们旨在对有/无CV危险因素的孕妇的尿蛋白质组进行分析,以确定与产后RR相关的蛋白质。我们的研究包括32名健康和27名肥胖和/或高血压和/或糖尿病孕妇的前瞻性队列,这些孕妇接受了经胸超声心动图检查,脉搏波速度,在妊娠晚期和产后6个月收集尿液。鸟枪HPLC-MS/MS异形蛋白。使用广义线性混合效应模型来确定尿蛋白和左心室质量(LVM)之间的关联。RR的代理人。从妊娠晚期到分娩后6个月,动脉僵硬度增加。在有CV危险因素的女性中显著升高。此外,至少一个CV危险因素的存在与LVMRR恶化相关.我们鉴定了与高和低LVM回归相关的6和11种蛋白质,分别。这些蛋白质在功能上与胰岛素样生长因子(IGF)转运和IGF结合蛋白的摄取调节相关,血小板活化,信号和聚集以及免疫系统的活动。尿样中IGF-1的浓度与分娩后低LVM消退相关。尿液蛋白质组显示出可预测的潜力,可用于识别产后RR不完整的孕妇。
    The association of postpartum cardiac reverse remodeling (RR) with urinary proteome, particularly in pregnant women with cardiovascular (CV) risk factors who show long-term increased risk of cardiovascular disease and mortality is unknown. We aim to profile the urinary proteome in pregnant women with/without CV risk factors to identify proteins associated with postpartum RR. Our study included a prospective cohort of 32 healthy and 27 obese and/or hypertensive and/or diabetic pregnant women who underwent transthoracic echocardiography, pulse-wave-velocity, and urine collection at the 3rd trimester and 6 months postpartum. Shotgun HPLC-MS/MS profiled proteins. Generalized linear mixed-effects models were used to identify associations between urinary proteins and left ventricle mass (LVM), a surrogate of RR. An increase in arterial stiffness was documented from 3rd trimester to 6 months after delivery, being significantly elevated in women with CV risk factors. In addition, the presence of at least one CV risk factor was associated with worse LVM RR. We identified 6 and 11 proteins associated with high and low LVM regression, respectively. These proteins were functionally linked with insulin-like growth factor (IGF) transport and uptake regulation by IGF binding-proteins, platelet activation, signaling and aggregation and the immune system\'s activity. The concentration of IGF-1 in urine samples was associated with low LVM regression after delivery. Urinary proteome showed a predicting potential for identifying pregnant women with incomplete postpartum RR.
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  • 文章类型: Journal Article
    确定母乳喂养对妊娠糖尿病妇女产后葡萄糖不耐受风险的影响。
    两项多中心前瞻性队列研究(BEDIP-N和MELINDA)对1008例妊娠糖尿病妇女的子分析。数据收集在怀孕期间和产后平均12周。采用多因素logistic回归分析母乳喂养对糖耐量异常的影响,随着种族的调整,教育,收入,专业活动和BMI。
    在所有参与者中,56.3%(567)纯母乳喂养,10.1%(102)给予混合牛奶喂养,33.6%(339)不母乳喂养。在母乳喂养和混合牛奶喂养组中,平均母乳喂养时间为3.8±2.4和3.7±2.1个月(p=0.496)。与无母乳喂养组[29.5%(100)]相比,母乳喂养组[22.3%(126)]和混合奶喂养组[25.5%(26)]的葡萄糖不耐受率均较低,与无母乳喂养组相比,母乳喂养组葡萄糖不耐受的校正OR为0.7(95%CI0.5-1.0),与无母乳喂养组相比,混合奶喂养组的校正OR为0.7(95%CI0.4-1.2).产后,哺乳期妇女的BMI较低,产后体重保留较少,降低空腹甘油三酯,与混合牛奶喂养和不母乳喂养组相比,胰岛素抵抗更少,胰岛素分泌敏感性指数-2更高。混合牛奶喂养组通常来自非白人背景,与无母乳喂养组相比,血压较低,空腹甘油三酯较低。
    母乳喂养(独家和混合牛奶喂养)与妊娠期糖尿病妇女产后早期葡萄糖耐受不良和代谢改善有关。
    UNASSIGNED: To determine the impact of breastfeeding on the risk of postpartum glucose intolerance in women with gestational diabetes.
    UNASSIGNED: Sub-analysis of two multi-centric prospective cohort studies (BEDIP-N and MELINDA) in 1008 women with gestational diabetes. Data were collected during pregnancy and at a mean of 12 weeks postpartum. Multivariate logistic regression was used to estimate the effect of breastfeeding on glucose intolerance, with adjustment for ethnicity, education, income, professional activity and BMI.
    UNASSIGNED: Of all participants, 56.3% (567) breastfed exclusively, 10.1% (102) gave mixed milk feeding and 33.6% (339) did not breastfeed. Mean breastfeeding duration was 3.8 ± 2.4 and 3.7 ± 2.1 months in the breastfeeding and mixed milk feeding groups (p=0.496). The rate of glucose intolerance was lower in both the breastfeeding [22.3% (126)] and mixed milk feeding [25.5% (26)] groups compared to the no breastfeeding group [29.5% (100)], with an adjusted OR of 0.7 (95% CI 0.5-1.0) for glucose intolerance in the breastfeeding group compared to no breastfeeding group and an adjusted OR of 0.7 (95% CI 0.4-1.2) for the mixed milk feeding group compared to the no breastfeeding group. Postpartum, breastfeeding women had a lower BMI, less often postpartum weight retention, lower fasting triglycerides, less insulin resistance and a higher insulin secretion-sensitivity index-2 than the mixed milk feeding and no breastfeeding group. The mixed milk feeding group was more often from an non-White background, had a lower blood pressure and lower fasting triglycerides compared to the no breastfeeding group.
    UNASSIGNED: Breastfeeding (exclusive and mixed milk feeding) is associated with less glucose intolerance and a better metabolic profile in early postpartum in women with gestational diabetes.
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  • 文章类型: Journal Article
    产后抑郁症是一种常见且严重的分娩并发症。这是一个重要的公共卫生问题,对母亲和儿童都有重大影响。影响产后抑郁症发生的确切机制和因素尚不清楚。文献表明,怀孕期间和产后的某些饮食不足可能会导致母亲抑郁的风险增加。本文就硒在产后抑郁症中的作用作一综述。它从已发表的干预和观察性研究中收集了证据,这些研究调查了产前和产后期间硒的摄入量与产后妇女的精神状态之间的关系,并总结了有关硒状态与产后抑郁症之间可能存在关联的生物学机制的信息。该审查包括通过Medline(通过PubMed)和GoogleScholar数据库的电子搜索确定的研究,直到2023年12月。尽管相关研究数量很少,而且它们在方法上存在潜在的局限性,研究结果表明,优化硒状态可能有助于预防和治疗产后抑郁症。需要进一步的纵向和介入性研究来确认这些效应的临床意义。
    Postnatal depression is a common and severe complication of childbirth. It is an important public health problem with significant implications for both mothers and children. The exact mechanisms underlying and the factors influencing the occurrence of postnatal depression remain unclear. The literature suggests that certain dietary deficiencies during pregnancy and the postnatal period may contribute to a greater risk of maternal depression. This review focuses on the role of selenium in postnatal depression. It collects evidence from published interventional and observational studies investigating the relationship between selenium intake during the antenatal and postnatal periods and the mental status of postpartum women and summarises information about biological mechanisms that may underlie the association between selenium status and postnatal depression. The review includes studies identified through electronic searches of Medline (via PubMed) and Google Scholar databases until December 2023. Despite the small number of relevant studies and their potential methodological limitations, the findings suggest that optimizing selenium status may support the prevention and treatment of postnatal depression. Further longitudinal and interventional studies are necessary to confirm the clinical significance of these effects.
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  • 文章类型: Journal Article
    目的是调查血清维生素D浓度与抑郁症状的关系,并评估维生素D浓度对20-44岁孕妇抑郁症状发生的影响。产后妇女,非pp妇女(非怀孕/产后妇女),和男人,包括对产后母乳喂养和非母乳喂养妇女的单独亚组分析。研究人群选自2007-2018年NHANES公开数据。主观访谈数据和客观实验室数据,包括抑郁症状,血清维生素D浓度,营养素摄入量,和人口统计信息被利用。使用主成分分析创建了两种饮食模式,并采用贝叶斯多项式模型来预测每个亚群的抑郁结果。对所有队列的对数维生素D斜率参数的估计均为负;随着维生素D的增加,没有抑郁的可能性增加了,而抑郁症的可能性下降。怀孕的队列有最陡的维生素D斜率,其次是产后妇女,然后是非人民党的男女。与非PP女性和男性相比,较高的维生素D浓度对降低孕妇和产后女性抑郁风险的影响更大。在产后妇女中,与未母乳喂养的女性相比,较高的维生素D浓度对降低母乳喂养女性抑郁风险的影响更大.
    The objective was to investigate associations of serum vitamin D concentration with depressive symptoms and assess the impact that vitamin D concentration has on the occurrence of depressive symptoms in 20-44-year-old pregnant women, postpartum women, non-pp women (non-pregnant/postpartum women), and men, including a separate subgroup analysis of postpartum breastfeeding and non-breastfeeding women. The study populations were selected from the 2007-2018 NHANES public data. Subjective interview data and objective laboratory data including depressive symptoms, serum vitamin D concentration, nutrient intake, and demographic information were utilized. Two diet patterns were created using principal component analysis, and a Bayesian multinomial model was fit to predict the depression outcomes for each subpopulation. The estimates for the log vitamin D slope parameter were negative for all cohorts; as vitamin D increased, the probability of having no depression increased, while the probability of depression decreased. The pregnant cohort had the steepest vitamin D slope, followed by postpartum women, then non-pp women and men. Higher vitamin D concentration had more impact on decreasing depression risk in pregnant and postpartum women compared to non-pp women and men. Among postpartum women, higher vitamin D concentration had a greater influence on decreasing breastfeeding women\'s depression risk than non-breastfeeding women.
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  • 文章类型: Journal Article
    背景和目的:女性最重要的精神问题之一是与围产期有关的抑郁症。我们的研究旨在确定围产期抑郁症症状的频率和过程,特别是产后抑郁症的客观发生率和结局。材料和方法:188名孕妇/产后妇女被纳入前瞻性研究,纵向,观察性研究,在妊娠晚期估计抑郁症状,第一个,第六,和产后第十二个月。所有参与者都完成了为研究目的而构建的半结构化社会人口统计学问卷,爱丁堡产后抑郁量表,多伦多述情障碍量表,贝克焦虑量表,和每个时间点的情绪障碍问卷。产后抑郁症的诊断由具有长期经验的训练有素和认证的精神科医生确认。为了更好地了解抑郁症症状学和真正的产后抑郁症的轨迹,我们将抑郁症分为新发抑郁症和上一个观察期留下的抑郁症。结果:一般来说,48.9%的研究参与者在调查期间的某个时候感到沮丧。共有10.6%的女性在妊娠晚期抑郁。新发抑郁症的比例最高(25%)是在分娩后的第一个月,并维持长达六个月,之后出现是零星的。大多数产后抑郁症在分娩后的第一个月至第六个月期间解决(20.7%)。发作主要具有单相抑郁症的特征。结论:我们的结果表明,在最初的六个月中,抑郁症的新发作最为严重。之后,这是零星的。需要进一步的研究来探索出生后的所有抑郁症状是否相同,或者产后抑郁症,以这种方式分类,具有特定的特征,病因学,因此不同的治疗和预防选择。
    Background and Objectives: One of the most significant psychiatric problems in women is depression related to the perinatal period. Our study aims to determine the frequency and course of depressive symptomatology in the perinatal period with particular reference to objective rate and outcome of postpartum depression. Materials and Methods: One hundred and eighty-eight pregnant/postnatal women were included in a prospective, longitudinal, observational study during which the depressive symptomatology was estimated at the third trimester of pregnancy, and the first, sixth, and twelfth month\' postpartum. All participants completed a semi-structured sociodemographic questionnaire constructed for research purposes, the Edinburgh Postnatal Depression Scale, Toronto Alexithymia Scale, Beck Anxiety Inventory, and The Mood Disorder Questionnaire at each time point. Postpartum depression diagnosis was confirmed by a trained and certified psychiatrist with long-standing experience. For a better understanding of the trajectory of depressive symptomatology and genuine postpartum depression, we classified depression into those with new-onset and those left over from the previous observation period. Results: In general, 48.9% of participants in the study were depressed at some point during the investigation. A total of 10.6% of women were depressed in the third trimester. The highest percentage of new-onset depression (25%) was in the first month after giving birth and was maintained for up to six months, after which the appearance was sporadic. Most of the postpartum depression resolved in the period from the first month to the sixth month after childbirth (20.7%). The episodes mainly had characteristics of unipolar depression. Conclusions: Our results imply that a new onset of depression is most intensive during the first six months, and after that, it is sporadic. Further studies are needed to explore whether all depressive symptomatology in the postnatal period is the same, or perhaps postpartum depression, classified in this way, has specific characteristics, etiology, and consequently different treatment and preventive options.
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  • 文章类型: Journal Article
    背景:这项前瞻性队列研究,从怀孕到产后六个月进行,并以STROBE方法为基础,定量探讨高危孕妇的产前母乳喂养意向与后续母乳喂养结果之间的关系,与低风险妊娠组相比。
    方法:这项研究是在阿提卡最大的公立医院之一进行的,该医院为孕妇提供护理。招募380名参与者,分为高风险(n=200)和低风险(n=180)队列。数据收集时间为20个月(从2020年5月底至2022年1月),从怀孕到产后六个月,通过全面的问卷。
    结果:统计分析显示,两组的产前母乳喂养意向和实际母乳喂养行为之间存在显著的相关性。具体来说,高危人群中81.1%的女性和低危人群中82.5%的女性表达了在怀孕期间纯母乳喂养的意图。产后六个月,54.9%的高风险和64.3%的低风险妊娠组设法维持母乳喂养。延长产前住院时间是一个具有统计学意义的因素(p=0.045),对高危妊娠的纯母乳喂养意愿产生负面影响。
    结论:研究结果阐明了产前意向对母乳喂养结局的关键影响,特别是在高危妊娠中。此外,该研究确定了长期住院对母乳喂养愿望的不利影响.这些见解强调了细微差别的必要性,旨在提高母乳喂养率的支持性干预措施,从而推进符合世界卫生组织建议的孕产妇和新生儿健康目标。
    BACKGROUND: This prospective cohort study, conducted from pregnancy to six months postpartum and grounded in STROBE methodology, quantitatively explores the relationship between antenatal breastfeeding intentions and subsequent breastfeeding outcomes among high-risk pregnant women, compared to a low-risk pregnancy group.
    METHODS: The study was conducted in one of the largest public hospitals in Attica that provides care to pregnant women, enrolling 380 participants divided into high-risk (n = 200) and low-risk (n = 180) cohorts. Data were collected over 20 months (starting from the end of May 2020 until January 2022), spanning from pregnancy to six months postpartum, via comprehensive questionnaires.
    RESULTS: Statistical analysis revealed a pronounced correlation between prenatal breastfeeding intentions and actual breastfeeding behaviors across both groups. Specifically, 81.1% of women in the high-risk group and 82.5% in the low-risk group expressed intentions of exclusively breastfeeding during pregnancy. By six months postpartum, 54.9% of the high-risk and 64.3% of the low-risk pregnancy group managed to sustain breastfeeding. Extended antenatal hospitalization emerged as a statistically significant factor (p = 0.045) negatively impacting exclusive breastfeeding intentions among high-risk pregnancies.
    CONCLUSIONS: The findings illuminate the critical influence of antenatal intentions on breastfeeding outcomes, particularly among high-risk pregnancies. Moreover, the study identifies the detrimental effect of prolonged hospital stays on breastfeeding aspirations. These insights underscore the necessity for nuanced, supportive interventions aimed at bolstering breastfeeding rates, thereby advancing maternal and neonatal health objectives aligned with World Health Organization recommendations.
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  • 文章类型: Journal Article
    女性生理变化会影响牙周组织的假说是本研究的主题,和炎症标志物如基质金属蛋白酶-8可以测量对炎症的易感性。该研究旨在分析产后妇女和无妊娠史妇女牙周部位的MMP-8水平。比较健康参数和牙周病。这是一项有40名参与者的病例对照研究,20例(产后妇女)和20例对照(未怀孕的妇女),谁接受了临床牙周检查和牙沟龈液的收集。ELISA法检测MMP-8水平。产后妇女牙周参数较差,如探查时的出血指数,CAL≥3的部位数量,并且存在较少的牙齿。在没有怀孕史的妇女组中,在健康部位观察到MMP-8水平显着降低,在牙周袋中观察到较高的MMP-8水平(p<0.01)。相比之下,在产后妇女中,MMP-8水平在健康部位和牙周袋中均升高(p>0.01)。牙龈液中的MMP-8水平似乎与牙周临床参数有关,并且可能是产后妇女牙周组织破坏酶促变化的可能标志。
    The hypothesis that physiological changes in women can affect periodontal tissues is the subject of this study, and inflammatory markers such as matrix metalloproteinase-8 can measure susceptibility to inflammation. The study aimed to analyze MMP-8 levels in periodontal sites of postpartum women and women without a history of pregnancy, comparing health parameters and periodontal disease. This is a case-control study with 40 participants, 20 cases (women in the postpartum period) and 20 controls (women without any pregnancy), who underwent clinical periodontal examination and the collection of crevicular gingival fluid. The ELISA test was used to detect MMP-8 levels. Postpartum women had worse periodontal parameters, such as bleeding index on probing, number of sites with CAL ≥ 3, and fewer teeth present. In the group of women without a history of pregnancy, a significantly lower MMP-8 level was observed in healthy sites and a higher one was observed in periodontal pockets (p < 0.01). In contrast, in postpartum women, MMP-8 levels were elevated in both healthy sites and periodontal pockets (p > 0.01). The MMP-8 levels in gingival fluid appear to be related to periodontal clinical parameters and may be a possible marker of enzymatic changes involved in periodontal tissue destruction in postpartum women.
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  • 文章类型: English Abstract
    OBJECTIVE: To analyze the distribution characteristics of Rh phenotype in pregnant and postpartum women in Chongqing area, and to explore the clinical significance of Rh phenotype in pregnant and postpartum women and the feasibility of Rh phenotype compatible blood transfusion.
    METHODS: The ABO blood group and Rh phenotype of 65 161 pregnant and postpartum women were detected by microcolumn gel method, and 48 122 males in the same period were taken as controls. The data were analyzed by Chi-square test.
    RESULTS: There were 112 870 cases (99.64%) of RhD+ in 113 283 samples. In RhD+ cases, CCDee (48.39%) and CcDEe (32.88%) were the main phenotypes. The first case of D-- phenotype in Chongqing area was detected. 413 cases (0.36%) of RhD- were detected, with ccdee (52.78%) and Ccdee (33.41%) as the main phenotypes. Compared with RhD- group, RhD+ group showed statistically significant difference in Rh phenotype distribution (P < 0.01). Among 65 161 maternal samples, the positive rate of 5 antigens of Rh blood group from high to low was D > e > C > c > E, and there was no significant difference compared with male samples (P >0.05). There was no significant difference in the distribution of Rh phenotype between males and pregnant/postpartum women, as well as between pregnant/postpartum women with different ABO blood groups (P >0.05). In pregnant and postpartum women, there was no significant difference in distribution of Rh phenotype among the normal pregnancy population, the population with adverse pregnancy history, the population using human assisted reproductive technology (ART) and the population with infertility (P >0.05). There was no significant difference in the distribution of Rh phenotype between the 4 populations mentioned above and the inpatients in the local general Grade A hospitals and the blood donors (P >0.05). In RhD positive pregnant and postpartum women, the probability of finding compatible blood for CcDEe phenotype was 100%, the probability of finding compatible blood for CCDee, CcDee and CCDEe phenotypes was 45%-60%, the probability of finding compatible blood for ccDEE, ccDEe and CcDEE phenotypes was 5%-10%, and the probability of finding compatible blood for other phenotypes was lower than 0.5%. The supply of blood with CCDee and ccDEE phenotypes can meet the compatible transfusions requirements of 7 Rh phenotypes in more than 99% of patients.
    CONCLUSIONS: Rh phenotype detection should be carried out for pregnant and postpartum women, and it is feasible to carry out Rh phenotype-matched or compatible blood transfusion for pregnant and postpartum women who need blood transfusion.
    UNASSIGNED: 孕产妇Rh表型分布特征及相容性输血的可行性探讨.
    UNASSIGNED: 分析重庆地区孕产妇Rh表型分布特征,探讨Rh表型在孕产妇中的临床意义及实行Rh表型相容性输血的可行性。.
    UNASSIGNED: 采用微柱凝胶法对65 161例孕产妇进行ABO血型和Rh表型检测,以同期48 122例男性为对照,通过χ2检验对数据进行比较分析。.
    UNASSIGNED: 113 283例样本中,RhD+ 112 870例(99.64%),以CCDee(48.39%)和CcDEe(32.88%)为主要表型,并检出重庆地区首例Rh缺失型D--表型;RhD-413例(0.36%),以ccdee(52.78%)和Ccdee(33.41%)为主要表型;RhD+组与RhD-组的Rh表型分布差异有统计学意义(P < 0.01)。在65 161例孕产妇中,Rh 5种抗原的阳性率由高到低为D>e>C>c>E,与男性相比差异无统计学意义(P >0.05);孕产妇Rh表型分布与男性相比差异无统计学意义(P >0.05);不同ABO血型的孕产妇间Rh表型分布差异无统计学意义(P >0.05)。在孕产妇中,正常妊娠人群、有不良流产史人群、采用人类辅助生殖技术人群和不孕症患者人群间Rh表型分布无明显差异(P >0.05), 4个孕产妇人群与本地区综合性三甲医院住院患者和献血者相比,Rh表型分布差异无统计学意义(P >0.05)。RhD阳性孕产妇中,CcDEe表型找到相容性血液的概率为100%,CCDee、CcDee和CCDEe表型找到相容血液的概率为45%-60%,ccDEE、ccDEe、CcDEE表型找到相容血液的概率为5%-10%,其余表型的相容概率均低于0.5%;提供CCDee和ccDEE两个表型的血液即可满足99%以上患者7种Rh表型相容性输血需求。.
    UNASSIGNED: 应对孕产妇进行Rh表型检测,对需要输血的孕产妇推行Rh表型相同或相容性输血是切实可行的输血举措。.
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