11 September 2024, Volume 35 Issue 5

    

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  The association between serum 8-hydroxy-2′-deoxyguanosine exposure and hypertensive disorders of pregnancy

  JIN Ming, LIU Xiaojing, LIU Xiaowen, ZHANG Ziyi, GAO Suhong, WU Yaxian, CHEN Junxi, ZHANG Le, YE Rongwei, LIU Xiaohong, LI Zhiwen, LI Nan

  Chinese Journal of Reproductive Health. 2024, 35(5): 401-407.

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  Objective This study aims to investigate the association between 8-hydroxydeoxyguanosine(8-OHdG) in serum and the incidence of hypertensive disorders of pregnancy(HDP). Methods This nested case-control study was based on a cohort of pregnant women at the Haidian Maternal and Child Health Hospital in Beijing. The cohort recruited pregnant women from October 2017 to October 2018. The study ultimately included 150 HDP cases and 490 healthy controls. General demographic characteristics and lifestyle information were collected through structured face-to-face questionnaires during baseline prenatal visits, and leftover blood samples were retained from laboratory tests. The concentration of 8-OHdG in the serum of pregnant women was measured using an ELISA kit. HDP was diagnosed based on the first occurrence of hypertension after 20 weeks of pregnancy. Logistic regression was used to analyze the association between serum 8-OHdG and the risk of HDP, calculating the odds ratio(OR) and 95% confidence interval(CI). Further exploration of the dose-response relationship between serum 8-OHdG and HDP, as well as the potential interaction between pre-pregnancy body mass index(BMI) and serum 8-OHdG on the incidence of HDP, was conducted. Results In this study, the detection rate of serum 8-OHdG in pregnant women was 93.59%, with a median concentration of 28.98 ng/mL. Logistic regression results showed that high exposure to serum 8-OHdG had a significant protective effect against HDP. When serum 8-OHdG was divided into quartiles, the risk of HDP in the high exposure group(Q4) was 0.42 times that of the low exposure group(Q1)(95%CI:0.22, 0.78), and there was a significant dose-response relationship(linear trend test P=0.001). High exposure to 8-OHdG significantly reduced the risk of HDP only in pregnant women with a pre-pregnancy BMI ≥ 24 kg/m², and there was a significant interaction between pre-pregnancy BMI and serum 8-OHdG on the incidence of HDP(P=0.012). Conclusion Exposure to serum 8-OHdG during pregnancy can reduce the risk of HDP, and pre-pregnancy BMI can modify this association.
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  The number of births and the proportion of births of the third child and above in a county in Shandong before and after the implementation of the three-child policy

  TAN Xiaoyu, ZHAO Lihua, ZHOU Yubo, JIN Caiqin, LIU Yang, ZHENG Aini, LI Aihong, LI Hongtian, LIU Jianmeng

  Chinese Journal of Reproductive Health. 2024, 35(5): 408-415.

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  Objective To describe the number of births and the composition of child-orders in a county in Shandong from the second half of 2019 to the first half of 2023, and to analyze the impact of the three-child policy on the number of births and the proportion of births of the third child and above. Methods Based on the regular statistic data of births registration in a county in Shandong from July 2019 to June 2023, the variables including the newborn's birth date and mother's parity were obtained; the mother's parity was used as the approximate index of the newborn's child-order. Considering the proposal time of the three-child policy and referring to previous studies, the baseline period was defined as from July 2019 to February 2022, and the three-child policy effect period was defined as from March 2022 to June 2023. Interrupted time series models were used to study the impact of the three-child policy on the monthly number of births and the monthly proportion of births of the third child and above. Results The number of births was 26 642 in the research area from July 2019 to June 2023; the number of births in the baseline period was 18 007, with a monthly average of 562.72; and the total number of births was 8 635 in the three-child policy effect period, with a monthly average of 539.69. The interrupted time series analysis showed that the overall number of births decreased by an average of 4.56 per month during the baseline period(P=0.094). At the beginning of the three-child policy coming into effect, the total number of births decreased by 91.19 instantaneously(P=0.075), followed by an average monthly increase of 8.78(P=0.075) during the policy effect period. However, none of these changes were statistically significant. There were 11 956 births of the first child, 11 733 births of the second child, and 2 128 births of the third child and above during the study; the proportion of births of the third child and above was 8.24%, with 7.77% during the baseline period and 9.18% during the period of the three-child policy effect period. The interrupted time series analysis showed that the proportion of births of the third child and above increased by an average of 0.05% during the baseline period(P=0.048). At the beginning of the three-child policy coming into effect, the total number of births decreased by 0.64% instantaneously(P=0.417), followed by an average monthly increase of 0.14%(P=0.200) during the policy effect period, but the changes of the proportion of births of the third child and above in the instantaneous level and the subsequent trend after the three-child policy took effect were not statistically significant. Conclusion The total number of births in the study area did not change significantly after the three-child policy was implemented, the proportion of births of the third child and above did not increase significantly either, suggesting that the implementation of the three-child policy had no significant impact on the childbearing behavior of women at reproductive age in the research area in the short term.
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  Trend and mutation analysis of long-acting contraceptive service utilization and induced abortion in Guangdong province Based on Mann-Kendall Test

  MA Yuanzhu, WU Yingfang, WU Li, XIA Jianhong, ZHAO Qingguo,WU Yuntao, ZHU Yingxian

  Chinese Journal of Reproductive Health. 2024, 35(5): 416-423.

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  Objective To understand the trend of long-acting contraceptive service utilization and induced abortion in Guangdong Province, and to provide basis for formulating effective reproductive health care service strategy and improving women's reproductive health. Methods Mann-Kendall test was used to analyze trends and mutations of the total number of long-acting contraceptive service utilization, the number and proportion of various long-acting contraceptive methods, the number of induced abortion and induced abortion and live birth ratio in Guangdong province from 2008 to 2021. Results From 2008 to 2021, the total number of long-acting contraceptive service utilization showed a downward trend, the number of long-acting irreversible contraceptive methods showed an increasing trend followed by a decreasing trend, while the number of long-acting reversible contraceptive methods showed a declining trend. The mutation points of the total number of long-acting contraceptive service utilization, irreversible contraceptive methods and reversible contraceptive services methods appeared in 2016, 2018 and 2014, respectively. In terms of the proportion of various long-acting contraceptive methods,intrauterine device, female sterilization, male sterilization and subcutaneous implant accounted for 67.3%, 29.1%, 3.5% and 0.1%, respectively. The number of induced abortion in Guangdong province showed a decreasing trend. The mutation point of induced abortion appeared in 2018, and induced abortion and live birth ratio was relatively stable, with an average annual ratio of 76.5%. It showed a parallel relationship between the trend line of the number of long-acting reversible contraceptive methods and that of number of induced abortion in Guangdong Province and the Pearl River Delta, while the relationships in the other regions beyond Pearl River Delta regions varied. Conclusion In Guangdong Province, intrauterine device was the dominant long-acting contraceptive method, followed by was female sterilization. The responsibility for long-acting contraception primarily lay on women. There was a different relationship between long-acting reversible contraceptive methods and induced abortion in the four regions of Guangdong Province. It is necessary to learn the factors attributing to regional differences, and to promote the implementation of contraceptive services in different regions effectively, so as to avoid unintended pregnancies. In addition, it is suggested that the regional governments integrate contraceptive services into women full life-cycle services, and actively protect women's reproductive health.
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  The effects of fear for childbirth on pregnancy outcomes of single primiparas

  ZHANG Yiwen, HE Yinfang

  Chinese Journal of Reproductive Health. 2024, 35(5): 424-429.

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  Objective To investigate the fear of childbirth of single primipara in our hospital and to explore the influence of fear of childbirth on pregnancy outcome. To provide theoretical basis for further improving pregnancy care services and maternal and infant outcomes. Methods From October 1, 2021 to October 31, 2022, a total of 617 single primiparas who received regular birth examination and gave birth in the Department of Obstetrics, the First Hospital of Shanxi Medical University were included as subjects. A questionnaire survey was conducted on pregnant women when they came to the hospital for obstetrical examination, and information about childbirth was obtained according to relevant information, including gestational week, delivery mode, postpartum blood loss, labor process, length of stay, etc., to analyze the influence of different degrees of fear of childbirth on pregnancy outcomes. Results A total of 617 pregnant women were investigated in this study. There were 461 pregnant women with fear of childbirth, with an incidence rate of 74.7%. With the deepening of fear of childbirth, the rate of natural delivery gradually decreased, and the incidence of non-medical indications of caesarean section gradually increased, the difference was statistically significant(P<0.05). There were statistically significant differences among all groups in total gestation days, incidence of premature infants, 2h postpartum blood loss, postpartum hemorrhage rate, Apgar score, neonatal weight, low birth weight infants, postpartum hospital stay days, and incidence of non-medical indications of cesarean section(P<0.05), which mainly affected the moderate and severe fear of childbirth group. There were no significant differences in the total labor course, the incidence of macrosomia, the rate of lateral perineal resection and the incidence of cesarean section transfer(P>0.05). Conclusion The incidence of fear of childbirth is relatively high in our hospital. Fear of childbirth can increase the incidence of adverse maternal and infant outcomes and increase the rate of cesarean section. We should pay attention to the mental health education of pregnant women and improve the comprehensive health care services during pregnancy.
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  Effect of multiple pronuclei on the outcome of frozen-thawed embryo transfer in patients with polycystic ovarian syndrome

  WANG Li, YANG Ye, XIE Qi-jun, PENG Li-jun, YANG Yu-qin, LING Xiu-feng

  Chinese Journal of Reproductive Health. 2024, 35(5): 430-437.

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  Objective To investigate the impact of multiple pronuclei(PN) on the outcome of frozen-thawed embryo transfer(FET) in infertile women with polycystic ovary syndrome(PCOS). Methods A total of 2 665 patients who underwent IVF treatment in Women's Hospital of Nanjing Medical University from January 2016 to December 2021 were retrospectively analyzed. First, they were divided into PCOS group(N=1295) and control group(N=1370) according to the cause of infertility, and the incidence of multiple PN was compared between the two groups. Subsequently, we only included patients whose whole embryos were frozen and underwent FET in the PCOS group, and excluded those who were lost to follow-up or who had not yet arrived for delivery. Finally, 999 PCOS patients were included and divided into three subgroups according to fertilization status:547 patients in the 2PN group, 414 cases in the low-proportion multiple PN group(multiple PN rate ≤20%), and 38 cases in the high-proportion multiple PN group(multiple PN rate >20%). The clinical outcomes of these three subgroups were compared. Results The PCOS group had a significantly higher rate of multiple PN than the control group(P<0.05). Compared with patients in the 2PN group, those in the the low proportion of multi-PN group had higher baseline AMH, number of oocytes retrieved and number of IVF oocytes(P<0.05), lower number of transferable embryos, blastocyst formation rate and high-quality blastocysts, biochemical pregnancy rate and live birth rate were lower(P<0.05). The number of retrieved oocytes and IVF oocytes in high proportion of multi-PN group were lower than those in low proportion of multi-PN group(P<0.05), the number of transferable embryos, blastocyst formation rate, and high-quality blastocysts in low proportion of multi-PN group were lower than those in 2PN group and low proportion of multi-PN group(P<0.05), and the biochemical pregnancy rate and live birth rate were lower than those in 2PN group and low proportion of multi-PN group(P<0.05). There was no significant difference in embryo implantation rate and clinical pregnancy rate among the three groups(P>0.05). Conclusion Multiple PN in PCOS patients undergoing FET reduces embryo quality, biochemical pregnancy rate and live birth rate.
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  Analysis on factors that influence the clinical efficacy of diastasis recti abdominis with acupuncture

  HE Bolin, WANG Jiamen, SHI Yue, LIU Fang, ZHANG Liyuan, LI Yahui, QIAO Ting, LU Jing

  Chinese Journal of Reproductive Health. 2024, 35(5): 438-442.

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  Objective To study the relevant factors affecting the clinical efficacy of acupuncture treatment for diastasis recti abdominis. Methods A retrospective analysis was conducted on 98 postpartum women diagnosed with diastasis recti abdominis treated with acupuncture in our hospital from January 2022 to January 2023. Data on their age, postpartum days, height, weight, number of pregnancies, mode of delivery, weight gain during pregnancy, and the initial inter-recti distance were collected. Statistical analysis of data was conducted using SPSS 25.0 software. Results The influencing factors selected by the rank sum test were the pregnancy times(P＜0.05) and the initial inter-recti distance(P<0.01). The influencing factors selected by the correlation analysis were the delivery times(r=0.23, P<0.05), the pregnancy times(r=0.22, P<0.05), and weight(r=0.20, P<0.01); The influencing factors identified by the Logistic regressive analysis include the delivery times(P＜0.05), mode of delivery(P＜0.05), and number of fetuses(P＜0.05). Conclusion The influencing factors of acupuncture treatment for diastasis recti abdominis include the pregnancy times, the delivery times, weight, delivery method, number of fetuses, and initial inter-recti distance.