服用MOM营养饮品孕妇血清中多种元素的测定

服用ＭＯＭ营养饮品孕妇血清中多种元素的测定钱美伦刘善英盖铭英徐蕴华我们对服用雀巢公司生产的母恩－孕产妇营养饮品ＭＯＭ（每１００ｇＭＯＭ中含有钙１０７５ｍｇ、镁１９０ｍｇ、铜０．８９ｍｇ、锌４８ｍｇ、铁４８ｍｇ）的孕妇，进行了多种元素测定。一、对象与方...     

孕期营养状况及膳食摄入营养素水平与妊娠结局关系的调查

目的 调查孕妇孕期营养状况,了解孕期营养状况对妊娠结局的影响,为采取针对性的干预措施提供依据.方法 于2006年1月至2008年4月间对厦门市妇幼保健院的800例正常孕妇进行营养知识、态度及行为的调查,共734例按要求合格完成调查,记录了其中571例孕妇人组时(<孕20周)、孕26～27周、孕35～36周的多个营养素指标、妊娠结局,分析彼此间关系.结果 (1)孕妇文化程度越高,营养知识、态度及行为的科学性越高(P<0.05).734例孕妇中,39.2%(288例)的孕妇营养知识不足,44.4%(326例)营养知识匮乏,营养行为不良者占48.8%(358例).对1927份孕期膳食结构问卷分析发现孕期每天均有奶类、鱼贝类或豆类摄入者分别占52.2%、34.3%、29.5%.(2)入组时只有血清甘油三酯水平在不同体重指数(BMI)孕妇中存在差异,BMI越高甘油三酯越高(P<0.01).此外,随孕周增加,血清铁蛋白和叶酸呈显著下降趋势(P<0.05),甘油三酯,胆固醇呈显著上升趋势(P<0.01).(3)新生儿出生体重与孕20周前BMI呈正相关(r=0.23,P<0.05),入组时BMI过高是新生儿出生体重异常的危险因素(OR=4.051,95%CI:1.085～15.117,P<0.05),且剖宫产率显著高于BMI低下或正常者(60.3%与29.4%和34.7%,P<0.05).孕期孕妇血清铁蛋白水平越低,产后出血量越多(P<0.05).结论 孕前及孕期合理控制体重,孕期加强营养知识指导,增加奶类、鱼贝类及豆类食品的比例,控制高脂高糖饮食,注重红色动物性食物摄入,全程补充叶酸、铁和钙,避免血脂过高,可能降低异常体重儿、产后出血及剖宫产率,改善妊娠结局.     

米非司酮配伍米索前列醇用于终止14—33周妊娠的临床研究

采用２００ｍｇ米非司酮一次顿服，２４ｈ后每隔３ｈ服用米索前列醇０．２ｍｇ的方法，对７０例１４～３３周妊娠进行了引产临床观察（Ａ组），并以６５例常规利凡诺引产作为对照组（Ｂ组）。结果：Ａ组引产成功６３例，失败７例，成功率为９０．００％，Ｂ组引产成功６２例，失败３例，成功率为９５．３８％。４８ｈ内Ａ组有９６．８３％孕妇引产成功，Ｂ组仅５９．６８％（Ｐ＜０．０１）；平均引产时间Ａ组显著短于Ｂ组，分别为３７．１９±７．１０ｈ与４５．１９±１３．５９ｈ（Ｐ＜０，０１）；Ａ组中经产妇或≤１６孕周的孕妇引产时间显著短于初产妇或＞１６孕周者（Ｐ均＜０．０１），而Ｂ组引产时间在产次、孕周方面差异无显著性。米非司酮配伍米索前列醇的服药方案用于中、晚孕引产效果与利凡诺相似，且具有引产时间短，服药方便、安全等优点，为≤１６孕周的引产提供了良好的安全引产方法。     

营养干预对妊娠期糖尿病孕妇孕期体重增长和血脂代谢水平及分娩结局的影响北大核心CSCD

目的探讨营养干预对妊娠期糖尿病(GDM)孕妇孕期体重增长、血脂水平及分娩结局的影响。方法选择2020年1月至2021年8月在厦门市妇幼保健院产科门诊及营养门诊就诊的GDM孕妇135例(GDM组)及同期就诊的糖耐量试验正常孕妇463例(正常组)。对GDM孕妇予以一对一的营养指导,开具妊娠期糖尿病食谱并嘱其监测血糖;对糖耐量试验正常的孕妇则依据孕期膳食指南予以饮食指导。收集两组孕妇基本信息资料、孕期体重增长情况、孕中晚期血脂水平及分娩结局,探讨分析营养干预对GDM孕妇孕期体重增长、血脂水平变化及分娩结局的影响。结果(1)两组孕妇年龄、文化程度差异无统计学意义;GDM组孕妇孕前BMI高于正常组孕妇,但两组在孕前BMI分层方面差异无统计学意义。(2)孕24周前,GDM组孕妇体重增长幅度超过正常组孕妇(P<0.05);孕24~36周期间,GDM孕妇体重增长幅度小于正常组孕妇(P<0.05)。整个孕期阶段,两组孕妇孕期体重总增长幅度差异无统计学意义(P>0.05)。(3)在孕中期,GDM组孕妇甘油三酯水平高于正常组孕妇,而高密度脂蛋白水平低于正常组孕妇(P<0.05);在孕晚期,两组孕妇甘油三酯及高密度脂蛋白水平差异无统计学意义(P>0.05),但GDM组孕妇的低密度脂蛋白水平低于正常组孕妇(P<0.05)。同时,从整个孕期来看,两组孕妇在血脂各项指标方面均呈上升趋势。(4)两组孕妇在新生儿出生体重、分娩孕周、巨大儿发生率、早产率、剖宫产率、新生儿低血糖发生率等方面,差异均无统计学意义(P>0.05)。结论对GDM孕妇给予及时、合理的饮食控制,能有效地改善GDM孕妇的分娩结局。饮食控制期间,GDM孕妇的体重增长幅度会有所减小,甚至可能出现短期内的体重下降,但这并不影响胎儿的生长。同时,饮食控制也能改善GDM孕妇的血脂水平,主要体现在减小低密度脂蛋白上升幅度方面。     

妊高征倾向孕妇151例补充钙剂后血浆钙离子内皮素一氧化氮的变化分析

我们对有妊高征倾向的孕妇补钙后进行了研究 ,以探讨孕期补钙降低妊高征发病率的机制 ,现报道如下。1　材料与方法1 1　观察对象　 1998年 1月至 2 0 0 0年 3月来我院产前检查的孕妇中 ,有妊高征好发因素的孕妇 ,即体重指数≥0 2 4、平均动脉压≥ 11 3ｋＰａ者 2 2 7例 ,平均年龄 (2 6 45±3 5 3)岁 ,孕周为 2 0～ 2 4周 ,无内科疾病。1 2　方法　将 2 2 7例孕妇随机分组 ,Ａ1组 (71例 ) :每日服用钙尔奇 -Ｄ 1片至分娩 ;Ａ2组 (80例 ) :每日服用钙尔奇 -Ｄ 2片。 (钙尔奇 -Ｄ每片含碳酸钙 15 0 0ｍｇ ,其中元素钙 6 0 0ｍｇ ,维生素Ｄ3 1…     

正常及妊高征孕妇尿中各种蛋白的变化

应用酶联免疫方法对正常未孕妇女２８例、不同孕周的正常孕妇１０１例（包括产后）及妊高征患者２５例尿中各种蛋白进行检测。结果：孕妇在妊娠早期尿中白蛋白及ＩｇＭ排出较非孕妇女明显增多（Ｐ＜０．０５－０．０１），ＩｇＧ亦有增多趋势。妊高征患者与正常不同孕周的孕妇相比，ＩｇＧ，ＩｇＡ、白蛋白的排出均明显增加（Ｐ＜０．０５－０．０１），而ＩｇＭ无差异、产后与孕晚期妇女相比，ＩｇＭ明显减少（Ｐ＜０．０５）；正常     

铁强化酱油对孕妇血红蛋白的影响研究

目的:探讨铁强化酱油对孕妇血红蛋白的影响。方法:将96例孕妇分为实验组和对照组,实验组从孕12周开始在膳食中加服铁强化酱油,对照组使用普通膳食。分别测定两组孕妇12周前、28~32周、36~40周各期的血红蛋白、红细胞数、血清铁蛋白、血清转铁蛋白含量。结果:实验组中血红蛋白、红细胞数、血清铁蛋白均较对照组增高,转铁蛋白较对照组降低;实验组妊娠期缺铁性贫血发生率低于对照组。结论:孕妇服用铁强化酱油有助于提高孕期血红蛋白和孕期铁储备,能有效预防妊娠期缺铁性贫血,改善孕期生理性贫血。     

妊娠期补充铁剂、叶酸后的血液及临床效果观察

为观察孕期补充铁剂，叶酸的效果，并探讨适合于我国孕妇的补充剂量．我们将１１６名孕中期妇女随机分为：（１）对照组（３７例）；（２）补铁组（４０例，给元素４ｋ３０ｍｇ／日）；（３）补叶酸组（３例，给叶酸５００ｕｇ／日）。分别于孕中、晚期取血并观察临床结局．结果表明：血红蛋白、血清铁蛋白及叶酸水平均随妊娠进展而进行性下降，晚期均表现明显缺乏，尤以铁缺乏为著（９７．３％）。补铁后，贫血及铁缺乏状况在一定程度上得以改善．但血清铁蛋白水平仍继续下降，提示补铁剂量（３０ｍｇ）可能不足．补叶酸后，血清叶酸水平明显上升，但贫血状况无改善，表明单纯补叶酸不能纠正贫血。从临床结局看，二治疗组妊高征、宫缩乏力发生率虽低于对照组，但差异无显著性。     

中度高原地区正常及妊高征孕妇血脂及脂质过氧化变化…

测定了未孕妇女、正常孕妇和妊高征患者的血胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白－－胆固醇（ＨＤＬ－Ｃ）及亚组（ＨＤＬ３－Ｃ、ＨＤＬ２－Ｃ），低密度脂蛋白－胆固醇（ＬＤＬ－Ｃ０、超氧化物皮化酶（ＳＯＤ）、丙二醛（ＭＤＡ）和维生素Ｅ（ＶＥ）的水平。结果显示：孕妇血中各项血脂均明显高于未孕妇女（Ｐ〈０．０１），妊高征组与正常孕妇组相比，ＴＣ、ＴＧ更高（Ｐ〈０．０１），ＨＤＬ－Ｃ有下降趋势，ＨＤＬ     

中国孕期、哺乳期妇女的常见营养问题和膳食对策

近年的调查表明,当前中国孕妇和乳母中值得特别关注的营养问题有两个方面:第一,铁、钙、锌、维生素A、维生素B2、叶酸等微量营养素缺乏仍较为普遍,许多微量营养素摄入量与推荐水平存在较大差距,从而严重影响妇女自身健康和子代出生前后的生长发育.     

Insulin-like growth factor 1 and its binding protein 1 during normal and diabetic pregnancies.

Investigations of circulating insulin-like growth factor 1, hPL, and infant size during pregnancy in normal and insulin-dependent diabetic women have yielded conflicting results and have not been analyzed longitudinally. We studied serial changes in maternal serum insulin-like growth factor 1 levels (measured by radioimmunoassay after acid ethanol extraction) throughout pregnancy in 22 normal women and in 38 with insulin-dependent diabetes. The diabetic women had significantly lower serum insulin-like growth factor 1 concentrations than normal women throughout pregnancy and after delivery, although the rates of change in both groups of women were similar. Within-patient analysis showed a significant decrease in serum insulin-like growth factor 1 between 6-12 weeks' gestation and a significant increase between 24-32 weeks, followed by a significant decrease from 36 weeks' gestation to 12 weeks after delivery. Incremental changes in insulin-like growth factor 1 between 24-32 weeks' gestation correlated significantly with incremental changes in hPL (r = 0.40; P less than .001) and with birth weight (r = 0.37; P less than .01), but not with ultrasound measurements of fetal growth. The correlation of increments in insulin-like growth factor 1 and birth weight became nonsignificant when the association of hPL with both insulin-like growth factor 1 and birth weight was taken into account. Neither insulin-like growth factor binding protein 1 (placental protein 12) nor its ratio to insulin-like growth factor 1 showed any association with infant size. The physiologic changes in maternal serum insulin-like growth factor 1 in pregnant diabetic women do not appear related to the increased birth weight of their infants.     

Plasma adiponectin concentrations in non-pregnant, normal and overweight pregnant women

AIMS: Adiponectin is an adipokine that has anti-diabetic, anti-atherogenic, anti-inflammatory and angiogenic properties. This hormone has been implicated in both the physiological adaptation to normal pregnancy and in obstetrical complications. The aims of this study were to determine normal maternal plasma concentrations of adiponectin throughout gestation and to explore the relationships between plasma adiponectin concentration, pregnancy, and maternal overweight. METHODS: A cross-sectional study was designed to include normal pregnant (normal weight and overweight; 11-42 weeks of gestation), and non-pregnant women. Plasma adiponectin concentration was determined by immunoassay. Non-parametric statistics were used for analysis. RESULTS: (1) Adiponectin was detectable in the plasma of all patients; (2) there was no significant differences in the median adiponectin concentration between pregnant and non-pregnant women; (3) plasma adiponectin concentrations were negatively correlated with gestational age only among normal weight pregnant women; and (4) overweight patients had significantly lower plasma adiponectin concentrations than normal weight women. CONCLUSIONS: Consistent with the increased insulin resistance and weight gain that occur in pregnancy, adiponectin concentrations were negatively correlated with gestational age. The results of this study and the nomogram herein presented, can serve as the basis to explore the relationship between adiponectin and pregnancy complications and facilitate the clinical use of this important adipokine.     

Folic acid supplement and intrauterine growth

The effect of a folic acid supplment on birth weight and placental weight in women delivering in the early summer in Denmark was investigated. Thirty-six women with normal pregnancy and expected delivery in the first half of June were selected consecutively. They were paired two and two, and allotted to two groups, one of which was supplied daily with 5 mg folic acid, and the second with tablets without folic acid, from the 23rd week of pregnancy. A significant correlation was found between erythrocyte folic acid and birth weight. The infants in the folic acid group were 12.7 per cent heavier than those in the control group (p less than 0.01). A similar difference was found with regard to placental weight and the number of placental cells.     

Alpha1-fetorprotein concentrations in maternal serum during normal pregnancy.

Measurement of amniotic fluid concentrations of alpha1-fetoprotein has been proposed as a potentially important screening test of fetal well-being. Because maternal serum is more easily obtainable, the present study was performed to determine if there is a definable normal pattern of maternal serum alpha1-fetoprotein levels during gestation. Sequential alpha1-fetoprotein determinations were performed throughout gestation on the serums of 151 women having apparently normal pregnancies. Before 13 weeks, all samples contained less than 20 nanograms of alpha1-fetoprotein per milliliter of serum, and in 12.5 per cent of normal pregnancies, alpha1-fetoprotein was still undetectable as late as 21 weeks of gestation. One normal term delivery followed a negative alpha1-fetoprotein determination at the 24th week of pregnancy. Beyond the 21st week of pregnancy, there was a wide range of normal absolute values noted between women at the same stage of pregnancy. Moreover, wide fluctuations in maternal serum concentrations of alpha1-fetoprotein were observed from point to point in specimens from individual women studied longitudinally throughout gestation. The distribution of alpha1-fetoprotein concentrations at each stage of pregnancy was skewed. We conclude that studies of maternal serum alpha1-fetoprotein concentrations are likely to be more meaningful from a diagnostic point of view prior to 21 weeks of gestation, when the range of circulating maternal alpha1-fetroportein values is relatively small. Undetectable maternal serum alpha1-fetoprotein as late as the 24th week of pregnancy is compatible witha viable conceptus. Because unexplained and marked elevations of maternal alpha1-fetoprotein may occur, particularly in the third trimester, it would appear inappropriate to base clinical decision on maternal serum alpha1-fetoprotein measurements alone, and such decisions certainly should not be taken after only single maternal serum alpha1-fetoprotein measurements. Finally, no correlation was found between maternal alpha1-fetoprotein concentrations near term and the birth weight of the infant.     

Can serum ferritin,vitamin B12 and folic acid levels affect serum screening tests during pregnancy?

Objective: To examine the relation of serum folate, vitamin B₁₂ and ferritin levels to 1st and 2nd trimester serum screening markers. Methods: Fetal crown-rump length (CRL), nuchal translucency (NT), and first and second trimester serum screening tests of 228 pregnant women were obtained. In all cases, serum vitamin B₁₂, folic acid and ferritin levels were analyzed during the 11–14 week period. Levels below <15 µg/L, 3 ng/mL and 211 pg/mL were accepted as nutrient deficiency for serum ferritin, folic acid and vitamin B₁₂, respectively. Results of serum screening markers of women below and above these values were compared with each other. Results: Comparison of groups with ferritin levels <15 and >15 µg/L for 1st and 2nd trimester serum screening parameters revealed significant differences between groups in terms of pregnancy associated plasma protein-A (PAPP-A), free β-human chorionic gonadotropin (fb-hCG), AFP and hCG. Comparison of women with low versus normal B₁₂ levels revealed significant differences in terms of NT, PAPP-A and fb-hCG. Conclusion: Although sufficient, number of cases is limited in this study so results cannot be generalized to all population. It could be advised that in addition to folic acid supplementation, deficiencies of ferritin and B₁₂ must be corrected in patients considering pregnancy or early 1st trimester pregnant women to obtain more accurate serum screening results.     

Maternal serum alpha-fetoprotein screening: the effect of participation on anxiety and attitude toward pregnancy in women with normal results

The purpose of this study was to assess the psychological impact of maternal serum alpha-fetoprotein screening on pregnant women with normal results and their male partners. Assessments of anxiety (as measured by the state-trait anxiety inventory) and attitudes toward pregnancy (as measured by the maternal attitude to pregnancy instrument) were conducted sequentially beginning at 16 weeks' gestation in women participating in the maternal serum alpha-fetoprotein screening with normal results and in women without access to screening. Screened subjects exhibited similar or lower levels of anxiety at each point in time as compared to unscreened subjects. In addition, they exhibited a similar or more positive attitude toward pregnancy. No differences in anxiety were observed between male partners in the two groups. Participation in screening appeared to have no adverse psychological effect on the subjects studied.     

Arterial blood pressure standards during normal pregnancy and their relation with mother-fetus variables

The purpose of our work was to study blood pressure variations during pregnancy in a normal Latin American population from Argentina and Uruguay; to investigate blood pressure variations according to maternal age, parity, or pregnancy weight gain; and to correlate diastolic blood pressure levels in the last trimester of pregnancy with newborn birth weight. This prospective study included follow-up throughout gestation of 249 normal pregnant women (129 nulliparous and 120 multiparous) with a weekly blood pressure control under the same experimental conditions. Our results demonstrate that there is only a low correlation between maternal age and diastolic blood pressure, but no correlation was found with systolic blood pressure; maternal weight gain correlates with blood pressure changes; no correlation was found between gestational age and blood pressure, although an increasing tendency in systolic and diastolic blood pressure was found toward the end of gestation; and a significant correlation was observed between birth weight and average diastolic blood pressure during the third trimester. These findings demonstrate the potential significance of the use of standard blood pressure data from normal pregnant women for the future clinical evaluation of our population.     

Relation of obstetric parameters to the concentrations of four pregnancy-associated plasma proteins at term in normal gestation.

The relations between normal obstetric parameters and the maternal levels of four pregnancy-associated plasma proteins (PAPP) were studied, with the use of plasma samples taken from 187 normal pregnant women within seven days before delivery. PAPP-A levels were correlated with placental and newborn weights. The levels of this pregnancy protein was higher in primigravid women and in groups with higher diastolic blood pressure than in other groups. Women with extremely high PAPP-A concentrations were likely to have extremely large placental weight was not necessarily associated with a high PAPP-A level. PAPP-C was not correlated with placental or newborn weight. The relationship between PAPP-C and maternal age, as well as maternal weight, was significant by one but not in the other three statistical analyses employed. The pregnancy zone protein was found to be correlated with parity. In primigravid women, this protein additionally showed an inverse correlation with the placental weight. Human chorionic somatomammotropin was significantly related to placental weight and inversely related to maternal weight. Its relationship with newborn weight was best seen in primigravid subjects. Other parameters (systolic blood pressure, one- and five-minute Apgar scores, weeks of gestation, days before delivery, newborn sex, and newborn bilirubin level) were not related to any of these pregnancy proteins.     

正常妊娠和妊娠高血压综合征妇女血清瘦素水平的动态检测

目的　动态检测正常妊娠、妊娠高血压综合征 (妊高征 )妇女血清瘦素水平的变化特点。方法　采用放射免疫法测定 40例正常非妊娠妇女 (对照组 )以及 5 0例正常妊娠和 14例妊高征妇女(观察组 )孕 16～ 2 0、2 4～ 2 8、3 2～ 3 6周及分娩前的血清瘦素水平及其新生儿的脐血瘦素水平 ,同时测量身高、体重、血压及胎盘重量。结果　 ( 1)随着孕周的增加 ,观察组妇女血清瘦素水平呈上升趋势 ,其中妊高征妇女血清瘦素水平为 ( 14 1± 2 2 )～ ( 2 5 4± 2 7) μg/L ,较正常妊娠妇女的 ( 13 4± 3 0 )～( 2 1 4± 3 7) μg/L明显上升 (P <0 0 1) ,并持续至妊娠结束 ,而正常妊娠妇女血清瘦素水平在孕 2 8～3 6周时上升明显 ,孕 2 8周前及孕 3 6周后上升缓慢。 ( 2 )体重、体重指数与血清瘦素水平的相关性分析结果显示 ,正常妊娠、对照组妇女均呈显著性正相关 (r =0 478～ 0 63 9,P <0 0 5或P <0 0 1) ,而妊高征妇女无显著相关性 (r=0 0 3 5～ 0 3 79,P >0 0 5 )。( 3 )收缩压、舒张压、平均动脉压与血清瘦素水平的相关性分析结果显示 ,正常妊娠、孕 2 0周前的妊高征及对照组妇女无显著相关性 (r=0 113～0 498,P >0 0 5 ) ,而妊高征妇女孕 2 0周后呈显著正相关 (r=0 63 9～ 0 85 2 ,P <0 0 5 )