我国少数民族孕产妇孕期保健及其健康现状综述

孕产妇孕期保健及孕产妇健康对促进安全分娩和优生优育起着十分重要的作用,随着我国孕产妇保健工作的进一步完善及国家二胎政策的实施,现代临床医学所倡导的优生优育的观念已逐渐被社会广泛认可。然而,我国少数民族地区多有经济落后、地理位置偏僻、思想观念陈旧等问题,导致我国少数民族孕产妇孕期保健水平还比较低下,孕产妇健康状况有待改善。为预防少数民族地区出生缺陷,降低出生缺陷率,提高优生率,提高少数民族地区出生人口素质,通过完善医疗制度,改善医疗环境,合理营养干预及加强家庭访视等相关健康教育促进孕期保健,提高孕前检查的依从性,实现优生,孕产期健康教育可以降低整个孕期出现的危险因素,本文对我国少数民族的孕产妇孕期保健及健康做一综述。     

The Association of Neighborhood Social Capital and Ethnic (Minority) Density with Pregnancy Outcomes in the Netherlands

Background

Perinatal morbidity rates are relatively high in the Netherlands, and significant inequalities in perinatal morbidity and mortality can be found across neighborhoods. In socioeconomically deprived areas, ‘Western’ women are particularly at risk for adverse birth outcomes. Almost all studies to date have explained the disparities in terms of individual determinants of birth outcomes. This study examines the influence of neighborhood contextual characteristics on birth weight (adjusted for gestational age) and preterm birth. We focused on the influence of neighborhood social capital – measured as informal socializing and social connections between neighbors – as well as ethnic (minority) density.

Methods

Data on birth weight and prematurity were obtained from the Perinatal Registration Netherlands 2000–2008 dataset, containing 97% of all pregnancies. Neighborhood-level measurements were obtained from three different sources, comprising both survey and registration data. We included 3.422 neighborhoods and 1.527.565 pregnancies for the birth weight analysis and 1.549.285 pregnancies for the premature birth analysis. Linear and logistic multilevel regression was performed to assess the associations of individual and neighborhood level variables with birth weight and preterm birth.

Results

We found modest but significant neighborhood effects on birth weight and preterm births. The effect of ethnic (minority) density was stronger than that of neighborhood social capital. Moreover, ethnic (minority) density was associated with higher birth weight for infants of non-Western ethnic minority women compared to Western women (15 grams; 95% CI: 12,4/17,5) as well as reduced risk for prematurity (OR 0.97; CI 0,95/0,99).

Conclusions

Our results indicate that neighborhood contexts are associated with birth weight and preterm birth in the Netherlands. Moreover, ethnic (minority) density seems to be a protective factor for non-Western ethnic minority women, but not for Western women. This helps explain the increased risk of Western women in deprived neighborhoods for adverse birth outcomes found in previous studies.     

Population ecology of rhesus monkeys (Macaca mulatta) at Nanwan Nature Reserve,Hainan, China

Rhesus monkeys (Macaca mulatta) at the Nanwan peninsula of Hainan Island, China, have been observed in the field for 25 years, and have been studied intensively for eight years, beginning in 1981. There were about 115 monkeys in 5 natural groups when the Nanwan Reserve was founded in 1965. From 1965 to 1984, the number of groups increased from 5 to 19, and the total population increased from 115 to 930 individuals, an annual population increase of 12.7%. From 1984 to 1987, the population continued a slower rate of increase (8.9%) to approximately 1200 monkeys in 20 groups. The home ranges of each monkey group at Nanwan varied from 0.16 to 0.72 km², with a mean and standard deviation of 0.37 ± 0.18. The size of the home range of the rhesus was affected by the quality of vegetation and rhesus population density. The average birth rate per year was 77.8 ± 13.9%, varying from 53.8% to 100% since 1978. From 1978, the birth rates of two food provisioned groups were higher in alternate years (x? = 91.7%) and lower in intervening years (x? = 68.8%; P = <0.01). A minority (26.5%) of females have given birth at 4 years of age, most at 5 years. The sex ratio of newborns in any one year varied from 0.3 to 3.5 males to females, with a mean and standard error of 1.09 ± 0.37 males to females.     

Reproductive attitudes of couples having a child with cystic fibrosis in Saguenay-Lac-Saint-Jean (Quebec, Canada)

Cystic fibrosis (CF) has a high incidence (1/936 live births) and carrier rate (1/15 inhabitants) in Saguenay-Lac-Saint-Jean. One objective of a major enquiry among several subsets of individuals from this high-risk population for CF was to evaluate the reproductive behaviour of couples with a CF child attending the comprehensive CF clinic in Chicoutimi. The knowledge of the recurrence risk resulted in deciding against further progeny or in reducing the number of children. More reliable contraception methods after the birth of the CF child, but not prenatal diagnosis, were used. Although a minority of parents with a CF child would abort a CF foetus, they apparently started viewing pregnancy interruption for CF after prenatal diagnosis as an acceptable reproductive option.     

In visible bodies: minority women, nurses, time, and the new economy of care

Health care reform in Canadian hospitals has resulted in increased workloads and bureaucratization of patient care contributing to the development of a new economy of care. Interviews with nurses and visible (non-white) minority women who have given birth in institutions undergoing health care reform revealed that nurses felt compelled to avoid interactions with patients deemed too costly in terms of time. Overwhelmingly, these patients were members of culturally marginalized populations whose bodies were read by nurses as potentially problematic and time consuming. As their calls for assistance go unanswered, visible minority women complained of feeling invisible. Taken in context of historical and contemporary interethnic relations, these women regarded such avoidance patterns as evidence of racism. Obstetrical nurses, too, understood that the new economy of care wrought by health care restructuring has altered nursing practice and patient care to the detriment of minority women.     

母亲年龄对中国双生子出生率的影响

选用全国人口普查时登报的 1 989年 1月 1日至 1 2月 31日期间中国育龄妇女 ( 1 5— 49岁 )的生产记录 ,用 Weinberg差别法进行双生子卵性分类 ,分析了中国总体、DZ和 MZ双生子出生率与母亲年龄之间的关系以及双生子的出生性别比。结果表明 ,中国总体、 DZ和 MZ双生子的出生率分别为 0 .787± 0 .0 0 2 % ,0 .573± 0 .0 0 2 %和 0 .2 1 4± 0 .0 0 1 % ,DZ双生子出生率在 33岁前随母亲年龄增高单调上升 ,随后下降 ,但在 46岁后又随龄上升 ,MZ双生子出生率在 34岁前相对恒定 ,随后随龄上升。中国双生子出生性别比显著性低于同期群体出生性别比 ,1 5— 1 9岁和 45— 49岁年龄组出生的双生子性别比低于其它年龄组出生的双生子性别比 ,1 5— 1 9岁和 45— 49岁年龄组出生的双生子性别比较低可能是较低的 MZ双生子出生性别比造成的。     

Dispersal of adult grasshoppers,Mecostethus magister,under the field condition

Estimation of the number of adult grasshoppers, Mecostethus magister, was made by means of the mark-and-recapture method. The birth and death rates are possible to be estimated at the same time, but the immigration and the emigration rate are inevitably involved in these respectively. The immigration and emigration rates must be made clear to know the true birth and death rates. For this purpose the movement of the marked males in 1963 was analyzed. The grasshoppers dominantly moved in the directions of N, NW and W, and the difference in frequency among the movement directions was not so large. The distribution of the dispersal-distance relationship of each quadrate on each released day was fitted approximately to normal distribution. It could be concluded that almost all of the grasshoppers moved within the range of about 31–35m. The emigration rate from the quadrate (12×12m²) was about 0.73–0.77 and the difference in the rate among the released days was small. From these values the emigration rate from the station (84×60m²) was estimated as 0.21–0.23. Subtracting the emigration rate from the death-and-emigration rate, the true death rate was calculated. The death rate was very low until the number of males reached to the peak, then increased gradually. Supposing that immigration rate was equal to the emigration rate, the true birth rate was also estimated. But the presumption might not be pertinent, for the value of birth rates became negative.     

Evolutionary ecology of human birth sex ratio under the compound influence of climate change, famine, economic crises and wars

1.  Human sex ratio at birth at the population level has been suggested to vary according to exogenous stressors such as wars, ambient temperature, ecological disasters and economic crises, but their relative effects on birth sex ratio have not been investigated. It also remains unclear whether such associations represent environmental forcing or adaptive parental response, as parents may produce the sex that has better survival prospects and fitness in a given environmental challenge.
2.  We examined the simultaneous role of wars, famine, ambient temperature, economic development and total mortality rate on the annual variation of offspring birth sex ratio and whether this variation, in turn, was related to sex-specific infant mortality rate in Finland during 1865–2003.
3.  Our findings show an increased excess of male births during the World War II and during warm years. Instead, economic development, famine, short-lasting Finnish civil war and total mortality rate were not related to birth sex ratio. Moreover, we found no association between annual birth sex ratio and sex-biased infant mortality rate among the concurrent cohort.
4.  Our results propose that some exogenous challenges like ambient temperature and war can skew human birth sex ratio and that these deviations likely represent environmental forcing rather than adaptive parental response to such challenges.     

Placental restriction of fetal growth reduces size at birth and alters postnatal growth, feeding activity, and adiposity in the young lamb

Intrauterine growth restriction (IUGR) is associated with accelerated growth after birth. Together, IUGR and accelerated growth after birth predict reduced lean tissue mass and increased obesity in later life. Although placental insufficiency is a major cause of IUGR, whether it alters growth and adiposity in early postnatal life is not known. We hypothesized that placental restriction (PR) in the sheep would reduce size at birth and increase postnatal growth rate, fat mass, and feeding activity in the young lamb. PR reduced survival rate and size at birth, with soft tissues reduced to a greater extent than skeletal tissues and relative sparing of head width (P < 0.05 for all). PR did not alter absolute growth rates (i.e., the slope of the line of best fit for age vs. parameter size from birth to 45 days of age) but increased neonatal fractional growth rates (absolute growth rate relative to size at birth) for body weight (+24%), tibia (+15%) and metatarsal (+18%) lengths, hindlimb (+23%) and abdominal (+19%) circumferences, and fractional growth rates for current weight (P < 0.05) weekly throughout the first 45 days of life. PR and small size at birth reduced individual skeletal muscle weights and increased visceral adiposity in absolute and relative terms. PR also altered feeding activity, which increased with decreasing size at birth and was predictive of increased postnatal growth and adiposity. In conclusion, PR reduced size at birth and induced catch-up growth postnatally, normalizing weight and length but increasing adiposity in early postnatal life. Increased feeding activity may contribute to these alterations in growth and body composition following prenatal restraint and, if they persist, may lead to adverse metabolic and cardiovascular outcomes in later life.     

Social,biological, and political considerations on fertility in Arab populations

In analyzing fertility in the Arab countries, crude birth rate, total fecundity rate, and age specific fertility rates were measured. The data was obtained from United Nations, UNICEF, and the World Bank. In the early 1980's 13 of the countries had birth rates 40/1000. The majority of countries showed a decline in their crude birth rate (CBR) between 1960-83, except Somalia, which increased. The United Arab Emirates (UAE), Tunisia, Lebanon, and Kuwait, had the largest CBR decreases, followed by Morocco, Egypt, and Saudi Arabia. The global fecundity rate (GFR) shows the number of expected births a woman lives through her reproductive period, having children at the prevailing rate for each age. The GFR in these countries is much higher than those of non Moslem countries in the area. Results show that the fertility of Arab countries are in a gradual decline, but remain high, and many have a CBR over 40/1000. In the last 20 years Saudi Arabia, with the largest population of oil producing countries, has had a decreasing CBR. It is not in agreement with its high GFR, but this can be attributed to the large number of immigration workers in the country. The UAE showed a decrease in CBR from 46/1000 to 27/1000, the largest decrease in these countries. This decline coincided with the economic development due to oil production. Kuwait had a 25.5% decrease in CBR but less than Tunisia and Lebanon. The fertility decline in Kuwait intensified in the middle 1970's; the decline in northern Africa began in the late 1960's. There were declines in birth rates in the North African countries in the early 1970's except for Tunisia. The rapid declines in fertility can be attributed to the countries' socioeconomic and political situations.     

Modification of alternative splicing in bovine somatic cell nuclear transfer embryos using engineered CRISPR-Cas13d

Animal cloning can be achieved by somatic cell nuclear transfer(SCNT), but the resulting live birth rate is relatively low. We previously improved the efficiency of bovine SCNT by exogenous melatonin treatment or by overexpression of lysine-specific demethylase 4D(KDM4D) and 4E(KDM4E). In this study, we revealed abundant alternative splicing(AS) transitions during fertilization and embryonic genome activation, and demonstrated abnormal AS in bovine SCNT embryos compared with in vitro fertilized ...     

Impact of group size on female reproductive success of free-ranging Rhinopithecus roxellana in the Qinling Mountains, China

Group size influences female reproductive success through scramble/contest feeding competition, predation pressures and infanticide risks in primates. The Sichuan snub-nosed monkey (Rhinopithecus roxellana) is an endangered folivorous colobine species living in a multilevel society. From 2002 to 2008, we studied a free-ranging band of R. roxellana in the Qinling Mountains of China to examine the effect of group size on female reproductive success. During our observation period, the number of monkeys in the study band fluctuated from 61 to 108, and the number of one-male/multi-female groups within it varied from 7 to 10. A significant negative linear relationship was found between group size and birth rate, but group size was not significantly correlated with infant survival rate or interbirth interval. These results suggest that group size influences female reproductive success via within-group scramble competition in this folivorous species.     

Developmental regulation of rat lung Cu,Zn-superoxide dismutase.

In the present investigation we found that lung Cu,Zn-superoxide dismutase (SOD) activity (units/mg of DNA) increases steadily in the rat from birth to adulthood. The specific activity (units/micrograms of enzyme) of Cu,Zn-SOD was unchanged from birth to adulthood, excluding enzyme activation as a mechanism responsible for the increase in enzyme activity. Lung synthesis of Cu,Zn-SOD peaked at 1 day before birth and decreased thereafter to adult values. Calculations, based on rates of Cu,Zn-SOD synthesis and the tissue content of the enzyme, indicated that lung Cu,Zn-SOD activity increased during development owing to the rate of enzyme synthesis exceeding its rate of degradation by 5-10%. These calculations were supported by measurements of enzyme degradation in the neonatal (half-life, t1/2, = 12 h) and adult lung (t1/2 = greater than 100 h); the difference in half-life did not reflect the rates of overall protein degradation in the lung, since these rates were not different in lungs from neonatal and adult rats. We did not detect differences in the Mr or pI of Cu,Zn-SOD during development, but the susceptibility of the enzyme to inactivation by heat or copper chelation decreased with increasing age of the rats. We conclude that the progressive increase in activity of Cu,Zn-SOD is due to a rate of synthesis that exceeds degradation of the enzyme. The data also suggest that increased stabilization of enzyme conformation accounts for the greater half-life of the enzyme in lungs of adult compared with neonatal rats.     

Effects of chemical activation and season on birth efficiency of cloned pigs

The effects of chemical activation on birth efficiency of cloned pigs were studied by investigating the developmental process from porcine oocyte activation to birth of cloned pigs. Three different activation methods were used: (i) Electroporation (Ele); (ii) Ele followed by incubation with 6-dimethylaminopurine (6-DMAP); and (iii) Ele followed by a treatment with cycloheximide (CHX). In experiment 1, the rates of cleavage, developmental rates and cell number of porcine parthenogenetic (PA) embryos were investigated in the three treatment groups. In experiment 2, NT embryos produced by the three different activation treatments were compared for the rates of cleavage, development and cell number. Finally, the effects of Ele and Ele+CHX activation methods on birth efficiency of cloned pigs were compared. The activated oocytes treated by combination activation generally showed a higher (P<0.05) blastocyst rate and produced more expanded blastocysts than oocytes activated with Ele. The rates of cleavage and total cell number of parthenotes were not significantly different. Parthenogenetic embryos activated with 6-DMAP developed into blastocyst and expanded blastocyst stages at a significantly (P<0.05) higher rate than those treated with Ele, but the developmental capability was dramatically decreased in NT embryos. With the CHX activation method, the NT embryo blastocyst rate was substantially (P<0.05) increased although the production of expanded blastocysts was not significantly different from that by the other two methods. The birth rate of cloned pigs increased in the CHX group, though the rate was not significantly different from Ele. The effects of season on developmental rate of the porcine PA embryos and birth rate of cloned pigs were also examined in our study. Porcine oocytes collected in the spring had higher developmental capabilities than those collected in the winter. However, no difference in birth rate of the cloned pigs was found between the oocytes collected in the two seasons. The results obtained from PA and NT embryos, following different activation methods, were inconsistent, suggesting that activation mechanisms are dissimilar in PA and NT embryos. Although the chemical activation in our study leads to an elevation of the blastocyst rate, it does not improve the oocyte’s molecular programming and so does not significantly improve the efficiency of producing cloned pig births. Supported by National Key Basic Research and Development Program (China of Grant No. G200000161).     

An evolutionary model of stature, age at first birth and reproductive success in Gambian women

We have built a model to predict optimal age at first birth for women in a natural fertility population. The only existing fully evolutionary model, based on Ache hunter-gatherers, argues that as women gain weight, their fertility (rate of giving birth) increases-thus age at first birth represents a trade-off between time allocated to weight gain and greater fertility when mature. We identify the life-history implications of female age at first birth in a Gambian population, using uniquely detailed longitudinal data collected from 1950 to date. We use height rather than weight as an indicator of growth as it is more strongly correlated with age at first birth. Stature does not greatly influence fertility in this population but has a significant effect on offspring mortality. We model age at first reproduction as a trade-off between the time spent growing and reduced infant mortality after maturation. Parameters derived from this population are fitted to show that the predicted optimal mean age of first birth, which maximizes reproductive success, is 18 years, very close to that observed. The reaction norm associated with variation in growth rate during childhood also satisfactorily predicts the variation in age at first birth.     

Obesity reduction within a generation: the dual roles of prevention and treatment

In 2010, the White House Task Force on Childhood Obesity provided benchmark goals for reducing childhood obesity. We evaluated the balance of prevention and treatment required for achieving Task Force goals in benchmark years 2015, 2020, and 2030. We created a simulation of US birth cohorts (2-19 years) born 2008-2030. For each year, we assumed "old" birth cohorts (part of previous benchmark obesity estimates) would benefit from obesity treatment strategies, and "new" birth cohorts would benefit from obesity prevention strategies. We assessed obesity prevalence that must be achieved through prevention strategies, under varying assumptions of treatment effectiveness. When we assumed a 1% absolute reduction in prevalence through treatment, we found that prevention strategies would need to achieve an obesity prevalence of 12% by 2015, 8% by 2020, and 0.3% by 2030. Because of higher obesity prevalence among minority children, prevention strategies would need to achieve a negative prevalence by 2030, which is implausible. Under more generous assumptions of treatment effectiveness, estimates became positive but remained low. Task Force goals are more difficult to achieve with each benchmark year. Policies must focus on obesity treatment interventions, particularly targeted to racial/ethnic minority children, to make progress in stemming the epidemic.     

Effects of delta 9-tetrahydrocannabinol, phenobarbital, and their combination on pregnancy and offspring in rats

delta 9-THC, sodium phenobarbital, or a combination of these drugs, were administered to pregnant mice on gestation days 6 to parturition. Levels of delta 9-THC in blood approximated levels attained in humans after smoking one to two marijuana cigarettes. Blood cannabinoid levels in mice were not significantly elevated by concurrent drug administration. Both drugs significantly reduced litter size and weight per pup at birth, but the combination of these drugs did not affect these outcomes to a significantly greater degree than either drug by itself. Phenobarbital but not delta 9-THC increased resorption rate.     

Effects of age, ethnicity and health behaviours on the prevalence of adverse birth outcomes in Taiwan

This study sampled 8432 singleton first live births from Taiwan's 2005 Birth Registration Database to determine if there were more pre-term or low birth weight deliveries among aboriginal women than there were among Han Chinese women, and if the 'weathering' hypothesis applied to aboriginal women in Taiwan. Although the aboriginal women were socially disadvantaged and engaged in more unhealthy behaviours, including smoking, drinking, chewing betel quid and exposure to second-hand smoke, the evidence did not support the hypothesis that these teenaged minority women would have better birth outcomes, as has been demonstrated among teenage African-American women in the United States. Behaviours and not ethnicity were risk factors for teenage aboriginal mothers, who started deleterious health behaviours earlier than did their older counterparts. Teenage mothers had more adverse outcomes regardless of ethnicity and aboriginal mothers had more risky behaviours in all age groups. The prevalence of detrimental health behaviour among teenage mothers in Taiwan is of concern, particularly for aboriginal teenage mothers.     

Reproductive parameters of female Japanese macaques: Thirty years data from the arashiyama troops,Japan

Over a 30-year period from 1954 to 1983, 975 live births were recorded for Japanese macaque females at the Iwatayama Monkey Park, Arashiyama, Japan. Excluding unknown birth dates, primiparous mothers gave birth to 185 infants (182 cases with age of mother known) and multiparous mothers gave birth to 723 infants (603 cases with age of mother known). The peak month of birth was May with 52.3% of the total births occurring during the period. Multiparous females who had not given birth the previous year did so earlier than multiparous females who had given birth the previous year and also earlier than primiparous females. Among the females who had given birth the previous year, females whose infant had died gave birth earlier than females who had reared an infant the previous year. The offspring sex ratio (1:0.97) was not significantly different from 1:1, and revealed no consistent association with mother's age. Age-fecundity exhibited a humped curve. The annual birth rate was low at the age of 4 years but increased thereafter, ranging between 46.7% and 69.0%, at between 5 and 19 years of age, but again decreased for females between 20 and 25 years of age. Some old females displayed clear reproductive senescence. The infant mortality within the first year of age was quite low (10.3%) and the neonatal (less than 1 month old) mortality rate accounted for 49.0% of all infant deaths. There was no significant difference between the mortality rates of male and female infants. A female's rank-class had no apparent effect on the annual birth rate, infant mortality, and offspring sex ratio. These long-term data are compared with those from other primate populations.     

Pseudo-exponential growth in length of the fission yeast, Schizosaccharomyces pombe

The growth patterns of individual cells of the fission yeast (Schizosaccharomyces pombe wild-type cells, strain 972 h-; cells exposed to hydroxyurea; and cdc mutants, 11-123, 2-33) were investigated by time-lapse photomicrography. Wild-type cells showed one, two, or three linear-growth segments followed by a constant-length stage. Cells with two segments were most frequent. Hydroxyurea cells that divided as oversized cells (about three times the birth length) had three linear-growth segments in a cycle. Mutant cdc11-123 cells did not divide but had a constant-length stage separating the cycles; both the first and second cycles consisted of two linear-growth segments, and cells were oversized at the second constant-length stage (about 3.5 times the birth length). Elongating cdc2-33 cells that did not divide and were oversized (about five times the birth length) while under observation, showed four linear-growth segments. Cells of all strains showed 30 to 40% increase in growth rate at the rate-change point and maintained approximate exponential (pseudo-exponential) growth. We conclude that the normal growth pattern of individual fission-yeast cells is the pseudo-exponential pattern.