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孕期環境因子暴露對子代健康之影響

為了解決previa二手的問題，作者黃世惠 這樣論述：

我們已知在胚胎早期若受到毒性物質的危害是最容易影響其胎兒生長,而且影響久遠。在孕期暴露於菸害對胎兒有很多危害，例如:低體重、早產等;微量元素(如:鐵、銅、錳)對於人體是必須的礦物質，但過量卻是有毒的。孕婦暴露於必需微量元素(錳、銅、鐵)和重金屬(汞)、菸害對胎兒的健康效應，是一個全世界婦女都關心的重要議題。而在醫學方面，台灣很少有同時具有成對的孕婦/胎兒全血中的必需微量元素和重金屬濃度的相關資料可利用。因此本研究分為二部分來探討孕期環境因子暴露對子代健康之影響。第一部分 探討孕期暴露於菸害(Cotinine)對出生結果的影響;第二部分探討孕期暴露於重金屬的母嬰研究(1)評估成對孕婦和胎兒之間

全血中汞(Hg)、錳(Mn)、鐵(Fe)和銅(Cu)濃度的相關性; (2)研究懷孕期間潛在的干擾因子;(3)分析母親海鮮攝取量及維他命對母血及臍帶血中汞濃度的影響。本研究的對象：2009年2月至2011年5月，到屏東縣輔英科技大學東港附設醫院婦產科進行產檢之懷孕孕婦並同意參與本研究。及該孕婦於輔英科技大學附設醫院婦產科生產之新生兒。在孕婦第三孕期28-30週產檢時抽血及收集尿液、問卷。新生兒資料由病歷中抄錄。第一部分研究結果發現:研究對象中有7.2%抽菸, 而有40.6% 的孕婦孕期暴露在二手菸或環境菸害. 孕婦分為三組:(1)不抽菸(2)二手菸(3)抽菸，不抽菸這組孕婦其所生的子代體重較重，

且三組比較呈顯著差異, 胸圍較大，出生後3天膽紅素較高 , 尿中cotinine 濃度較低。當母親暴露於菸害增加時，驗出尿中cotinine ?d 143 μg/g creatinine;且發現其出生新生兒體重

Examination of the risk factors associated with adverse pregnancy outcomes and parental emotional disturbances during perinatal periods

為了解決previa二手的問題，作者貝若珊 這樣論述：

Purpose:Adverse pregnancy and delivery outcomes, and psychological disturbances of women and their spouses are common complications of the perinatal periods. The purpose of our investigations was to explore the association of potentially modifiable risk factors with adverse outcomes in high-risk pr

egnancies and parental perinatal mental illnesses. The first study aimed to examine the effects of various measures of prenatal care on adverse pregnancy outcomes in women with history of infertility. The aim of the second study was to explore whether the paternal smoking status is longitudinally as

sociated with maternal and paternal depression and anxiety from early pregnancy to 6 months postpartum.Methods:In the first project a retrospective cohort study was undertaken by linking 2 large nationwide population-based datasets, the National Health Insurance Research Database and Taiwan Birth Ce

rtificate Registry. The study sample included 15,056 women with an infertility diagnosis and 60,224 randomly selected women matched to the study sample by maternal age without infertility. Conditional logistic regression models were performed for the analysis.The second study is a prospective cohort

study of pregnant women and their partners. The sample consisted of 533 consecutive couples. Depressive and anxiety symptoms were assessed by self-report questionnaires at five time points: 1st, 2nd, 3rd trimester of pregnancy, 1 and 6 months postpartum. Paternal smoking at baseline was categorized

into 3 groups: non-smoker, smoking but not in the mother’s presence, and smoking in the mother’s presence. Generalized estimating equations were used for the analyses.Results:The first study findings showed that women diagnosed with infertility respectively had 1.39 (95% CI, 1.06~1.83), 1.15 (95% C

I, 1.08~1.24), 1.13 (95% CI, 1.08~1.18), and 1.08 (95% CI, 1.05~1.12) higher odds of having very low birth weight babies, preterm births, labor complications, and cesarean sections, compared to women without infertility. Inadequate numbers of total and major prenatal visits and late initiation of pr

enatal care increased the risks of adverse pregnancy outcomes in women with infertility, especially the risk of a very low birth weight baby. However, no significant associations were found for the risks of adverse birth outcomes in infertile women with adequate prenatal care compared to fertile wom

en with adequate care.As for the second study, we found that fathers who smoked in the mother’s presence had higher depressive (regression coefficient=1.0, 95% confidence interval (CI) 0.3~1.8) and anxiety symptoms (3.0, 95% CI 1.2~4.7) during perinatal periods, compared to non-smoking fathers. Pate

rnal smoking in the mother’s presence also increased risk of maternal disturbances, especially for depression during pregnancy (1.2, 95% CI 0.1~2.3) and anxiety during the postpartum period (3.4, 95% CI 0.6~6.3). No significant association was found between paternal smoking but not in the mother’s p

resence and maternal emotional disturbances. Paternal smoking but not in the mother’s presence affected only paternal anxiety, especially in the postpartum period (regression coefficient 2.7, 95% CI 0.7~4.7), compared to non-smoking fathers.Conclusions:The findings of the first study suggest that ad

equate prenatal care can reduce the risk of adverse pregnancy outcomes in women with infertility. Findings of our second study have implications for public health interventions regarding the need to at least restrict the father’s smoking to outside the presence of the pregnant wife during perinatal

periods, if quitting smoking is tentatively unattainable. These findings have important clinical and public health implications because both prenatal care utilization and smoking are potentially modifiable.