Aims and objectives:The aim of this study is to estimate differences in healthpromoting behaviour levels throughout the pregnancy trimesters, to identify distinct patterns of health-promoting behaviour trajectories during pregnancy and to evaluate predictors of these trajectory group memberships.Background: Promoting healthy lifestyle behaviours during pregnancy could decrease devastating outcomes for the mother and foetus. However, there is currently limited insight into the dynamics of health-promoting behaviours during pregnancy.Design: An observational longitudinal study.Methods: 158 pregnant women were recruited from June 2020 to June 2021 in Qingdao, China. The Health-Promoting Lifestyle Profile was used to assess healthpromoting behaviours. Latent growth model was performed to compare healthpromoting behaviours at different time points. Group-based trajectory model was applied to identify health-promoting behaviour trajectories. Multinomial logistic regression was adopted to determine the predictors of trajectory group memberships. We used the STROBE checklist to report this study. Results:The entire sample of pregnant women experienced a significant increase in health-promoting behaviours during pregnancy. Three trajectories were identified including a 'low-increase behaviour trajectory (20.1% of sample)', a 'moderate-increase behaviour trajectory (58.0% of sample)' and a 'stable then increased behaviour trajectory (21.9% of sample)'. Low maternal sense of coherence, lack of pre-pregnancy exercise habit, artificial insemination and low monthly family income were significantly associated with the low-increase behaviour trajectory. High self-efficacy and prepregnancy exercise habit were significantly associated with the stable then increased behaviour trajectory. Conclusions:Pregnant women exhibit different health-promoting behaviours throughout the pregnancy trimesters. Meanwhile, three trajectories were identified among pregnant women. Thus, more attentions should be paid on early identification and targeted intervention in a future study.

Aims To investigate the association between pregnancy intention and smoking or alcohol consumption in preconception and pregnancy periods. Background Suboptimal lifestyle such as smoking and alcohol consumption can lead to devastating outcomes on the maternal and foetus. Pregnancy intention exerts a significant effect on promoting healthy lifestyle behaviours. However, no reliable evidences confirmed pregnancy intention was associated with smoking and alcohol consumption before and during pregnancy. Design Systematic review and meta‐analysis. Methods We performed a comprehensive search from databases including PubMed, Cochrane, Web of Science, IEEE Xplore, MEDLINE, ProQuest and Scopus from the inception of these databases up to November, 2020. All eligible studies exploring the association between pregnancy intention and smoking or alcohol consumption were included. The fixed‐ or random effect pooled measure was used to estimate the odds ratio (OR) or risk ratio (RR) and 95% CI. In addition, the PRISMA checklist was used in this meta‐analysis. Results A total of 23 studies were included in this systematic review and meta‐analysis. During pregnancy, the findings suggested that women with unplanned pregnancy were 68% more likely to consume cigarettes (OR = 1.68, 95% CI = 1.44–1.95) and 44% more likely to consume alcohol (OR = 1.44, 95% CI = 1.15–1.81) than those women with planned pregnancy. Meanwhile, during preconception, women with unplanned pregnancy were 30% more likely to consume cigarettes (OR = 1.30, 95% CI = 1.10–1.53) and 20% more likely to consume alcohol (OR = 1.20, 95% CI = 1.01–1.42) than those women with planned pregnancy. Conclusion The findings suggested that women with unplanned pregnancy were more likely to follow unhealthy behaviours such as smoking and alcohol consumption before and during pregnancy. Health professionals should consider the women's desire for pregnancy to decrease preconception and pregnancy smoking or alcohol consumption in future studies. Relevance of clinical practice Pregnancy intention is the key determinant of smoking and alcohol consumption during preconception and pregnancy periods. Offering effective contraception in primary healthcare setting could prevent unplanned pregnancy. Meanwhile, popularising minimal alcohol consumption and comprehensive smoke‐free legislation would be beneficial to improve reproductive outcomes.

Background: To identify distinct trajectories of body mass index (BMI) in a large sample of Chinese children by urban-rural and sex disparities.Methods: Data for this study were obtained from the National Surveys on Chinese Students' Constitution and Health among 16,060 children aged 6–11 years. Weight and height data were used to calculate BMI. Group-based trajectory modeling (GBTM) was used to identify distinct BMI trajectories.Results: Seven distinct trajectories were identified, “sustained healthy weight” (46.01%), “sustained obesity” (17.26%), “sustained underweight” (4.50%), “obesity to overweight” (6.45%), “obesity to healthy weight” (11.75%), “healthy weight to overweight” (8.67%), and “healthy weight to obesity” (5.36%). The proportions of “sustained obesity,” “healthy weight to obesity,” and “healthy weight to overweight” trajectories were much higher among boys compared with girls (P < 0.001). Meanwhile, children living in rural areas were more represented in the “healthy weight to obesity” trajectory (P < 0.001).Conclusion: In this study, the proportions of BMI development trajectories among 6–11-year-old children varied by sex and urban-rural areas, which may require tailored interventions specifically toward these at-risk trajectories.

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Aims and Objectives To evaluate the effects of e‐health interventions on disease activity, self‐efficacy, pain and quality of life among patients with rheumatoid arthritis (RA). Background Prior systematic reviews have only reported the quality and features of e‐health interventions in patients with RA. However, the effect of e‐health interventions in patients with RA is unclear. Design Systematic review and meta‐analysis. Methods This review was conducted following the PRISMA guideline. We searched 5 databases, including PubMed, EMBASE, CINAHL, Scopus and the Cochrane library. The risk of bias was assessed using the Cochrane risk of bias tool. The quality of the evidence was assessed via the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria. Using a random‐effects model adopted the standardised mean difference (SMD) with a 95% confidence interval (CI). A chi‐squared test and an I2 test were used to assess heterogeneity. Subgroup analyses were conducted based on different controls. Results A total of 9 randomised control trials were included in this study. Compared with the control group, disease activity of the e‐health group significantly decreased (SMD with 95% CI: −.17 [−.30, −.04], p = .01, I2 = 1%). Meanwhile, trials with usual care control had a larger effect on disease activity (SMD with 95% CI: −.21 [−.40, −.02], p = .03, I2 = 38%). The effect of e‐health interventions on self‐efficacy was controversial; pain and quality of life were negative in the currently included studies. The quality of evidence was rated as low for disease activity and very low for pain, self‐efficacy and quality of life. Conclusions The effect of e‐health interventions on disease activity was statistically significant. More well‐designed randomised controlled trials are still needed to verify the effects in the future. Relevance to clinical practice This study shows the potential value of e‐health in improving health outcomes in patients with RA.