Incidence, temporal trends and risk factors of puerperal infection in Mainland China: a meta-analysis of epidemiological studies from recent decade (2010–2020)

Li, Peng; Li, Yan; Zhang, Youjian; Zhao, Lina; Li, Xiaohong; Bao, Junzhe; Guo, Jianing; Yan, Jun; Zhou, Ke; Sun, Mingjie

doi:10.1186/s12884-023-06135-x

Cited by 3 publications

References 73 publications

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Study on the Correlation Between Physical Activity During Pregnancy and Delivery Mode in Nulliparous Patients：A prospective cohort study

Ren,

Zhang,

Zhao

et al. 2024

Preprint

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BACKGROUND: Physical activity during pregnancy is a beneficial behavioral intervention aimed at enhancing pregnancy outcomes. Nevertheless, the association between prenatal physical activity and mode of delivery remains contentious. This study seeks to investigate whether physical activity during pregnancy correlates with the mode of delivery, with the ultimate objective of bolstering pregnant women's self-efficacy regarding physical activity and ameliorating pregnancy outcomes. OBJECTIVE: This study aims to test the hypothesis that physical activity during pregnancy is associated with a reduced risk of cesarean delivery. STUDY DESIGN: This prospective cohort study surveyed women with singleton pregnancies, free from contraindications to physical activity, utilizing the Chinese version of the Pregnancy Physical Activity Questionnaire. This instrument categorizes and quantifies physical activity by type and intensity. The primary outcome of interest is the mode of delivery. Univariate and multivariate binary logistic regression models were employed to ascertain the relationship between prenatal physical activity and mode of delivery. RESULTS: A total of 217 women participated in the physical activity survey during pregnancy and subsequently gave birth at our hospital. The median energy expenditure from physical activity during pregnancy was 145.70 (111.92, 181.69) MET-h·wk⁻¹. The mean age of the participants was 30.20±3.71 years. Among the 217 primiparas, 131 experienced vaginal deliveries, while 86 underwent cesarean sections. After comprehensive adjustment for covariates, the risk of cesarean delivery was found to be reduced by 60% in the group that adhered to the recommended levels of physical activity during pregnancy compared to the group that did not (OR: 0.40, 95% CI: 0.20 to 0.83, P=0.0130). CONCLUSION: Elevated levels of physical activity during pregnancy are associated with a reduced risk of cesarean delivery. Physical activity need not be confined to structured exercise programs; routine activities such as cleaning, shopping, and commuting on foot are effective means of increasing energy expenditure and achieving recommended physical activity levels.

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Study on the Correlation Between Physical Activity During Pregnancy and Delivery Mode in Nulliparous Patients：A prospective cohort study

Ren,

Zhang,

Zhao

et al. 2024

Preprint

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A simple predictive model for puerperal infections: emphasizing risk factors and pathogen analysis

Wen,

Ming,

Yang

et al. 2024

Front. Cell. Infect. Microbiol.

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BackgroundPuerperal infection (PI) accounting for approximately 11% of maternal deaths globally is an important preventable cause of maternal morbidity and mortality. This study aims to analyze the high-risk factors and pathogenic bacteria of PI, design a nomogram to predict the risk of PI occurrence, and provide clinical guidance for prevention and treatment to improve maternal outcomes.MethodsA total of 525 pregnant women were included in the study. The mothers were randomly divided into a training cohort (n=367) and a test cohort (n=158). The performance of our model was assessed using the area under the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analyses. All the women in the group of PI underwent blood culture tests, if the bacteria were detected, drug sensitivity tests were performed. The drug sensitivity spectrum was recorded and analyzed.ResultsUnivariate analysis showed that 12 indicators were significantly different (P < 0.05). Logistic regression analysis showed 6 factors, such as parity, number of vaginal examinations, amount of postpartum bleeding, antibiotics administered in one week before admission, induced labor, and indwelling catheter were significantly different between the PI group and control group (P < 0.05). The area under the ROC curve was 0.904 (95% CI: 0.871-0.936) in the training set and 0.890 (95% CI: 0.837-0.942) in the test set. The calibration curve of the nomogram showed good agreement between prediction and observation. The analysis of the clinical decision curve showed that the nomogram is of practical significance. There were 100 patients with positive blood cultures in the PI group, and Escherichia.coli was the main pathogenic bacteria, accounting for 89%. The sensitivity to Meropenem and Imipenem was 100%, to Piperacillin tazobactam 97.75%, to Ceftazidime 95.51%, and to Amoxicillin/Clavulanat (AMC) was 93.26%.ConclusionThe risk of PI will be significantly reduced by controlling the number of vaginal examinations less than 4 times, postpartum hemorrhage less than 414ml, and reducing the time of urethral catheter indwelling. If PI was clinically diagnosed or highly suspected, it was recommended to use antibiotics that were sensitive to Escherichia. coli, such as Piperacillin tazobactam, Ceftazidime, and AMC

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Hypertensive disorders of pregnancy in Hunan Province, China, 2012–2022

Zhou,

Wu,

Chen

et al. 2024

Front. Med.

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ObjectiveTo explore the relationship between hypertensive disorders of pregnancy (HDP) and adverse pregnancy outcomes and explore the risk factors for HDP.MethodsData were obtained from the Maternal Near-Miss Surveillance System in Hunan Province, China, 2012–2022. Chi-square trend tests (χ2trend) were used to determine trends in prevalence by year. Unadjusted odds ratios (uORs) were used to examine the association between HDP and adverse pregnancy outcomes. Multivariate logistic regression analysis (method: Forward, Wald, α = 0.05) and adjusted odds ratios (aORs) were used to identify risk factors for HDP.ResultsOur study included 780,359 pregnant women, and 38,397 women with HDP were identified, with a prevalence of 4.92% (95% CI 4.87–4.97). The prevalence of preeclampsia-eclampsia, gestational hypertension, chronic hypertension, and chronic hypertension with superimposed preeclampsia was 2.28% (95% CI 2.25–2.31), 2.04% (95% CI 2.00–2.07), 0.43% (95% CI 0.41–0.44), and 0.18% (95% CI 0.17–0.19), respectively. From 2012 to 2022, the prevalence of HDP increased from 3.11 to 7.39%, showing an upward trend (χ2trend = 2220.88, p < 0.01). HDP was associated with the following adverse pregnancy outcomes: maternal deaths (uOR =4.05), maternal near-miss (uOR =6.37), preterm birth (uOR =2.51), stillbirth and neonatal death (uOR =1.45), low birthweight (uOR =4.37), abruptio placentae (uOR =4.45), uterine atony (uOR =1.49), retained placenta (uOR =1.54), puerperal infections (uOR =2.14), abdominal surgical site infections (uOR =2.50), urinary tract infections (uOR =1.60), upper respiratory tract infections (uOR =1.75), heart disease (uOR =2.76), embolism (uOR =2.66), liver disease (uOR =1.25), anemia (uOR =1.38), diabetes mellitus (uOR =2.35), renal disease (uOR =4.66), and pulmonary disease (uOR =4.70, p < 0.05). Results of multivariate logistic regression analysis showed risk factors for HDP: maternal age > 30 years (aOR > 1, p < 0.05), gravidity > = 4 (aOR =1.10, 95% CI 1.05–1.14), primipara (aOR > 1, p < 0.05), and previous cesarean sections (aOR =1.27, 95% CI 1.24–1.31).ConclusionThe prevalence of HDP was relatively high in Hunan Province. HDP was associated with many adverse pregnancy outcomes. Advanced maternal age, high gravidity, primipara, and previous cesarean section were risk factors for HDP.

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Incidence, temporal trends and risk factors of puerperal infection in Mainland China: a meta-analysis of epidemiological studies from recent decade (2010–2020)

Cited by 3 publications

References 73 publications

Study on the Correlation Between Physical Activity During Pregnancy and Delivery Mode in Nulliparous Patients：A prospective cohort study

Study on the Correlation Between Physical Activity During Pregnancy and Delivery Mode in Nulliparous Patients：A prospective cohort study

A simple predictive model for puerperal infections: emphasizing risk factors and pathogen analysis

Hypertensive disorders of pregnancy in Hunan Province, China, 2012–2022

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