目的：探讨孕期心理弹性支持与产后患者应对方式的关系，并检验心理弹性在其中的中介效应。方法：采用便利抽样法，于2025年3月-2026年3月选取350例产后1～6个月的患者为研究对象。采用一般资料调查表、孕期心理弹性支持量表、心理弹性量表及简易应对方式量表进行回顾性调查。采用Pearson相关分析变量间关系，分层回归检验总效应，PROCESS宏Model 4结合Bootstrap法检验中介效应。结果：孕期心理弹性支持与积极应对呈显著正相关（r=0.30，P<0.01），与消极应对呈显著负相关（r=-0.21，P<0.01）。孕期心理弹性支持对积极应对的正向预测作用显著（β=0.28，P<0.001），对消极应对的负向预测作用显著（β=-0.19，P<0.001）。心理弹性在孕期心理弹性支持与积极应对间的间接效应为0.12（95%CI：0.08～0.17），在消极应对间的间接效应为-0.07（95%CI：-0.11～-0.04）。结论：孕期心理弹性支持对产后应对方式的影响完全通过心理弹性的中介作用实现，提示围产期心理保健应将外部支持内化为产妇心理资源，增强心理弹性，以促进产后积极应对。

Objective: To explore the relationship between prenatal psychological resilience support and coping styles of postpartum patients, and to examine the mediating effect of psychological resilience. Methods: Convenience sampling was used to recruit 350 patients at 1-6 months postpartum from March 2025 to March 2026. A retrospective survey was conducted using a general information questionnaire, the Prenatal Psychological Resilience Support Scale, the Connor-Davidson Resilience Scale (CD-RISC), and the Simplified Coping Style Questionnaire (SCSQ). Pearson correlation analysis was performed to examine relationships among variables, hierarchical regression analysis was conducted to test the total effect, and the PROCESS macro Model 4 with bootstrapping was employed to test the mediating effect. Results: Prenatal psychological resilience support was significantly positively correlated with positive coping (r = 0.30, P<0.01) and significantly negatively correlated with negative coping (r=?0.21, P<0.01). Prenatal psychological resilience support significantly and positively predicted positive coping (β = 0.28, P<0.001) and significantly and negatively predicted negative coping (β=?0.19, P<0.001). The indirect effect of psychological resilience between prenatal psychological resilience support and positive coping was 0.12 (95% CI: 0.08-0.17), and the indirect effect between prenatal psychological resilience support and negative coping was ?0.07 (95% CI: ?0.11 to ?0.04); the direct effects were not significant, indicating a full mediating role of psychological resilience. Conclusion: The impact of prenatal psychological resilience support on postpartum coping styles is fully mediated by psychological resilience, suggesting that perinatal mental health care should focus on internalizing external support into maternal psychological resources and enhancing psychological resilience to promote positive postpartum coping.

目的 研究母代不同孕期巨细胞病毒（CMV）感染对自身精神及行为的影响。方法 72只BALB/c雌鼠随机分为12组（A1、A2、A3、B1、B2、B3、C1、C2、C3、D1、D2、D3,每组6只）,A为孕期再感染、B为既往感染、C为孕期原发感染、D为空白对照,1为孕早期、2为孕中期、3为孕晚期。母鼠腹腔注射小鼠CMV（murine CMV,MCMV）Smith株建立播散性感染模型,或注射无菌生理盐水建立对照模型。母鼠产仔后同笼合养,产后22 d分笼;母鼠做行为学试验。试验结束,每组随机处死3只母鼠;测量子宫、肝、脑脏器重量系数及唾液腺中MCMV含量。结果 A、B、C组母鼠产后次日体质量均低于D组（均P<0.05）,其中C2、C3组母鼠低体质量情况持续至产后22日（均P<0.05）。A、B、C组母鼠唾液腺组织均测出MCMV。与D组母鼠相比,A1、C1组母鼠活胎率降低（均P<0.05）,A、C组母鼠的子宫、肝、脑脏器系数升高（均P<0.05）且脑组织有病损表现。产后6天时,A3、B3、C组母鼠水平运动总距离和直立次数减少（均P<0.05）,糖水偏好量降低（均P<0.05）,悬尾不动时间延长（P<0.05）;其中,C2、C3组母鼠以上行为退缩情况至产后22天仍存在,且有逃避潜伏时间延长（均P<0.01）,穿越原平台位置次数减少（均P<0.01）情况。结论 孕期CMV感染损害母代身心健康,有可能增加子代不良抚养的风险。

Objective To investigate the effects of cytomegalovirus（CMV）infection in different stages of maternal pregnancy on its own spirit and behavior．Methods A total of 72 female BALB/c mice were randomly divided into 12 groups（each group had 6 mice）：A1-A3,B1-B3,C1-C3,D1-D3（group A had re-infection,group B had previous infection,group C had primary infection,group D was blank control,group 1 was in early pregnancy,group 2 was in middle pregnancy,group 3 was in late pregnancy）．The disseminative infection model was established by intraperitoneal inoculation of murine CMV（MCMV）Smith strain,and the blank control model was established by intraperitoneal inoculation of 0.9% sterile saline（NaCl）．After 21 days of parturition,the mothers and offspring were reared in separate cages,mothers were selected for the behavior experiments．At the end of all the behavior tests,3 mothers in each group were killed randomly．Weighed and calculated the organ coefficients of the uteri,livers and brains,and detected the expression levels of MCMV in salivary gland．Results On the first day after delivery,the weights of mothers in groups A,B and C were lower than those in group D（all P<0.05）,the low body weight of mice in C2 and C3 groups lasted to the 22th day（all P<0.05）．The MCMV in salivary gland tissue were found in groups A,B and C,but not in group D．The live fetus rates of groups A1 and C1 were significantly lower than that of group D．The organ coefficients of uteri,livers and brains in groups A and C were higher than those in group D（all P<0.05）．And the lesions of brain tissues in groups A and C were more serious than in the other groups．On the 6th day,compared with the other groups,the mothers of groups A3,B3 and C were significantly abnormal in the open field test,the tail suspension test and the sugar preference test（all P<0.05）．But on 22th day,only the mothers of groups C2 and C3 were significantly abnormal in those tests（all P<0.01）,and even in the water maze test（all P<0.01）．Conclusions Maternal CMV infection in different stages pregnancy have impacts on mother mice's physical and mental health．Those bad situations may bring poor parenting to the offspring．

目的 探讨孕期盆底肌锻炼联合产后盆底功能康复治疗对产后女性盆底功能障碍的防治效果。方法 选取2019年1月—2020年6月在我院产科门诊定期产检,B超确认为单胎足月顺产,剔除妊娠合并症及并发症,符合入组标准病例共316例,随机分成观察组和对照组,观察组131例,对照组185例,观察组在孕12周开始宣教孕期定期行盆底肌Kegel运动,并在产后42天开始行盆底康复治疗仪治疗6周,统计临床疗效,2组均在产后42天、3个月、6个月统计2组盆底功能检测、盆底器官脱垂(pelvic organ prolapse,POP)和压力性尿失禁(stress urinary incorrtinence,SUI)发生情况。结果 观察组和对照组一般资料,2组在年龄、分娩孕周、新生儿平均体重无统计学差异(P＞0.05),2组盆底功能进行检测比较,产后42天观察组阴道收缩持续时间、Ⅱ类肌纤维强度(85.24±22.19 cmH₂O)高于对照组(74.14±19.94 cmH₂O),差异具有统计学意义(P＜0.05),产后3月观察组I类肌纤维强度、阴道收缩持续时间、Ⅱ类肌纤维强度(76.41±16.42 cmH₂O;4.35±1.78 s;94.15±18.25 cmH₂O)高于对照组(62.45±17.55 cmH₂O;3.89±1.52 s;88.55±18.36 cmH₂O),差异具有统计学意义(P＜0.05),产后6月观察组I类肌纤维强度、阴道收缩持续时间、Ⅱ类肌纤维强度(79.56±15.78 cmH₂O;5.46±2.01 s;99.78±23.47 cmH₂O)明显高于对照组(67.63±14.45 cmH₂O;4.13±1.45 s;90.16±18.75 cmH₂O),差异具有统计学意义(P＜0.05)。对比2组POP和SUI发生率情况,产后42天观察组SUI发生率(28.24%)低于对照组(35.14%),差异具有统计学意义(P＜0.05);产后3月观察组POP和SUI发生率(18.32%;13.74%)低于对照组(22.70%;17.83%),差异具有统计学意义(P＜0.05),产后6月观察组POP和SUI发生率(0.00%;0.07%)明显低于对照组(8.10%;11.89%),差异具有统计学意义(P＜0.05)。 结论 孕期行盆底肌锻炼联合产后盆底功能康复治疗能明显改善产后盆底功能状态,显著降低产后盆底功能障碍性疾病的发生率。

Objective To explore the prevention and treatment effect of pelvic floor muscle exercise during pregnancy combined with postpartum pelvic floor function rehabilitation therapy on postpartum pelvic floor dysfunction in women. Methods From January 2019 to June 2020, women in our hospital's obstetrics outpatient department for regular obstetric checkups were selected, which ultrasound confirmed it was a singleton full-term delivery. The cases of stillbirth, fetal malformation and placenta previa were excluded. A total of 316 cases met the inclusion criteria and were randomly divided into the observation group and the control group, with 131 cases in the observation group and 185 cases in the control group. Observation group started regular pelvic floor muscle Kegel exercises from 12 weeks of gestation,and accepted pelvic floor rehabilitation therapeutic treatment from 42 days to six weeks postpartum. We summerized the pelvic floor function tests results, pelvic organ prolapse (POP) and stress urinary incontinence (SUI) situation of both groups in 42 days, 3 months and 6 months postpartum. Results The general information of the observation group and the control group showed that there were no statistical differences in age, gestational age of delivery and average weight of newborn (P>0.05). The pelvic floor function 42 days after delivery of the two groups was tested and compared, duration of vaginal contraction and class Ⅱ muscle fiber strength of the observation group [(85.24±22.19) cmH₂O] was significantly higher than that of the control group [(74.14±19.94) cmH₂O], and the difference was statistically significant (P＜0.05). Class I muscle fiber strength, duration of vaginal contraction and class Ⅱ muscle fiber strength were observed at 3 months postpartum, those of observation group[(76.41±16.42) cmH₂O; (4.35±1.78) s; (94.15±18.25) cmH₂O] were significantly higher than that in the control group [(62.45± 17.55) cmH₂O; (3.89±1.52) s; (88.55±18.36) cmH₂O], and the difference were statistically significant (P<0.05). At 6 months postpartum, class I muscle fiber strength, vaginal contraction duration and class Ⅱ muscle fiber strength in observation group [(79.56±15.78) cmH₂O; (5.46±2.01) s; (99.78±23.47) cmH₂O] were significantly higher than that of the control group [(67.63±14.45) cmH₂O; (4.13± 1.45) s; (90.16±18.75) cmH₂O], and the difference were statistically significant (P<0.05). Comparison of the incidence of POP and SUI between the two groups showed that the incidence of SUI in the observation group at 42 days postpartum (28.24%) was significantly lower than that in the control group (35.14%), the difference was statistically significant (P＜0.05). The incidences of POP and SUI in the observation group at 3 months postpartum (18.32%; 13.74%) were significantly lower than that of the control group (22.70%; 17.83%), the difference were statistically significant (P＜0.05). The incidences of POP and SUI in the observation group at 6 months postpartum (0.00%; 0.07%) were significantly lower than that of the control group (8.10%; 11.89%), the difference were statistically significant (P＜0.05). Conclusion Pelvic floor muscle exercise during pregnancy combined with postpartum pelvic floor function rehabilitation therapy can significantly improve postpartum pelvic floor function and significantly reduce the incidence of postpartum pelvic floor dysfunction diseases.

目的 探讨孕期生殖道菌群变化特征及其与不良妊娠结局的相关性。方法 选取2015年1月—2015年9月期间在我院妇产科门诊进行常规产科检查的90例孕妇为研究对象,根据孕期分为孕早期组28例(孕周＜14周),孕中期组29例(孕周14～28周),孕晚期组33例(29～42周)。采集阴道分泌物或宫颈分泌物,对生殖道菌群进行检测。比较三组生殖道菌群分布情况。根据细菌检测结果分为阳性组与阴性组,分别为44例、46例。观察两组不良妊娠结局发生情况,分析生殖道菌群变化特征及其与不良妊娠结局的相关性。结果 90例孕妇中,细菌检测阳性44例,占48.89%,依次为解脲脲原体20例(45.45%)、假丝酵母菌属9例(20.45%)、肠杆菌属8例(18.18%)、葡萄球菌属3例(6.82%)、阴道加德纳菌属2例(4.55%)与衣原体2例(4.55%);孕早期、孕中期、孕晚期孕妇生殖道菌群分布情况相比,差异无统计学意义(P＞0.05);细菌检测阳性者胎膜早破、产褥感染、新生儿感染、早产发生率高于细菌检测阴性者,差异有统计学意义(P＜0.05);不同菌属类型者不良妊娠结局相比,差异无统计学意义(P＞0.05)。结论 孕期生殖道菌群以解脲脲原体、假丝酵母菌属、肠杆菌属为主,细菌检测阳性者不良妊娠结局发生率高,而不同菌属类型与不良妊娠结局无关。

Objective To investigate the correlation between change characteristics of pregnant genital tract flora and adverse pregnancy outcomes. Methods 90 pregnant women received routine obstetric examination in our obstetrics and gynecology of hospital from January 2015 to September 2015 were selected as research object. According to duration of pregnancy, they were divided into 28 cases of early pregnancy group (gestational weeks<14 weeks), 29 cases of middle pregnancy group (14~28 weeks) and 33 cases of late pregnancy group (29~42 weeks). The vaginal or cervical secretions were collected, and genital tract flora was detected. The genital tract flora distribution of three groups were compared. According to bacteria detection results, patients were divided into 44 cases of positive group and 46 cases of negative group. The adverse pregnancy outcomes of two groups were observed, and the correlation between change characteristics of pregnant genital tract flora and adverse pregnancy outcomes was analyzed. Results Among 90 pregnant women, there were 44 cases of positive bacteria (48.89%), which included 20 cases of ureaplasma urealyticum(45.45%), 9 cases of Candida (20.45%), 8 cases of enterobacter (18.18%), 3 cases of staphylococcus (6.82%), 2 cases of vaginal gardnerella (4.55%) and 2 cases of chlamydia (4.55%); There was no statistical difference in the genital tract flora distribution among early, middle, late pregnancy group (P>0.05); The incidence of premature rupture of membrane, puerperal infection, neonatal infection and premature birth in patients with positive bacteria was higher than that in patients with negative bacteria (P<0.05); There was no statistical difference in the adverse pregnancy outcomes in patients with different types of bacterial genus (P>0.05). Conclusion Pregnant genital tract flora are mainly ureaplasma urealyticum, candida and enterobacter, and the incidence of adverse pregnancy outcomes in patients with positive bacteria is higher, but different types of bacterial genus has no correlation with adverse pregnancy outcomes.

目的 对中医治未病在社区孕妇孕期保健应用中效果进行探讨。方法 选取符合条件的300名社区孕妇,随机分为对照组和干预组,对照组不采取干预措施,干预组依据孕妇的中医体质判定表实施相应的中医干预方法,持续二个月,并对两组孕妇进行随访。对比分析两组孕妇的分娩和产后情况。结果 干预组孕妇自然分娩95例,剖宫产55例,自然分娩率高于对照组孕妇,差异有统计学意义(P<0.05);干预组新生儿巨大儿的发生率为6.7%,低于对照组的16.7%,差异有统计学意义(P<0.05);此外,干预组孕妇先兆流产、早产、妊娠期高血压和妊娠期糖尿病的发生例数低于对照组孕妇(P<0.05)。结论 应用中医治未病思想指导孕期保健,有助于减少孕产妇并发症和巨大儿发生率,保证母儿健康。

目的 对出生缺陷知信行健康教育模式效果进行策略分析与探讨,为进一步完善围产期保健服务及健康教育工作提供合理化建议。方法 采用《孕期妇女出生缺陷基本知识知晓率专题测评问卷》并结合实际情况设定有关信念、行为方面的7个问题,对2011年1月—2013年6月期间在中心孕妇学校参加健康教育活动课堂的孕妇进行调查,并应用决策树模型对中心现有的出生缺陷知信行健康教育模式效果进行探讨。结果 预防出生缺陷知识方面,对初高中及中专文化程度的孕期妇女加强出生缺陷预防知识健康教育的预期收益合计达到51.2%,可作为重点目标人群;预防出生缺陷信念方面,主要决定因素是户籍类型和年龄,加大对本地户籍及25岁以上流动妇女人群的健康教育,促进孕期妇女树立预防出生缺陷信念的预期收益累计达95.9%;预防出生缺陷行为方面,主要影响因素是产检医生的嘱咐,受到嘱咐的孕期妇女预期收益为62.3%。结论 为了达到出生缺陷防治目标与健康教育整体效果的提高,应将预防出生缺陷的健康教育工作重点放在初高中及中专文化程度人群,本地户籍孕期妇女和25岁以上流动性孕期妇女又是需要树立预防出生缺陷信念的重点人群,强化产检医生的嘱托义务是提高孕期妇女出生缺陷知信行健康教育模式效果的有力保证。

Objective To identify factors related to the knowledge, attitude and practice KAP of birth defects prevention among pregnant women, and provide reasonable suggestions to improve perinatal health services and health education. Methods Using cluster sampling method, 5500 participants from pregnant women school were enrolled. Information on “awareness of basic knowledge of birth defects” and 7 questions about attitudes and practice to participant actual situation was gathered through personal interviews using a structured questionnaire. The related factors were analyzed by classification tree model of SPSS 19.0. Results As to birth defects related knowledge, prospective return was more than 50% in the pregnant women with junior, senior high school and technical secondary school education level. As to birth defects prevention faith, the main determinant was census register types; prospective return of pregnant women who were local permanent residents and floating population aged ≥25 years was 95.9%. The main influencing factor of practice was prenatal doctor's education; prospected return was 62.3% after strengthening the health education of prenatal doctor. Conclusion In order to improve birth defects education effect, pregnant women who have junior, senior high school and technical secondary school education level and are local permanent residents or floating population aged ≥25 years should be key targeted population. Prenatal doctor's health education will be a powerful guarantee.

目的 探讨二维超声联合三维超声检测不同孕期胎儿肢体畸形的临床价值。方法 回顾性分析我科2013年1月—2015年1月超声筛查的1352名孕15~34周的孕妇,运用二维及三维超声,采用连续顺序追踪超声法检测胎儿四肢,将产前诊断结果与引产或引产结果对照。结果 1352名孕妇胎儿畸形46例(3.40%,46/1352),总涉及肢体73处(近端肢体畸形65处,远端肢体畸形8处),其中四肢短小9例(骨发育不全2例,单纯四肢短小畸形5例,成骨发育不全2例),漏诊2例;足畸形16例34处,漏诊1例,残肢畸形15例;手畸形6例,漏诊1例。结论 孕中期二维连续顺序追踪超声法联合三维超声胎儿肢体畸形检出率高,对及早发现胎儿肢体畸形有一定的诊断价值。