Evidence was insufficient to suggest that physical activity during pregnancy might be effective to lower the risk of developing GDM.

BackgroundBreast milk is the most important nutrition for premature babies, but mothers of premature infants have difficulty in initiating and sustaining lactation. Breastfeeding infants who are separated with mothers have decreased morbidity. Nevertheless, such decrease is limited due to insufficient milk supply resulting from mother–baby separation during lac.ObjectiveTo evaluate the effect of intervention methods based on the health belief model on promoting the secretion of milk among mothers who were separated with their babies.MethodsIn this prospective, randomized controlled clinical trial, we enrolled 260 separation mothers between September 26, 2016 and March 7, 2017, in a 3rd-grade women and children hospital of Chengdu. The mothers all had cesarean delivery and were randomized into 2 groups: the intervention group (educated by investigators based on the health belief) and the control group (routinely educated by obstetric nurses). Data on the onset of lactation and the milk volume during 3 days postpartum were collected. The breast swelling rate within 3 days postpartum and the exclusive breastfeeding rate at 42 days postpartum were compared. The psychologic scores of separation maternal in both groups were assessed with State-Trait Anxiety Inventory at the 3rd day postpartum.ResultsCompared with the control group, the intervention group had significantly earlier lactation time (P < .01), significantly larger milk volume (P < .01) during 24, 24 to 48, and 48 to 72 hours, and significantly lower psychologic scores (P < .01) at the 3rd-day postpartum.The onset of lactation among mothers who initiated milk expression within 1 hour after childbirth were earlier than those who initiated milk expression between 1 and 6 hours (P < .01); the milk volume within 24-hour postpartum did not differ significantly between the 2 groups (P > .05). However, the milk volume of the early-expression group (<1 hour) was significantly higher than that of the late-expression group (1–6 hours) during 24 to 48 and 48 to72 hours (P < .05).The breast swelling rate of separation mothers within 3 days postpartum in the intervention group was lower than that in the control group (P < .05). The exclusive breastfeeding rate of mothers in the intervention group was significantly higher than that in the control group (59% vs 35%; P < .01) at 42 days postpartum.ConclusionNursing intervention based on the health belief model can stimulate milk secretion in mothers who were separated with their babies.

Among the factors that influenced the mental health of pregnant and postpartum women after earthquakes, family function appears to be one of the most important and deserves further exploration. Other mental health conditions such as minor psychiatric disorders should also be studied for their relationship with disasters and pregnancy. Well-designed studies are needed to enable a better understanding of the relationship between earthquakes and the mental disorders of peripartum women so that the most appropriate interventions can be proposed.

Objective To assess the patterns and intensities of physical activity among pregnant women in southwestern China, which help us create a fitness regimen based on the 2002 American College of Obstetricians and Gynecologists (ACOG) guidelines for exercise during pregnancy. Methods A cross-sectional study was performed to recruit pregnant women at a prenatal checking visit clinic with the self-administered Chinese version of Pregnancy Physical Activity Questionnaire (PPAQ). Results A total of 1179 Chinese pregnant women were enrolled, of whom 92.60% were classified as not meeting the ACOG guidelines. By intensity, 47.36% of the score was attributed to light-intensity activities (1.5 to <3.0 metabolic equivalent [MET]) in the first trimester; the other 2 trimesters were similar. By patterns, about 45.15% of the score was attributed to inactivity. More than 82.35% of enrolled pregnant women regarded slowly walking as the most common type of exercise during pregnancy. Conclusions This study represents a group of Chinese women who maintained an inactive lifestyle, including low-intensity activities and unitary type of exercises during their pregnancy. Health-care providers are advised to provide appropriate physical activity guidelines to pregnant women. Development of MET-hours/week recommendations is warranted to promote greater physical activity during pregnancy.

No abstract

Background In recent years, spiritual well-being has gradually gained the attention of health care providers in China, especially those in oncology departments, who have recognized the importance of improving spiritual well-being in cancer patients. Since most of the current research on spiritual well-being has been carried out in areas with religious beliefs, this study was conducted in the context of no development of formal religion. The purpose of this study was to explore the relationship between death anxiety and spiritual well-being and the related factors of spiritual well-being among gynecological cancer patients. Methods This cross-section study was conducted among 586 gynecological cancer patients. The European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-spiritual well-being32 (EORTC QLQ-SWB32) and Templer's Death Anxiety Scale (T-DAS) were used to measure spiritual well-being and death anxiety. The Multiple Linear Regression Model was used to determine the relationship between spiritual well-being and death anxiety. Results For all participants, the highest QLQ-SWB32 centesimal score was 75.13 on the Relationship with Other scale, and the lowest was 60.33 on the Relationship with Someone or Something Greater Scale. The mean Death Anxiety score was 5.31 (SD 3.18). We found that Relationship with Someone or Something Greater was the only scale not associated with death anxiety. Overall, patients with lower death anxiety have a higher level of spiritual well-being. Besides, a high Relationship with Other score was associated with living with a partner (B = 2.471, P < 0.001) and married (B = -6.475, P = 0.001). Patients with higher Global-SWB were retired (B = 0.387, P = 0.019). Conclusions Our study found that the spiritual well-being of patients with gynecological cancer in China was no worse than in other countries with religious beliefs and patients with lower death anxiety have a higher level of spiritual well-being. Clinical staff should pay attention to the spiritual health of cancer patients, and spiritual care should be regarded as an essential element in cancer care.

We conducted a systematic review and meta-analysis to compare the effect of breast-feeding and formula-feeding on body composition of preterm infants. We searched the literature using PubMed, Cochrane Central Library Issue, Ovid (Medline), Embase and other resources such as Google Scholar, electronic databases and bibliographies of relevant articles; two reviewers collected and extracted data independently. All the authors assessed risk of bias independently using the Newcastle-Ottawa Scale (NOS). A fixed-effects meta-analysis was undertaken with RevMan 5 software (The Cochrane Collaboration) using the inverse variance method (P ≥ 0·05; χ 2 test). In contrast, a random-effects meta-analysis was carried out. Altogether, 630 articles were identified using search strategy, and the references within retrieved articles were also assessed. A total of six studies were included in this systematic review. In formula-fed infants, fat mass was higher at term (mean difference 0·24 (95 % CI 0·17, 0·31) kg), fat-free mass was higher at 36 weeks of gestational (mean difference 0·12 (95 % CI 0·04, 0·21) kg) and the percentage of fat mass was higher at 36 weeks of gestation (mean difference 3·70 (95 % CI 1·81, 5·59) kg) compared with breast-fed infants. Compared with breast-feeding, formula-feeding is associated with altered body composition from birth to term in preterm infants. The effects of formula-feeding on preterm infant body composition from term to 12-month corrected age are inconclusive in our study. Well-designed studies are required in the future to explore the effects of formula-feeding compared with breast-feeding. Key words: Breast-feeding: Formula-feeding: Preterm infants: Body composition To achieve optimal growth, preterm infants need better nutrition in the neonatal period than any other time of their life because of decreased intra-uterine nutrient deposition (1) . The American Academy of Pediatrics recommends that breast milk should be the preferred feeding for all infants. Formula milk is recommended when human milk supply is inadequate or the mother is unable to breast-feed (2) . Meanwhile, preterm infants often require additional supervisions and support systems compared with term infants, because their buccal coordination and swallowing mechanisms are not fully matured (3) . In addition, despite lower weight and shorter length than term infants upon discharge, preterm infants have been found to show a catch-up growth and abnormal adiposity at term corrected age, which indicates a potential risk factor for CVD (4,5) . Therefore, it is essential to monitor growth and body composition changes continuously in relation to different nutrition interventions, because growth pattern and body composition appear to have a long-term effect on health outcomes (6) .It is quite clear that a period of rapid growth would be likely to have negative effects on long-term health outcomes (7) , and unbalanced catch-up growth of fat mass (FM) could attribute to this association. At the same time, two types of rapid cat...

No abstract