Background: Gestational diabetes mellitus is one of the most frequent metabolic complications of pregnancy. Previous studies have reported that using either probiotic yogurt or a probiotic supplement reduces the incidence of gestational diabetes. However, the results were inconsistent. Thus, the aim of the present study was to investigate the association between gestational diabetes mellitus and probiotic yogurt intake during pregnancy and pre-pregnancy in Chinese women. Methods: This was a case-control study involving 123 cases with gestational diabetes mellitus and 126 controls matched for age and pre-pregnancy body mass index. Each participant was interviewed face-to-face using a structured questionnaire to collect socio-demographic characteristics, diet and exercise habits, as well as probiotic yogurt consumption (containing Lactobacillus acidophilus and Bifidobacterium) during pregnancy and pre-pregnancy. An unconditional logistic regression analysis was used to analyze the data. Results: Mothers in both groups had similar socio-demographic backgrounds. Probiotic yogurt intake during pregnancy was significantly higher in normal pregnant women than that in women with gestational diabetes mellitus (adjusted odds ratio: 0.292, 95% confidence interval: 0.148 - 0.577, P < 0.05). There were no significant differences in probiotic yogurt consumption before pregnancy between cases and controls. Conclusion: Probiotic yogurt intake before pregnancy was not associated with gestational diabetes mellitus, but probiotic yogurt consumption during pregnancy was effective in reducing the risk of gestational diabetes mellitus in Chinese women. The findings from the present study may have implications for the future care of pregnant Chinese women with gestational diabetes mellitus.

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Background. Probiotic supplements may be seen as a promising way to improve glucose metabolism. This study aimed to evaluate the effects of probiotic supplements on blood glucose, insulin resistance/sensitivity, and prevention of gestational diabetes mellitus (GDM) among pregnant women. Methods. Eleven electronic databases were searched from inception to May 2020. Two authors independently identified randomized controlled trials (RCTs), assessed the eligibility and quality of the included studies, and then extracted data. The primary outcomes were fasting plasma glucose (FPG), 1 h and 2 h plasma glucose after 75 g oral glucose tolerance test (OGTT), HbA1c, fasting plasma insulin, insulin resistance, and insulin sensitivity. Fixed and random effect models were used to pool the results. Results. A total of 20 RCTs involving 2972 participants were included according to the inclusion and exclusion criteria. The pooled results of this research showed that probiotic supplements could reduce the level of FPG (mean difference (MD) = −0.11; 95% CI = −0.15 to −0.04; P = 0.0007 ), serum insulin (MD = −1.68; 95% CI = −2.44 to −0.92; P < 0.00001 ), insulin resistance (MD = −0.36; 95% CI = −0.53 to −0.20; P < 0.00001 ), and insulin sensitivity (MD = −21.80; 95% CI = −31.92 to −11.67; P < 0.00001 ). Regarding the subgroup analysis of different pregnant women, the effects of probiotics on FPG, insulin, and insulin resistance were more obvious among GDM and healthy women than among overweight/obese women. Furthermore, the differences were not significant in HbA1c (MD = −0.05; 95% CI = −0.12 to 0.03; P = 0.23 ), 1 h OGTT (MD = −0.07; 95% CI = −0.25 to 0.10; P = 0.42 ), and 2 h OGTT (MD = −0.03; 95% CI = −0.17 to 0.12; P = 0.72 ). Conclusion. This review found that probiotic supplements had certain functions to reduce the level of FPG and improve insulin, insulin resistance, and insulin sensitivity, especially for GDM and healthy pregnant women.

Aims and objectives: To observe the psychological status of pregnant women during COVID-19 pandemic, and to test a hypothetical model that estimates the influence of psychological response to COVID-19 and security sense on pregnancy stress. Background: COVID-19 advanced rapidly and then spread worldwide. Pregnant women were more susceptible to the COVID-19 infection. Furthermore, it is not clear whether this infection will increase the risk of congenital monstrosity, foetal growth restriction, premature delivery or cause other long-term adverse effects. Design: A descriptive, cross-sectional survey. Methods: A total of 331 pregnant women participated in this study. And this research adhered to the STROBE guideline. The psychological questionnaire for emergent events of public health, pregnancy stress scale and security questionnaire were used to collect data. The hypothetical path model was tested using the SPSS version 25.0 software and AMOS version 26.0 software. Results: Fear and depression were the most common psychological responses among pregnant women during the COVID-19 pandemic. The hypothesis model of this study fitted the data well, and the results showed that psychological response positively affected pregnancy stress, while security sense negatively affected pregnancy stress; security sense mediated between psychological response and pregnancy stress. Conclusion: Nurses and midwives can help reduce the stress in pregnant women by alleviating their psychological response to the COVID-19 pandemic and by improving their security sense. Relevance to clinical practice: It is essential for the health staff to build trust with pregnant women and their families, and communicate accurate information to them. Nurses should promptly conduct a psychological response evaluation and psychological guidance for pregnant women to alleviate their fears and hypochondria related to COVID-19.

The gestational weight gain (GWG) range of Chinese women with gestational diabetes mellitus (GDM) remains unclear. Our objective was to identify the ranges of GWG in Chinese women with GDM and to investigate the associations between prepregnancy body mass index (BMI), GWG and maternal-infant adverse outcomes. Cases of GDM women who delivered singletons from 2013 to 2018 in a public hospital were collected. Logistic regression analysis was used to assess the joint effects of prepregnancy BMI and GWG on maternal-infant adverse outcomes. Ultimately, 14,578 women were collected. The ranges of GWG in Chinese women with GDM were different from the National Academy of Medicine’s (NAM) recommendation. The ranges of GWG of Chinese women with GDM in the underweight, normal weight, overweight and obese groups were 5.95–21.95 kg, 4.23–21.83 kg, 0.88–21.12 kg and − 1.76 to 19.95 kg, respectively. The risks of large for gestational age (LGA), macrosomia and caesarean delivery were significantly increased with the increasing prepregnancy BMI. Furthermore, the risks of LGA, macrosomia and caesarean delivery were significantly higher in the normal weight group with a GWG higher than the NAM recommendation. Similarly, in the overweight group with a GWG higher than the NAM recommendation, the risks of LGA were significantly higher, while the risks of macrosomia were significantly lower. Overall, we determined the range of GWG in different prepregnancy BMI groups. And GDM women with high prepregnancy BMI and excessive GWG were associated with the higher risks of maternal-infants adverse outcomes in China.

Healthcare professionals who lack self-efficacy may fail to cope with stressful situations, which increases job burnout and turnout. Self-efficacy of midwives with high workload may affect the quality of service. However, little is known about midwives' self-efficacy and related factors. This study aimed to examine the level and influencing factors of self-efficacy among midwives, and to assess the relationships between their self-efficacy and job burnout. Methods: This was a multi-center cross-sectional study involving 700 midwives from 33 hospitals in China. Data were collected by three selfadministered questionnaires, including a socio-demographic questionnaire, General Self-Efficacy Scale and Maslach Burnout Inventory. Pearson correlation was utilized to analyze the association of self-efficacy with job burnout. A multiple linear regression model was performed to identify variables associated with midwives' self-efficacy. Results: The score of self-efficacy among Chinese midwives was 24.34 ± 5.28. The incidence of job burnout was 52.9%. The influencing factors of self-efficacy among midwives were low personal accomplishment, emotional exhaustion, length of service, interest in the midwifery field, marital status and whether they came from a one-child family or not. Conclusions: Chinese midwives had a moderate level of self-efficacy which easily led to job burnout. Also, several personal-related and work-related factors would affect the self-efficacy of midwives. Nursing managers are called on to attach importance to self-efficacy of midwives and provide effective interventions to improve their self-efficacy.

Aims To identify the level of workplace fatigue among midwives and factors influencing their fatigue. Background Midwives who play an important role in medical care are prone to experience workplace fatigue, which negatively affects their well‐being and work quality. Methods A multi‐centre cross‐sectional study was conducted among 666 Chinese midwives from 38 hospitals in March 2019. Data were collected by four questionnaires of self‐designed demographic questions, the Pittsburgh Sleep Quality Index, the Social Support Self‐Rating Scale and the 14‐item Fatigue Scale. Descriptive statistics, univariate analysis and multiple linear regression were used to analyse the data. Results Midwives had moderate levels of fatigue with the mean scores of physical fatigue, mental fatigue and total fatigue being 9.53, 6.25 and 15.79, respectively. Multiple linear regression results showed that sleep quality, social support, job satisfaction, occupational injuries, adverse life events, frequency of irregular meals and employment type were statistically significant factors influencing fatigue among the participants. Conclusions Physical and mental fatigue were generally common among midwives and were affected by personal‐related and work‐related factors, sleep quality and social support. Implications for Nursing Management Nurse administrators have the opportunity to advocate for improved health policy under the two children rule to prevent workplace fatigue amongst midwives.

Midwife-led care can reduce the caesarean section rate, promote normal birth, improve birth outcomes, and promote maternal and child health.