BACKGROUND & AIMS: :This study adds to research on family court's response to custody in the context of intimate partner abuse (IPA). Mediation is often used to assist family court with custody negotiation; however, debate exists in the field regarding its use when IPA exists. The following study examines experiences with court mediation among a sample of victimized mothers who divorced abusive husbands. Mixed-method data were collected from 19 women. Findings demonstrate that abuse is rarely considered in custody recommendations, as most court mediators prefer joint custody. Implications for the ongoing debate, as well as future directions for research, are discussed.

背景与目标： : 这项研究增加了对家庭法院在亲密伴侣虐待 (IPA) 背景下对监护权的反应的研究。调解通常用于协助家庭法院进行监护权谈判; 但是，当IPA存在时，有关其使用的辩论在该领域存在。以下研究考察了与虐待丈夫离婚的受害母亲样本中法院调解的经验。从19名女性中收集了混合方法数据。调查结果表明，在监护权建议中很少考虑虐待，因为大多数法院调解员更喜欢联合监护权。讨论了正在进行的辩论的含义以及未来的研究方向。

BACKGROUND & AIMS: BACKGROUND:Malnutrition in infants during weaning has been attributed to inappropriate complementary feeding practices and it underlies more than one-third of child mortality in Nigeria. Thus, addressing the influence of complementary feeding practice on nutritional status may be an important approach to reducing the burden of child malnutrition. This cross-sectional study investigated the association between complementary feeding practices among mothers and nutritional status of their infants in Akpabuyo Local Government Area, Nigeria. The study enrolled 330 mother-child pairs from 10 randomly selected out of 32 Health Facilities in Akpabuyo. Socio-demographic information, child and maternal characteristics were obtained using an interviewer-administered questionnaire. Complementary feeding practices were assessed with World Health Organization infant and young child feeding indicators. Nutritional indicators wasting, underweight and stunting were determined. RESULTS:Prevalence of timely introduction of complementary feeding among infants aged 6-8 months was 85.4%, minimum dietary diversity rate was 31.5%, and minimum meal frequency 36.7%, the rate of minimum acceptable diet was 7.3%. One-third (33.3%) of the infants were underweight, 26.4%, wasted and 24.6%, stunted. Children who did not receive timely complementary foods had higher odds for wasting (OR 5.15; 95% CI 1.50-17.73). Children who did not receive the minimum dietary diversity had higher odds for underweight than children who received the minimum dietary diversity (OR 2.07; 95% CI 1.17-3.70). Children who did not receive the minimum feeding frequency were more likely to be stunted than their peers who received the minimum feeding frequency (OR 1.57; 95% CI 1.53-4.03). CONCLUSION:Sub-optimal complementary feeding predisposed to infant's malnutrition.

背景与目标：

BACKGROUND & AIMS: :The thermal performance curve (TPC) illustrates the dependence on body- and therefore environmental- temperature of many fitness-related aspects of ectotherm ecology and biology including foraging, growth, predator avoidance, and reproduction. The typical thermal performance curve model is linear in its parameters despite the well-known, strong, non-linearity of the response of performance to temperature. In addition, it is usual to consider a single model based on few individuals as descriptive of a species-level response to temperature. To overcome these issues, we used generalized additive mixed modeling (GAMM) to estimate thermal performance curves for 73 individual hatchling Natrix natrix grass snakes from seven clutches, taking advantage of the structure of GAMM to demonstrate that almost 16% of the deviance in thermal performance curves is attributed to inter-individual variation, while only 1.3% is attributable to variation amongst clutches. GAMM allows precise estimation of curve characteristics, which we used to test hypotheses on tradeoffs thought to constrain the thermal performance curve: hotter is better, the specialist-generalist trade off, and resource allocation/acquisition. We observed a negative relationship between maximum performance and performance breadth, indicating a specialist-generalist tradeoff, and a positive relationship between thermal optimum and maximum performance, suggesting "hotter is better". There was a significant difference among matrilines in the relationship between Area Under the Curve and maximum performance - relationship that is an indicator of evenness in acquisition or allocation of resources. As we used unfed hatchlings, the observed matriline effect indicates divergent breeding strategies among mothers, with some mothers provisioning eggs unequally resulting in some offspring being better than others, while other mothers provisioned the eggs more evenly, resulting in even performance throughout the clutch. This observation is reminiscent of bet-hedging strategies, and implies the possibility for intra-clutch variability in the TPCs to buffer N. natrix against unpredictable environmental variability.

背景与目标： : 热性能曲线 (TPC) 说明了外热学生态学和生物学的许多与健身相关的方面 (包括觅食，生长，避免捕食者和繁殖) 对身体温度以及因此对环境温度的依赖性。尽管性能对温度的响应具有众所周知的强非线性，但典型的热性能曲线模型在其参数上是线性的。此外，通常考虑基于少数个体的单个模型来描述物种水平对温度的响应。为了克服这些问题，我们使用广义加性混合模型 (GAMM) 来估计来自七个离合器的73个个体孵化Natrix natrix草蛇的热性能曲线，利用GAMM的结构来证明几乎16% 的热性能曲线偏差归因于个体间的变化，而只有1.3% 可归因于离合器之间的变化。GAMM允许对曲线特性进行精确估计，我们用来检验被认为会限制热性能曲线的折衷假设: 更热更好，专家-多面手的权衡以及资源分配/获取。我们观察到最大性能与性能广度之间存在负相关关系，表明专家与多面手之间存在权衡，而热最佳性能与最大性能之间存在正相关关系，表明 “更热更好”。母系之间的曲线下面积与最大绩效关系之间的关系存在显着差异，最大绩效关系是资源获取或分配均匀性的指标。当我们使用未喂食的幼体时，观察到的母系效应表明母亲之间的繁殖策略有所不同，有些母亲分配卵子不平等，导致某些后代比其他后代更好，而其他母亲则更均匀地分配卵子，从而在整个离合器中表现均匀。这一观察结果让人想起押注对冲策略，并暗示了TPCs中离合器内变化的可能性，以缓冲N. natrix免受不可预测的环境变化。

BACKGROUND & AIMS: OBJECTIVE:To explore how a sample of Mexican American mothers with preschool-aged children recruited from a Midwestern Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic obtained information about 4 behaviors associated with childhood obesity risk: eating, physical activity, screen time, and sleep. DESIGN:One-on-one structured interviews in which participants were asked how they communicated with family, learned to take care of their first infant, and obtained information about the 4 targeted behaviors for their preschool-aged child. SETTING:An urban WIC clinic in the Midwest. PARTICIPANTS:Forty Mexican-descent mothers enrolled in WIC with children aged 3-4 years. PHENOMENON OF INTEREST:Exposure to information about the 4 targeted behaviors among Mexican-descent mothers participating in WIC. ANALYSIS:Quantitative and qualitative data were used to characterize and compare across participants. RESULTS:Participants primarily obtained information from their child's maternal grandmother during their first child's infancy and from health professionals for their preschool-aged child. Participants typically obtained information through interpersonal communication, television, and magazines. Participants were most interested in healthy eating information and least interested in screen time information. Some participants did not seek information. CONCLUSIONS AND IMPLICATIONS:Participants engaged in different patterns of information seeking across their child's development and the 4 behaviors, which suggests that future research should be behaviorally specific. Findings from this study suggest several hypotheses to test in future research.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:In an effort to mitigate missed opportunities to provide high-quality care, the World Health Organization (WHO) has developed the Safe Childbirth Checklist (SCC) to support health providers perform essential tasks. Our qualitative study is a baseline assessment of quality of care (QoC) perceived by mothers who gave birth at health facilities aiming to highlight areas where implementing the SCC can potentially improve the QoC as well as areas that are not part of the SCC yet require improvement. METHODS:Assessing the overall experience of care, our qualitative study focuses on 8 out of 29 items in the checklist that are related to the personal interactions between healthcare provider and mothers. Using a set of semi-structured questions, we interviewed 26 new mothers who gave institutional births in Aceh province in Indonesia. RESULTS:Our findings revealed some gaps where implementing the SCC can potentially improve safety and QoC. They include communicating danger signs at critical points during birth and after discharge, encouraging breastfeeding, and providing mothers with information on family planning. Moreover, taking a qualitative approach allowed us to identify additional aspects such as need for clarity at the point of admission, maintaining dignity, and protecting mothers' rights in the decision-making process to be also essential for better QoC. CONCLUSIONS:Our study highlights the need to actively listen to and engage with the experiences of women in the adaptation and implementation of the checklist. While our findings indicate that implementing the SCC has the potential to improve the quality of maternal care and overall birth experience, a more holistic understanding of the lived experiences of women and the dynamics of their interactions with health facilities, care providers, and their birth companions can complement the implementation of the checklist.

背景与目标：

BACKGROUND & AIMS: :Women with epilepsy who were service users of Epilepsy Action in the United Kingdom (UK) completed a questionnaire on the risks of caring for their baby and whether they were provided with useful information on fulfilling their caring role (Epilepsy Action is the trading name of the British Epilepsy Association a major UK charity for those with epilepsy). The cohort of 84 all reported some problems. The following were rated as being the most problematic; caring for their baby outside the home and bathing, whereas breastfeeding was rated as much less problematic. Some problems were rated as severe, which meant some babies were put at undue risk. Approximately 50% had been provided with information about caring and managing risk. Eighty-six percent found this information useful. The main conclusion is that more extensive, well-planned research is needed on this topic. There is virtually nothing in the academic literature to guide practice and this is needed. Present guidelines tend only to cover what the women rate as less problematic, e.g. breastfeeding, whereas what they rate highly problematic is often not covered. This needs attention in updates.

背景与目标： : 英国 (英国) 癫痫行动服务使用者的癫痫妇女填写了一份问卷，内容涉及照顾婴儿的风险，以及是否向她们提供了有关履行其护理角色的有用信息 (癫痫行动是英国癫痫协会的贸易名称) 癫痫)。84人的队列都报告了一些问题。以下被认为是最有问题的; 在家外照顾婴儿并洗澡，而母乳喂养的问题却少得多。一些问题被认为是严重的，这意味着一些婴儿面临不适当的风险。已向大约50% 人提供了有关护理和管理风险的信息。八十6% 认为这些信息很有用。主要结论是，需要对该主题进行更广泛，计划周密的研究。学术文献中几乎没有任何内容可以指导实践，这是必需的。目前的准则往往只涵盖妇女认为问题较少的问题，例如母乳喂养，而她们认为问题严重的问题往往没有涵盖。这需要在更新中注意。

BACKGROUND & AIMS: :Growth of weight, length, head circumference and skinfold thickness (subscapular and triceps) from birth to 6 months in 53 large-for-dates (LFD) Chinese babies weighing greater than 4.0 kg at term and born to non-diabetic mothers was investigated and correlated with biochemical indices of maternal glucose tolerance at birth: glycosylated haemoglobin (HbA1), serum corrected fructosamine and the area under the oral glucose (50 g) tolerance (OGTT) curve. Growth in all physical dimensions, especially weight, showed a downward shift towards a reference mean. These changes in relative size were caused by slower growth velocities. None of the mothers had abnormally high concentrations of HbA1 or fructosamine nor an abnormal OGTT. However, weight velocities did show small but significant correlations with fructosamine (r = -0.42), and OGTT area units (r = 0.39) but not with HbA1. For some macrosomic babies born to apparently normal mothers, birth is seen to interrupt a process operating in prenatal life that accelerates growth. Covert abnormalities of maternal glucose homeostasis could explain this. Abnormal glucose tolerance during pregnancy might therefore be viewed as a continuum extending from (i) its maximum expression, the frankly diabetic state, through (ii) gestational diabetes to (iii) the mother who has no biochemically evident abnormality of glucose homeostasis but who has sufficient alteration to modify fetal growth. Post-natal growth of LFD babies is additional information which, when taken along with other markers of maternal glucose tolerance, might help to identify the mother at later perinatal risk.

背景与目标： : 重量、长度、对53名足月体重大于4.0千克的中国婴儿和非糖尿病母亲出生时的头围和皮褶厚度 (肩胛下和三头肌) 从出生到6个月进行了调查，并与母亲的生化指标相关出生时糖耐量: 糖基化血红蛋白 (HbA1)，血清校正后的果糖胺和口服葡萄糖 (50g) 耐受性 (OGTT) 曲线下的面积。所有物理尺寸 (尤其是体重) 的增长均显示出向参考平均值的向下移动。相对大小的这些变化是由较慢的生长速度引起的。没有母亲的HbA1或果糖胺浓度异常高，也没有OGTT异常。然而，体重速度与果糖胺 (r = -0.42) 和OGTT面积单位 (r = 0.39) 确实显示出较小但显着的相关性，但与hba1无关。对于一些看似正常的母亲所生的大型婴儿来说，出生被认为会中断产前生活中加速生长的过程。母体葡萄糖稳态的隐性异常可以解释这一点。因此，怀孕期间的葡萄糖耐量异常可能被视为一个连续体，从 (i) 其最大表达，坦率地说，糖尿病状态，到 (ii) 妊娠糖尿病到 (iii) 母亲没有生化明显的葡萄糖稳态异常，但有足够的改变来改变胎儿的生长。LFD婴儿的产后生长是其他信息，当与母亲葡萄糖耐量的其他标志物一起使用时，可能有助于识别处于后期围产期风险的母亲。

BACKGROUND & AIMS: BACKGROUND:The breastfeeding position routinely used following a cesarean section is the side-lying position. However, there have been few studies about the effect of breastfeeding positions, including laid-back position on breastfeeding outcomes. OBJECTIVE:To compare the breastfeeding outcomes between using laid-back and side-lying breastfeeding positions in mothers delivering by cesarean section. MATERIALS AND METHODS:A randomized controlled trial was conducted. The postpartum mothers delivering by cesarean section who delivered term newborns were randomly assigned to learn the use of a laid-back or side-lying breastfeeding position. The breastfeeding outcomes were assessed by LATCH scores at the second day postpartum and exclusive breastfeeding rates during the 6-week postpartum period. The mother's satisfaction of each breastfeeding position was collected before discharge from the hospital. RESULTS:The data from 152 postpartum mothers delivering by cesarean section were available for analysis, 76 from the laid-back position group and 76 from side-lying position group. The baseline characteristics of both groups were similar. There were no statistically significant differences of the breastfeeding outcomes, LATCH scores at the second day postpartum and the exclusive breastfeeding rates during the 6-week postpartum period. But the mothers had expressed more satisfaction from the side-lying than the laid-back position. CONCLUSIONS:Among the mothers who delivered by cesarean section, the use of the laid-back breastfeeding position had not shown different breastfeeding outcomes from the side-lying breastfeeding position. It might be an alternative breastfeeding position, which can be taught for mothers delivering by cesarean section along with the side-lying position.

背景与目标：

BACKGROUND & AIMS: : Aim: The objective of our study was to determine whether the SARS-CoV-2-positive mothers transmit the virus to their hand-expressed colostrum. Methods: This is an observational prospective study that included pregnant women who tested positive for SARS-CoV-2 by PCR test on a nasopharyngeal swab at the moment of childbirth and who wanted to breastfeed their newborns. A colostrum sample was obtained from the mothers by manual self-extraction. To collect the samples, the mothers wore surgical masks, washed their hands with an 85% alcohol-based gel, and washed their breast with gauze that was saturated with soap and water. Results: We obtained seven colostrum samples from different mothers in the first hours postdelivery. SARS-CoV-2 was not detected in any of the colostrum samples obtained in our study. Conclusion: In our study, breast milk was not a source of SARS-CoV-2 transmission. Hand expression (assuring that a mask is used and that appropriate hygienic measures are used for the hands and the breast), when direct breastfeeding is not possible, appears to be a safe way of feeding newborns of mothers with COVID-19.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:This study aimed to (i) identify themes and issues that might usefully be addressed in a skills-and-support intervention for mothers with eating disorders who have children less than 5 years of age, and (ii) determine the most appropriate format for such an intervention. METHOD:Focus groups and individual interviews were conducted with seven mothers with eating disorders and pre-school children, and four local health professionals working with mothers of pre-school children. RESULTS:Thematic analysis of interview transcripts revealed 10 themes: 'Passing on Traits', 'Food Preparation and Provision', 'Interactions Around Food and Mealtimes', 'Mother's Intake', 'Self Care', 'Self Identity and Parental Expectations', 'Impact on General Parent-Child Relationship', 'Need for Control', 'The Group Experience' and 'Practicalities and Format'. DISCUSSION:Findings highlight a number of difficulties and concerns experienced by mothers with eating disorders who have pre-school age children. An intervention incorporating the identified themes could provide important support to this patient group and potential benefit to their offspring.

背景与目标：

BACKGROUND & AIMS: :Seventy-four mothers were surveyed to determine their attitudes toward the use of a Papoose Board (PB, Olympic Medical Corporation, Seattle, WA) to treat their uncooperative children (mean age 3.1 years). If, at the initial exam, it was agreed that the PB might be an acceptable treatment modality, the child was prescribed a sedative for the next appointment. At that appointment, the child was placed in the PB and teeth were restored using local anesthetic, mouth prop, and/or nitrous oxide. Afterward, each mother received a survey to complete at home and mail back anonymously. Seventy-four surveys were issued; 59 were mailed back. Of the 59, 50 were answered comprehensively; nine were incomplete. Of the 50 surveys, 90% of the mothers approved of the use of the PB, 96% thought the PB was necessary to perform the dentistry, 78% did not think it had a later negative effect on the child, and 86% were willing to use it with their next child.

背景与目标： : 对74名母亲进行了调查，以确定他们对使用Papoose委员会 (PB，奥林匹克医疗公司，华盛顿州西雅图) 治疗不合作的孩子 (平均年龄3.1岁) 的态度。如果在初次检查时同意PB可能是可接受的治疗方式，则为该孩子下一次约会开了镇静剂。在那次约会中，将孩子放在PB中，并使用局部麻醉剂，口腔支柱和/或一氧化二氮修复牙齿。之后，每个母亲都接受了一项调查，以在家中完成并匿名寄回。发布了74项调查; 邮寄了59项。在59人中，有50人得到了全面回答; 九个不完整。在50项调查中，有90% 的母亲批准了PB的使用，96% 认为PB对于牙科是必要的，78% 认为PB对孩子没有后来的负面影响，86% 愿意与下一个孩子一起使用。

BACKGROUND & AIMS: :The present study aims to prove an improvement in breast-feeding practices in mothers who received written instructions for successful breast-feeding and had individual counselling at the time of taking this questionnaire. The instructions were based on the results of a study carried out in Slovenia in 1993 and published in the Journal of Advanced Nursing (1998), 27, 1250-1256 (Hoyer & Pokorn 1998). The variables that were then found statistically significant in the initial and continued breast-feeding became the basis of written instructions for breast-feeding. The results obtained in the new current study were compared with that basic study which included 881 mothers. This was possible because the conditions of breast-feeding between 1993 and 1995 (when the new study was launched) had not changed. The idea of baby-friendly hospital initiative (BFHI) had not yet come into force in Slovenia. The current study comprised 203 pregnant women who were first visited during their 8th month of pregnancy. In order to collect data on breast-feeding and deliver instructions, a field nurse visited each mother eight times until the completion of first year and continued to visit them every third month and for all those who were still breast-feeding after that time, until the end of the lactation period. Statistical analysis was carried out by means of SPSS statistical package and survival analysis. All mothers in the study started breast-feeding. By the end of the first month 84.7% of them were still breast-feeding, while by the end of the third month it dropped to 74.9%, and by the end of the sixth month to 45.8%. Among these, breast-feeding alone was practised in the first week by 25.7%, by the end of the first month by 16.4%, and by the end of the third month by 9.5%. All the observed parameters were better than in the basic study. The mean duration of breast-feeding was 217 days, while the longest duration was 852 days. The survival analysis showed a statistically significant difference in the duration of breast-feeding. In the current study group, mothers weaned their infants at a slower rate than in the group from the year 1993. It has been found that the written instructions as well as personal encouragement by the field nurse exerted a favourable influence on breast-feeding practices, which was taken as a guideline for our further professional work and change of standards in the field of breast-feeding promotion.

背景与目标： : 本研究旨在证明在接受成功母乳喂养的书面指示并在接受此问卷调查时有个人咨询的母亲的母乳喂养方式有所改善。这些说明基于在斯洛文尼亚1993年进行的一项研究的结果，并发表在《高级护理杂志》 (1998)，27,1250-1256 (Hoyer & Pokorn 1998) 上。然后在初始和持续母乳喂养中发现具有统计学意义的变量成为母乳喂养书面说明的基础。将在新的当前研究中获得的结果与包括881名母亲的基础研究进行了比较。这是可能的，因为母乳喂养1993年和1995 (当新研究启动时) 的条件没有改变。爱婴医院倡议 (BFHI) 的想法尚未在斯洛文尼亚生效。目前的研究包括203名在怀孕8个月期间首次就诊的孕妇。为了收集有关母乳喂养的数据并提供指导，一名现场护士拜访了每位母亲八次，直到第一年结束，并每三个月继续拜访他们，并为所有在此之后仍在母乳喂养的人提供服务，直到哺乳期结束。通过SPSS统计软件包和生存分析进行统计分析。研究中的所有母亲都开始母乳喂养。到第一个月底，其中84.7% 人仍在母乳喂养，而到第三个月底，母乳喂养下降到74.9%，到第六个月底，到45.8%。其中，25.7% 在第一周进行母乳喂养，16.4% 在第一个月底进行母乳喂养，9.5% 在第三个月底进行母乳喂养。所有观察到的参数均优于基础研究。母乳喂养的平均持续时间为217天，而最长持续时间为852天。生存分析显示，母乳喂养的持续时间具有统计学上的显着差异。在当前的研究组中，母亲断奶的速度比1993年的组慢。已经发现，现场护士的书面指示和个人鼓励对母乳喂养做法产生了有利的影响，这被视为我们在母乳喂养促进领域进一步专业工作和改变标准的指导方针。

BACKGROUND & AIMS: :Public policy decisions directly affect the health care of women and children and also affect the practice of maternal and child nursing. The past quarter century has seen a shift in nursing involvement in the public policy process. Heightened awareness of the collective power of nurses, greater independence of the nursing profession, the increasing capability for generating research to guide the formulation of public policy, and nurses' better understanding of the political process have all contributed to the increasing influence of our nation's 2.6 million nurses. The passage of several significant pieces of legislation, such as expansions of the Medicaid program for pregnant women and children in the late 1980s, have opened up new opportunities for nurses to further shape the nation's health care agenda for women and children. Nurses can and should become more involved with the policy-making process at local, state, and national levels to assure that decisions are made that benefit this important population group. Leadership in the public policy arena will give nurses the best opportunities for putting forth the agendas that will accomplish these goals.

背景与目标： : 公共政策决定直接影响妇女和儿童的保健，也影响母婴护理的实践。在过去的四分之一世纪中，护理人员在公共政策过程中的参与发生了变化。对护士集体权力的认识的提高，护理专业的更大独立性，产生指导公共政策制定的研究能力的增强以及护士对政治过程的更好理解，都促进了我们国家260万护士的影响力的增加。几项重要立法的通过，例如扩大20世纪80年代末孕妇和儿童的医疗补助计划，为护士提供了新的机会，以进一步塑造国家的妇女和儿童医疗保健议程。护士可以而且应该更多地参与地方，州和国家各级的决策过程，以确保做出有利于这一重要人群的决策。公共政策领域的领导力将为护士提供最佳机会，以提出实现这些目标的议程。

BACKGROUND & AIMS: :Vitamin B-6 status, assessed by plasma pyridoxal phosphate (PLP) concentrations, and vitamin B-6 concentrations in breast milk were examined in 47 lactating mothers supplemented with different amounts of pyridoxine.HCl (PN.HCl) during pregnancy and the first 6 mo of lactation. PLP concentrations in cord blood and maternal plasma at 2 d postpartum and vitamin B-6 concentration in colostrum were positively correlated with the amount of PN.HCl supplementation prenatally (r = 0.71, p less than 0.001; r = 0.74, p less than 0.001; and r = 0.78, p less than 0.001, respectively). Correlations between the amounts of PN.HCl supplementation postnatally and plasma PLP concentrations increased with the length of supplementation. Plasma PLP concentrations were also correlated with vitamin B-6 concentrations of milk samples, which were obtained on the same day as plasma. PN.HCl supplements between 2.5 and 4.0 mg/d (2.1-3.4 mg PN equivalents) ensured vitamin B-6 adequacy of the mother and maintained relatively saturated concentrations of vitamin B-6 in breast milk.

背景与目标： : 在怀孕期间和哺乳期前6个月，在47名补充了不同量的吡哆醇的哺乳期母亲中，通过血浆磷酸吡哆醇 (PLP) 浓度和母乳中的维生素B-6浓度评估了维生素B-6状态。产后2 d脐血和孕妇血浆中的PLP浓度以及初乳中的维生素B-6浓度与产前补充PN.HCl的量呈正相关 (r = 0.71，p小于0.001; r = 0.74，p小于0.001; r = 0.78，p小于0.001，分别)。PN.HCl补充量与血浆PLP浓度之间的相关性随补充量的增加而增加。血浆PLP浓度也与牛奶样品的维生素B-6浓度相关，牛奶样品与血浆在同一天获得。PN.HCl补充剂2.5至4.0 mg/d (2.1-3.4 mg PN当量) 确保母亲的维生素B-6充足，并保持母乳中维生素B-6的相对饱和浓度。

BACKGROUND & AIMS: OBJECTIVE:To assess whether mothers and fathers have a higher long term risk of death, particularly from cardiovascular disease and cancer, after the mother has had pre-eclampsia. DESIGN:Population based cohort study of registry data. SUBJECTS:Mothers and fathers of all 626 272 births that were the mothers' first deliveries, recorded in the Norwegian medical birth registry from 1967 to 1992. Parents were divided into two cohorts based on whether the mother had pre-eclampsia during the pregnancy. Subjects were also stratified by whether the birth was term or preterm, given that pre-eclampsia might be more severe in preterm pregnancies. MAIN OUTCOME MEASURES:Total mortality and mortality from cardiovascular causes, cancer, and stroke from 1967 to 1992, from data from the Norwegian registry of causes of death. RESULTS:Women who had pre-eclampsia had a 1.2-fold higher long term risk of death (95% confidence interval 1.02 to 1.37) than women who did not have pre-eclampsia. The risk in women with pre-eclampsia and a preterm delivery was 2.71-fold higher (1.99 to 3.68) than in women who did not have pre-eclampsia and whose pregnancies went to term. In particular, the risk of death from cardiovascular causes among women with pre-eclampsia and a preterm delivery was 8.12-fold higher (4.31 to 15.33). However, these women had a 0.36-fold (not significant) decreased risk of cancer. The long term risk of death was no higher among the fathers of the pre-eclamptic pregnancies than the fathers of pregnancies in which pre-eclampsia did not occur. CONCLUSIONS:Genetic factors that increase the risk of cardiovascular disease may also be linked to pre-eclampsia. A possible genetic contribution from fathers to the risk of pre-eclampsia was not reflected in increased risks of death from cardiovascular causes or cancer among fathers.

背景与目标：