Objective:To understand the disease and health status of rural population of childbearing age in Yunnan, and to obtain the temporal, spatial and population distribution data of health risks of pre-pregnancy population.Methods:The temporal, spatial and population distribution of health risk factors of 1 445 656 rural couples who participated in free pre-pregnancy health examination in Yunnan Province from 2010 to 2019 was analyzed statistically.Results:From 2010 to 2019, among the rural population of childbearing age in Yunnan Province, the risk of wife's childbearing age increased year by year (linear by linear association value 5 175.82, P<0.001). The emaciation rate was the opposite (linear by linear association value 503.43, P<0.001). The rate of overweight in husbands and wives increased gradually (husbands linear by linear association value 6 358.09, P<0.001; wives linear by linear association value 4 947.09, P<0.001). The rate of contraceptive use between births declined year by year (linear by linear association value 40 389.67, P<0.001). There were significant differences in the rates of overweight, smoking, drinking, prevalence of hypertension, anti-hepatitis B positive, syphilis positive and the risk of diabetes, thalassaemia, environmental exposure and infertility risk in 16 cities of Yunnan Province (all Chi-square test P<0.05). In terms of population distribution, the higher the number of pregnancy, the higher the health risk before pregnancy. The poorer the economy was, the higher of the risks of childbearing age, the positive rate of hepatitis B and syphilis, the risk of thalassemia and infertility. The richer the economy was, the higher of the rates of overweight, environmental exposure, and smoking and drinking in men (all linear by linear association P<0.05). Conclusion:We need to attach great importance to the development trend of overweight, obesity, and strengthen the promotion and guidance of contraception and birth control. Rural revitalization should pay attention to the spread of hepatitis B and syphilis in backward areas. The allocation of comprehensive prevention and control resources for thalassemia need to be tilted towards high-risk areas in southern Yunnan. It is necessary to accurately prevent and control reproductive health risks before pregnancy, promote the transformation of projects to timely, continuous, complete, and systematic services, and block the intergenerational transmission of diseases.

Objective:To understand the disease and health status of rural population of childbearing age in Yunnan, and to obtain the temporal, spatial and population distribution data of health risks of pre-pregnancy population.Methods:The temporal, spatial and population distribution of health risk factors of 1 445 656 rural couples who participated in free pre-pregnancy health examination in Yunnan Province from 2010 to 2019 was analyzed statistically.Results:From 2010 to 2019, among the rural population of childbearing age in Yunnan Province, the risk of wife's childbearing age increased year by year (linear by linear association value 5 175.82, P<0.001). The emaciation rate was the opposite (linear by linear association value 503.43, P<0.001). The rate of overweight in husbands and wives increased gradually (husbands linear by linear association value 6 358.09, P<0.001; wives linear by linear association value 4 947.09, P<0.001). The rate of contraceptive use between births declined year by year (linear by linear association value 40 389.67, P<0.001). There were significant differences in the rates of overweight, smoking, drinking, prevalence of hypertension, anti-hepatitis B positive, syphilis positive and the risk of diabetes, thalassaemia, environmental exposure and infertility risk in 16 cities of Yunnan Province (all Chi-square test P<0.05). In terms of population distribution, the higher the number of pregnancy, the higher the health risk before pregnancy. The poorer the economy was, the higher of the risks of childbearing age, the positive rate of hepatitis B and syphilis, the risk of thalassemia and infertility. The richer the economy was, the higher of the rates of overweight, environmental exposure, and smoking and drinking in men (all linear by linear association P<0.05). Conclusion:We need to attach great importance to the development trend of overweight, obesity, and strengthen the promotion and guidance of contraception and birth control. Rural revitalization should pay attention to the spread of hepatitis B and syphilis in backward areas. The allocation of comprehensive prevention and control resources for thalassemia need to be tilted towards high-risk areas in southern Yunnan. It is necessary to accurately prevent and control reproductive health risks before pregnancy, promote the transformation of projects to timely, continuous, complete, and systematic services, and block the intergenerational transmission of diseases.

Objective:To explore the relationship between sleep quality and depression among fertile women, and provide a scientific reference for protecting the mental health of fertile women.Methods:The study included 12 518 fertile women who were 15 to 49 years old from the Second Affiliated Hospital of Kunming Medical University and Maternal and Child Health Hospital of Qujing in Yunnan Province from January 2019 to November 2019. Sleep quality was collected by using self-reported questionnaires, and depression was evaluated by using the Edinburgh Postpartum Depression Scale. We used logistic regression to analyze the relationship between sleep quality and depression after controlling for other factors.Results:Among 12 518 fertile women, 3197 had poor sleep quality which accounted for 25.54% (95% CI=24.77%-26.30%). The detection rate of depression was 55.59% (6959/12 518; 95% CI=54.72%-56.46%). The detection rate of depression of the poor sleep quality group [75.40% (2410/3197)] was significantly higher than that of the good sleep quality group [48.80% (4549/9321), P<0.001]. Multivariate logistic regression analysis showed that after controlling for basic demographic characteristics, health status, lifestyle habits and other factors, depression was still associated with poor sleep quality (a OR=3.28, 95% CI=2.99-3.60; P<0.001). Conclusion:The problem of depression and sleep quality on fertile women cannot be ignored, and sleep quality was associated with depression significantly which suggested that it was necessary to keep good life style, improve sleep quality and promote mental health.

Objective:To explore the relationship between sleep quality and depression among fertile women, and provide a scientific reference for protecting the mental health of fertile women.Methods:The study included 12 518 fertile women who were 15 to 49 years old from the Second Affiliated Hospital of Kunming Medical University and Maternal and Child Health Hospital of Qujing in Yunnan Province from January 2019 to November 2019. Sleep quality was collected by using self-reported questionnaires, and depression was evaluated by using the Edinburgh Postpartum Depression Scale. We used logistic regression to analyze the relationship between sleep quality and depression after controlling for other factors.Results:Among 12 518 fertile women, 3197 had poor sleep quality which accounted for 25.54% (95% CI=24.77%-26.30%). The detection rate of depression was 55.59% (6959/12 518; 95% CI=54.72%-56.46%). The detection rate of depression of the poor sleep quality group [75.40% (2410/3197)] was significantly higher than that of the good sleep quality group [48.80% (4549/9321), P<0.001]. Multivariate logistic regression analysis showed that after controlling for basic demographic characteristics, health status, lifestyle habits and other factors, depression was still associated with poor sleep quality (a OR=3.28, 95% CI=2.99-3.60; P<0.001). Conclusion:The problem of depression and sleep quality on fertile women cannot be ignored, and sleep quality was associated with depression significantly which suggested that it was necessary to keep good life style, improve sleep quality and promote mental health.

Objective:To determine the prevalence, epidemiological characteristics, and related factors of syphilis infection among rural childbearing age people to promote medical interventions on pre-pregnancy aristogenesis and syphilis infection in Yunnan province.Methods:The subjects in this study were 18-49-year-old rural couples of childbearing age from the National Free Preconception Health Examination Project in Yunnan province during 2013-2017. The descriptive study was carried out to determine the positive rate of Treponema pallidum specific antibody (TPsAb) and related sociodemographic characteristics. Results:The overall positive rate of TPsAb was 0.38% (8 204/2 160 455) in 2 160 455 rural childbearing age people in Yunnan. The positive rate of TPsAb was 0.39% (4 019/1 040 981) in men,higher than that in women (0.37%,4 185/1 119 474). The positive rate of TPsAb was highest in the age group 45-49 years (0.70%,158/22 511). The positive rate of TP antibody in the minority ethnic groups and Han ethnic groups appeared the same (0.38%). However,the highest positive rate of TPsAb was 0.77% (461/60 153) in Hani ethnic group among all the 17 minority ethnic groups. People with education level of primary education had the highest anti-TP positive rate (0.54%,2 327/431 275). The positive rate of TPsAb appeared the highest in Zhaotong (0.73%, 2 049/281 614) area among all the 16 prefectures of the province. The positive rate of TPsAb in the population from the impoverished regions (0.50%,2 963/590 039) was higher than in other disadvantaged areas (0.34%, 3 115/929 368) or areas with average income (0.33%,2 126/641 048). Significant differences appeared in the positive rate of TPsAb among populations of different ages, ethnic, education level, and economic level groups (trend χ2 test, P<0.001). Conclusions:The positive rate of TP antibody in rural childbearing age people in Yunnan was related to multi factors,including sex,age,ethnic group,education level,area, residence, and local economic situation. The positive rate of TPsAb was higher in men than in women. And people with elder age, lower education level, being Hani or Lahu ethnic group, and Zhaotong areas had higher TPsAb positive rates and higher syphilis infection risk.

Objective:To explore the association of induced abortion with subsequent stillbirth.Methods:The data collected from the National Free Pre-Pregnancy Health Examination Project in Yunnan Province between 2010 and 2017 were used in this analysis. Information on women's background characteristics, pregnant history, disease history, physical examination, etc. were recorded. After their pre-pregnancy health examination, women were routinely followed up and any pregnancies and pregnancy outcomes were recorded. By using SPSS20.0 and SAS9.4 software, we employed description analysis, Chi-square tests, stratified analysis and multivariate logistic regression for data analysis.Results:A total of 174 782 pregnancies were included in this analysis, and the total incidence rate of stillbirths was 0.64% (1119/174 782). The incidence rate of stillbirths in the group of women who had a previous history of induced abortion (exposed group) was 0.83% (333/40 216), which was significantly higher than 0.58% (786/134 566) in the non-induced abortion group (unexposed group). Results of unconditional multivariate logistic regression analysis demonstrated that, compared with unexposed group, the risk of stillbirth in exposed group was higher in those with 1 and 2 or more induced abortions ( OR=1.22, 95% CI=1.05-1.41; OR=1.33, 95% CI=1.08-1.64). The risk of stillbirth was significant lower in women who conceived in 2011-2016 than in 2010 ( OR=0.66, 95% CI=0.51-0.85). Mother's ethnicity, age, education level, parity and body mass index (BMI) before pregnancy were significantly associated with the risk of stillbirth. Women's occupation, previous histories of premature birth, stillbirth and natural abortion were not associated with subsequent stillbirth. Conclusion:Induced abortion is associated with an increase of the risk of subsequent stillbirth. Mother's ethnicity, age, education level, parity and BMI are significantly associated with the risk of stillbirth. Overweight and obesity before pregnancy increase the risk of stillbirth.

Objective:To explore the association of induced abortion with subsequent stillbirth.Methods:The data collected from the National Free Pre-Pregnancy Health Examination Project in Yunnan Province between 2010 and 2017 were used in this analysis. Information on women's background characteristics, pregnant history, disease history, physical examination, etc. were recorded. After their pre-pregnancy health examination, women were routinely followed up and any pregnancies and pregnancy outcomes were recorded. By using SPSS20.0 and SAS9.4 software, we employed description analysis, Chi-square tests, stratified analysis and multivariate logistic regression for data analysis.Results:A total of 174 782 pregnancies were included in this analysis, and the total incidence rate of stillbirths was 0.64% (1119/174 782). The incidence rate of stillbirths in the group of women who had a previous history of induced abortion (exposed group) was 0.83% (333/40 216), which was significantly higher than 0.58% (786/134 566) in the non-induced abortion group (unexposed group). Results of unconditional multivariate logistic regression analysis demonstrated that, compared with unexposed group, the risk of stillbirth in exposed group was higher in those with 1 and 2 or more induced abortions ( OR=1.22, 95% CI=1.05-1.41; OR=1.33, 95% CI=1.08-1.64). The risk of stillbirth was significant lower in women who conceived in 2011-2016 than in 2010 ( OR=0.66, 95% CI=0.51-0.85). Mother's ethnicity, age, education level, parity and body mass index (BMI) before pregnancy were significantly associated with the risk of stillbirth. Women's occupation, previous histories of premature birth, stillbirth and natural abortion were not associated with subsequent stillbirth. Conclusion:Induced abortion is associated with an increase of the risk of subsequent stillbirth. Mother's ethnicity, age, education level, parity and BMI are significantly associated with the risk of stillbirth. Overweight and obesity before pregnancy increase the risk of stillbirth.

Objective:To explore the current status of HBV infection before pregnancy among rural childbearing age people in Yunnan province, find out the population at high risk and areas with high incidence and provide evidence for promoting pre-pregnancy aristogenesis and medical interventions for prevention of HBV infection.Methods:The subjects in the study were rural childbearing age people aged 18-49 who received the national free pre pregnancy eugenic health examination in Yunnan province during 2013-2017. Descriptive analysis was conducted for HBsAg positive rate and its difference among various characteristics. The SPSS 22.0 software was used for statistical analysis.Results:A total of 2 180 841 rural childbearing age people were surveyed, the HBsAg positive rate before pregnancy was 3.13%(68 314/2 180 841) in Yunnan. And the HBsAg positive rate was 3.56% (37 694/1 057 376) in men, higher than that in women (2.73%, 30 620/1 123 465). The HBsAg positive rate was highest in age group 41-49 years (3.77%, 3 126/82 931). The HBsAg positive rate was higher in minority ethnic group (3.77%, 27 974/742 518) than in Han ethnicity group (2.81%, 40 024/1 425 870). Moreover, the highest HBsAg positive rate of was 8.20%(851/10 378) in Yao ethnic group. The people with education level of primary education had the highest HBsAg positive rate (3.97%, 17 294/435 219). The HBsAg positive rate was highest in Xishuangbanna Dai autonomous prefecture (6.65%, 3 875/58 232) in Yunnan. Moreover, the HBsAg positive population in severe poor area (3.32%, 19 755/595 665) was higher than those in less poor area (3.17%, 29 750/939 101) or normal areas (2.91%, 18 809/646 075). There was significant difference in HBsAg positive rate among populations in different age groups, ethnic groups, education level groups, areas and economic level groups ( P<0.001). Conclusions:The HBsAg positive rate in rural childbearing age people in Yunnan was related to multi factors, including sex, age, ethnic group, education level, area and economic development level. The HBsAg positive rate was higher in men, older age and lower education level, minority ethnic group (especially in Yao ethnic group), from Xishuangbanna prefecture and the poor living conditions in childbearing age population.

Objective To determine the situation of contraceptive use and impact factors among reproductive-age women seeking abortion in Kunming which was in the southwest of China in order to provide information for improving contraceptive use. Methods A hospital-based study was conducted among 397 women of reproductive age, seeking abortion in hospitals of different levels in Kunming from June 2011 to December 2011. They were face to face interviewed by the trained investigators with the questionnaires. Results Among 397 women, 229 cases (57.7%) had experienced induced abortion. Abortion accounted for 61.7% of married women, and unmarried accounted for 39.3%. About 36.3%never used any contraceptives, and only 21.4%of respondents used contraceptives at every intercourse. The main contraceptive before this pregnancy was condom (68.9%) . The use of contraceptives was mainly decided by couple (73.4%) . Multivariate logistic regression analysis indicated that respondents' age, educational level and access to contraceptives in hospital were associated with the use of contraceptive. Conclusion Premarital pregnancy and low rate of contraception are the main reason for induced abortion. Fewer reproductive-age women seeking abortion use contraceptives. It is necessary to increase their awareness of contraception and abortion related knowledge, provide feasible contraceptive to enable women to avoid unwilling pregnancy. Further more, it is important to promote male involvement in contraception.