Intrauterine growth restriction(IUGR),which refers to the failure of the fetus to achieve ad-equate growth potential,is a common complication of pregnancy.The disease seriously affects fetal growth and development,increases the risk of fetal and neonatal complications and death,and easily causes adverse perina-tal outcomes such as fetal distress and neonatal asphyxia.Children with IUGR have a high risk of lifelong neu-rodevelopmental consequences such as cognitive deficits,cerebral palsy,behavioral problems,learning and con-centration difficulties.Currently,there is no definite treatment method to protect neonates with IUGR from adverse neurological consequences.Early and accurate identification and intervention to promote neurodevelop-ment are essential to improve poor outcomes in neonates with IUGR.In addition,IUGR can also affect blood flow in the fetal brain,change the structure of the ventricles,affect brain functions and change molecular dy-namics indicators in the brain.The purpose of this article is to summarize the progress of research on fetal neurodevelopment of IUGR in recent years,and to review how IUGR affects fetal neurodevelopment and the corresponding diagnostic monitoring methods,so as to provide new ideas for further determining the plan to improve the long-term poor neurological prognosis.

Objective:To explore the correlation between the total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio during pregnancy and the onset of gestational metabolic syndrome (GMS), as well as its association with pregnancy outcomes.Methods:Clinical data of 153 pregnant women diagnosed with GMS in the third trimester admitted to Women′s Hospital of Nanjing Medical University from January 2020 to December 2022 (observation group) were collected, and data of 153 healthy pregnant women (control group) were randomly selected for a comparative study. Indicators of the two groups were observed and compared. Multiple linear regression and restricted cubic spline analysis were used to analyze the correlation between TC/HDL-C in the first and second trimesters and metabolic indicators in the third trimester and GMS risk, respectively. According to the pregnancy outcomes of GMS pregnant women with different TC/HDL-C ratios, the association between TC/HDL-C ratio and preterm birth subtypes was analyzed.Results:There were statistically significant differences between the two groups in age, gestational week, pre-pregnancy body mass index (BMI), weight gain during pregnancy, abdominal circumference in the third trimester, whether to deliver vaginally, history of preterm birth, history of cesarean section, history of abortion, neonatal birth weight, and neonatal length (all P<0.05). There were statistically significant differences in blood pressure and BMI between the two groups in the second and third trimesters (all P<0.01). In the first trimester (gestational week <14 weeks), there were statistically significant differences in fasting plasma glucose (FPG), HDL-C, and TC/HDL-C ratio between the two groups (all P<0.05). In the second trimester (gestational weeks 14-27) and third trimester (gestational week ≥28 weeks), the levels of FPG, fasting insulin (FINS), triglyceride (TG), TC, low-density lipoprotein cholesterol (LDL-C), and TC/HDL-C ratio in the observation group were higher than those in the control group, while HDL-C was lower (all P<0.05). There were statistically significant differences between the two groups in postpartum abnormal blood pressure, abnormal BMI, abnormal glucose metabolism, and abnormal lipid metabolism (all P<0.05). After adjusting for age, gestational week, and BMI, first-trimester TC/HDL-C ratio was correlated with third-trimester FPG, systolic blood pressure, diastolic blood pressure, TG, TC, and HDL-C (all P<0.05); second-trimester TC/HDL-C ratio was correlated with third-trimester FPG, FINS, systolic blood pressure, diastolic blood pressure, TG, TC, HDL-C, and LDL-C (all P<0.05), and both were linearly related to third-trimester GMS risk ( Pfor trend<0.01). The TC/HDL-C ratio was positively correlated with the preterm birth rate ( RR>1). Conclusions:An increased TC/HDL-C ratio is closely related to the occurrence of GMS, which is prone to cause preterm birth and affect fetal growth and development.

Objective:To develop the Hypoglycemia Prevention Knowledge, Attitude and Practice Questionnaire for Homebound Elderly Patients with Diabetes Mellitus to inform the development of targeted interventions for caregivers.Methods:The first draft of the questionnaire was formed through literature analysis, group discussion, semi-structured interviews, Delphi expert consultation and pre-testing based on the theory of knowledge, attitude and practice. Convenience sampling was applied to select homebound elderly diabetic patients within the Shangcheng District of Hangzhou City from August to September 2022, and the questionnaire was subjected to item analysis, reliability test and exploratory factor analysis. Patients within Gongshu District of Hangzhou City were selected from October to November 2022 for questionnaire survey and validation factor analysis.Results:The questionnaire included 31 entries in three dimensions of knowledge, attitude, and practice. The content validity index was 0.96 at the questionnaire level and 0.83 to 1.00 at the entry level. The overall Cronbach's α coefficient for the questionnaire was 0.933, the folded reliability was 0.836, and the retest reliability was 0.913. The exploratory factor analysis cumulative variance contribution was 68.917% and the validation factor analysis showed a good model fit.Conclusions:The Hypoglycemia Prevention Knowledge, Attitude and Practice Questionnaire for Homebound Elderly Patients with Diabetes Mellitus is scientific and practical and can be used to investigate the hypoglycemia prevention knowledge, attitude and practice among homebound elderly diabetic patients.

Objective:To explore the correlation between the total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) ratio during pregnancy and the onset of gestational metabolic syndrome (GMS), as well as its association with pregnancy outcomes.Methods:Clinical data of 153 pregnant women diagnosed with GMS in the third trimester admitted to Women′s Hospital of Nanjing Medical University from January 2020 to December 2022 (observation group) were collected, and data of 153 healthy pregnant women (control group) were randomly selected for a comparative study. Indicators of the two groups were observed and compared. Multiple linear regression and restricted cubic spline analysis were used to analyze the correlation between TC/HDL-C in the first and second trimesters and metabolic indicators in the third trimester and GMS risk, respectively. According to the pregnancy outcomes of GMS pregnant women with different TC/HDL-C ratios, the association between TC/HDL-C ratio and preterm birth subtypes was analyzed.Results:There were statistically significant differences between the two groups in age, gestational week, pre-pregnancy body mass index (BMI), weight gain during pregnancy, abdominal circumference in the third trimester, whether to deliver vaginally, history of preterm birth, history of cesarean section, history of abortion, neonatal birth weight, and neonatal length (all P<0.05). There were statistically significant differences in blood pressure and BMI between the two groups in the second and third trimesters (all P<0.01). In the first trimester (gestational week <14 weeks), there were statistically significant differences in fasting plasma glucose (FPG), HDL-C, and TC/HDL-C ratio between the two groups (all P<0.05). In the second trimester (gestational weeks 14-27) and third trimester (gestational week ≥28 weeks), the levels of FPG, fasting insulin (FINS), triglyceride (TG), TC, low-density lipoprotein cholesterol (LDL-C), and TC/HDL-C ratio in the observation group were higher than those in the control group, while HDL-C was lower (all P<0.05). There were statistically significant differences between the two groups in postpartum abnormal blood pressure, abnormal BMI, abnormal glucose metabolism, and abnormal lipid metabolism (all P<0.05). After adjusting for age, gestational week, and BMI, first-trimester TC/HDL-C ratio was correlated with third-trimester FPG, systolic blood pressure, diastolic blood pressure, TG, TC, and HDL-C (all P<0.05); second-trimester TC/HDL-C ratio was correlated with third-trimester FPG, FINS, systolic blood pressure, diastolic blood pressure, TG, TC, HDL-C, and LDL-C (all P<0.05), and both were linearly related to third-trimester GMS risk ( Pfor trend<0.01). The TC/HDL-C ratio was positively correlated with the preterm birth rate ( RR>1). Conclusions:An increased TC/HDL-C ratio is closely related to the occurrence of GMS, which is prone to cause preterm birth and affect fetal growth and development.

Objective:To develop the Hypoglycemia Prevention Knowledge, Attitude and Practice Questionnaire for Homebound Elderly Patients with Diabetes Mellitus to inform the development of targeted interventions for caregivers.Methods:The first draft of the questionnaire was formed through literature analysis, group discussion, semi-structured interviews, Delphi expert consultation and pre-testing based on the theory of knowledge, attitude and practice. Convenience sampling was applied to select homebound elderly diabetic patients within the Shangcheng District of Hangzhou City from August to September 2022, and the questionnaire was subjected to item analysis, reliability test and exploratory factor analysis. Patients within Gongshu District of Hangzhou City were selected from October to November 2022 for questionnaire survey and validation factor analysis.Results:The questionnaire included 31 entries in three dimensions of knowledge, attitude, and practice. The content validity index was 0.96 at the questionnaire level and 0.83 to 1.00 at the entry level. The overall Cronbach's α coefficient for the questionnaire was 0.933, the folded reliability was 0.836, and the retest reliability was 0.913. The exploratory factor analysis cumulative variance contribution was 68.917% and the validation factor analysis showed a good model fit.Conclusions:The Hypoglycemia Prevention Knowledge, Attitude and Practice Questionnaire for Homebound Elderly Patients with Diabetes Mellitus is scientific and practical and can be used to investigate the hypoglycemia prevention knowledge, attitude and practice among homebound elderly diabetic patients.