Journal of Obstetrics and Gynaecology Research最新文献_第3页

Maternal Renal Function During Pregnancy and the Early Postpartum Period in Normotensive and Hypertensive Pregnancies 正常妊娠和高血压妊娠期间孕妇肾功能及产后早期。

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-12-17 DOI: 10.1111/jog.70172

Takafumi Ushida, Satoru Katsuki, Kazuya Fuma, Sho Tano, Seiko Matsuo, Shigeru Yoshida, Mamoru Yamashita, Hiroaki Kajiyama, Tomomi Kotani

Aim

We aimed to assess renal function trends during pregnancy and the early postpartum period and establish trimester-specific reference ranges for maternal renal function parameters in Japan, including comparisons with pregnancies complicated by hypertensive disorders of pregnancy (HDP) and preeclampsia.

Methods

This multicenter retrospective study used data collected from 12 primary maternity care units in Japan between 2011 and 2018. Serum creatinine and blood urea nitrogen (BUN) levels were analyzed from early pregnancy to postpartum Day 7 in 17 460 women with uncomplicated term pregnancies (37^0/7–41^6/7 weeks of gestation) and 1460 women with HDP. Additionally, 17 460 non-pregnant women matched for age, body weight, and height were included in the study.

Results

Serum creatinine and BUN levels were lower in women with uncomplicated pregnancies than in non-pregnant women and reached their lowest levels in the second trimester. The 97.5th percentile serum creatinine value was 0.52 mg/dL in the second trimester, compared with 0.82 mg/dL in non-pregnant women. The median serum creatinine levels in uncomplicated pregnancies were approximately 30% lower than those in non-pregnant women. Serum creatinine levels began to normalize during the postpartum period but did not return to baseline non-pregnant status by Day 7. In women with HDP and preeclampsia, serum creatinine levels increased in the late third trimester and peaked on postpartum Day 1; in 7.0% of women with preeclampsia, they exceeded 1.0 mg/dL.

Conclusion

We determined reference ranges for maternal renal markers in a Japanese cohort study. Maternal renal function shows dynamic alterations from the non-pregnant state through pregnancy to the postpartum period.

目的：我们旨在评估日本孕妇孕期和产后早期的肾功能变化趋势，并建立孕妇孕期特异性肾功能参数参考范围，包括与合并妊娠高血压疾病（HDP）和先兆子痫的孕妇进行比较。方法：这项多中心回顾性研究使用了2011年至2018年间从日本12个初级产妇保健单位收集的数据。分析17460例无并发症足月妊娠（妊娠370/7-416/7周）妇女和1460例HDP妇女从妊娠早期到产后第7天的血清肌酐和血尿素氮水平。此外，研究还包括17460名年龄、体重和身高相符的未怀孕妇女。结果：无并发症妊娠妇女血清肌酐和BUN水平低于非妊娠妇女，并在妊娠中期达到最低水平。在妊娠中期，97.5%的血清肌酐值为0.52 mg/dL，而非妊娠妇女为0.82 mg/dL。无并发症妊娠妇女的中位血清肌酐水平比非妊娠妇女低约30%。血清肌酐水平在产后开始恢复正常，但在第7天没有恢复到基线非妊娠状态。在患有HDP和子痫前期的妇女中，血清肌酐水平在妊娠晚期升高，并在产后第1天达到峰值；在7.0%的先兆子痫女性中，它们超过了1.0 mg/dL。结论：我们在日本的一项队列研究中确定了母体肾脏标志物的参考范围。从非妊娠到妊娠至产后，母体肾功能呈现动态变化。

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引用次数: 0

Obstetric Outcome After Trachelectomy for Cervical Cancer Without Uterine Artery Preservation 不保留子宫动脉的宫颈癌气管切除术后的产科结局。

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-12-15 DOI: 10.1111/jog.70170

Atsuhiko Sakai, Hideaki Yahata, Takako Sugiura, Kazushige Nakahara, Ryo Kiyokoba, Nobutaka Hachisuga, Saki Kido, Ichiro Onoyama, Kazuo Asanoma, Kiyoko Kato

Aim

A trachelectomy is a fertility-preserving surgery that is performed for cervical cancer. Transecting the uterine arteries (UAs) during abdominal radical trachelectomy (ART) or abdominal modified radical trachelectomy (AmRT) has the advantage of simplifying other surgical procedures. However, the effect of UA transection on subsequent pregnancy outcome is unknown. The purpose of this study was to clarify the pregnancy outcomes in post-RT pregnancies in which the UAs were not preserved.

Methods

This was a retrospective cohort study of electronic case records involving pregnant women after ART and AmRT, which were managed at Kyushu University Hospital from January 2008 to July 2024.

Results

Complications that often occur in pregnancies after ART and AmRT, such as antepartum bleeding, premature birth, and preterm premature rupture of membranes, were noted to the same degree after UA-sparing ART. In contrast, abnormalities related to placental attachment, such as placenta previa and adherent placenta, occurred at a high rate after UA transection. Furthermore, compared to pregnancies with normal placentation, pregnancies with abnormal placentation had more blood loss during cesarean section (1150 g vs. 2289 g; p = 0.0004) and required blood transfusion more frequently (5.7% vs. 64.2%; p < 0.0001).

Conclusions

Although ART and AmRT with UA transection may increase the risk of abnormal placentation and bleeding-related complications during cesarean section, UA transection may not increase the risk of major obstetric complications after ART and AmRT. Therefore, UA transection should be considered during ART and AmRT due technical advantages.

目的：气管切除术是一种保留生育能力的手术，适用于宫颈癌。在腹部根治性气管切除术（ART）或腹部改良根治性气管切除术（AmRT）中横切子宫动脉（UAs）具有简化其他手术程序的优点。然而，UA横断对随后妊娠结局的影响尚不清楚。本研究的目的是阐明未保留子宫内膜的rt后妊娠的妊娠结局。方法：对2008年1月至2024年7月在九州大学医院接受ART和AmRT治疗的孕妇电子病历进行回顾性队列研究。结果：ART和AmRT术后妊娠常出现的并发症，如产前出血、早产、早产胎膜早破等，在保ua ART后出现的程度相同。相反，与胎盘附着相关的异常，如前置胎盘和附着胎盘，在UA横断后发生率很高。此外，与正常胎盘妊娠相比，异常胎盘妊娠剖宫产时出血量更多（1150 g对2289 g， p = 0.0004），需要输血次数更多(5.7%对64.2%；p结论：虽然ART和AmRT合并UA横断可能增加剖宫产时胎盘异常和出血相关并发症的风险，但UA横断可能不会增加ART和AmRT后主要产科并发症的风险。因此，由于技术优势，在ART和AmRT中应考虑UA横断。

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引用次数: 0

Effect of Genital Tract Injury During Consensual Sexual Intercourse on FSFI in Women? 两厢情愿性交时生殖道损伤对女性FSFI的影响？

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-12-15 DOI: 10.1111/jog.70163

Sule Atalay Mert, Berna Dilbaz, Tugba Agbal, Caner Kose, Yaprak Engin Ustun

Aim

Contrary to popular belief, there is evidence that GTI can occur not only in women who have had their first sexual intercourse but also in married women or those with children during CSI. The aim is to evaluate sexual function with Female Sexual Function Index (FSFI) scores before and after surgical repair of genital tract injury (GTI) that occurred during consensual sexual intercourse (CSI).

Methods

All women aged 18–45 who underwent surgical repair for GTI due to CSI at the Gynecology Clinic between January 2016 and 2020 were included in this retrospective study. Patients were routinely followed up for 1 year after surgery. All patients received counseling for sexual dysfunction following the surgical repair. Only patients with regular sexual activity had their FSFI scores evaluated both before and after surgery.

Results

Out of 45 patients, the mean age was 29.36 ± 8.24 years. Half of the patients (53.1%, 23/45) were between 20 and 40 years old. Among them, 73.3% (33/45) were married, and 72.73% (24/33) had been married for more than 1 year. A significant increase in FSFI scores was observed in all patients after surgery (p < 0.05), along with counseling for sexual dysfunction. However, all patients had preoperative and postoperative FSFI scores below 26.

Conclusion

Low FSFI scores and the improvement observed after sexual counseling highlight its importance. Therefore, clinicians should pay attention to providing sexual counseling alongside GTI repair and ensure they inform married women or those with children about its benefits.

目的：与普遍的看法相反，有证据表明，GTI不仅可能发生在第一次性交的妇女身上，也可能发生在CSI期间已婚妇女或有孩子的妇女身上。目的是用女性性功能指数（FSFI）评分来评估在双方同意的性交（CSI）中发生的生殖道损伤（GTI）手术修复前后的性功能。方法：2016年1月至2020年1月期间在妇科诊所因CSI进行GTI手术修复的所有18-45岁女性纳入本回顾性研究。术后常规随访1年。所有患者在手术修复后均接受了性功能障碍咨询。只有常规性行为的患者在手术前和手术后进行FSFI评分评估。结果：45例患者平均年龄29.36±8.24岁。一半的患者（53.1%,23/45）年龄在20 ~ 40岁之间。其中，73.3%（33/45）已婚，72.73%（24/33）已婚1年以上。所有患者术后FSFI评分均显著升高(p)。结论：低FSFI评分和性咨询后观察到的改善突出了其重要性。因此，临床医生应注意在GTI修复的同时提供性咨询，并确保他们告知已婚妇女或有孩子的妇女其益处。

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引用次数: 0

When a Journal Says, “I Am JOGR.” 当日记说：“我是JOGR。”

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-12-15 DOI: 10.1111/jog.70173

Shigeki Matsubara

引用次数: 0

Risk Factors for Biochemical Pregnancy in Women With Recurrent Pregnancy Loss: A Retrospective Cohort Study 复发性妊娠丢失妇女生化妊娠的危险因素：一项回顾性队列研究。

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-12-14 DOI: 10.1111/jog.70152

Huyan Huo, Ning Hu, Yanting Yang, Lin Liu, Fangxiang Mu, Fang Wang

Objective

To identify determinants of biochemical pregnancy (BP) in women with recurrent pregnancy loss (RPL) and develop a predictive nomogram.

Methods

This retrospective study included 621 RPL patients (207 with BP, 414 with clinical pregnancy) at Lanzhou University Second Hospital (2019–2022). Clinical data were compared between groups. Univariate and multivariate logistic regression identified BP predictors, and a nomogram was developed. Model performance was assessed via AUC and calibration curves.

Results

≥ 3 prior losses, assisted reproductive technology (ART), positive antinuclear antibody (ANA), positive lupus anticoagulant (LA), and elevated fasting glucose were independent BP risk factors (OR > 1, p < 0.05), while positive blocking antibody was protective (OR = 0.468, p = 0.029). The nomogram showed an AUC of 0.671 (95% CI: 0.627–0.716), with a well-fitted calibration curve (Hosmer–Lemeshow χ² = 8.426, p = 0.393).

Conclusion

This study developed a nomogram model incorporating multiple influential factors, thereby providing a robust tool for the clinical assessment of BP risk in RPL patients. Furthermore, it delivers valuable scientific insights to inform subsequent diagnostic approaches, therapeutic strategies, and preventative measures.

目的：探讨复发性妊娠丢失（RPL）患者生化妊娠（BP）的影响因素，并建立预测指标图。方法：对2019-2022年兰州大学第二医院621例RPL患者进行回顾性研究，其中BP患者207例，临床妊娠患者414例。比较两组临床资料。单变量和多变量逻辑回归确定了BP预测因子，并建立了nomogram。通过AUC和校准曲线评估模型性能。结果：既往损失≥3次、辅助生殖技术（ART）、抗核抗体（ANA）阳性、狼疮抗凝剂（LA）阳性、空腹血糖升高是独立的BP危险因素（OR >1, p 2 = 8.426, p = 0.393）。结论：本研究建立了一个包含多种影响因素的nomogram模型，为RPL患者BP风险的临床评估提供了一个可靠的工具。此外，它还提供了有价值的科学见解，为后续的诊断方法、治疗策略和预防措施提供信息。

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引用次数: 0

Effect of Postnatal Care Place on Health Statuses of Mothers and Infants and Childrearing Support at 4 Months: A Population-Based Evaluation of Satogaeri, a Japanese Postnatal Care Tradition 产后护理场所对4个月时母婴健康状况和育儿支持的影响：日本产后护理传统Satogaeri的人群评价

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-12-14 DOI: 10.1111/jog.70171

Hayato Yamana, Chikako Honda, Hiroshige Matsumoto, Riho Iwasaki-Motegi, Yuka Sumikawa, Kyoko Yoshioka-Maeda

Aim

To evaluate the effect of satogaeri, a Japanese custom of mothers returning to their parents' home for perinatal and postnatal support, on the health statuses of mothers and infants and the child-rearing support from the surrounding environment.

Methods

We conducted a retrospective cohort study of all pregnancies reported at a city in Tokyo in 2020. Propensity score matching was performed between expectant mothers with the intention to have satogaeri (satogaeri group) and those without (residence group), with age, birth order, place of their parents' residence, and other psychosocial conditions at pregnancy reporting as variables. Follow-up data on mothers and infants from the newborns' 4-month checkup were compared.

Results

We analyzed 1559 expectant mothers, including 399 who had satogaeri. Follow-up data of 270 and 314 in the satogaeri and residence groups, respectively, were compared after matching. Satogaeri was associated with neither infants' 4-month checkup results, including pediatrician assessments (no abnormality: satogaeri group 54% vs. residence group 46%, p = 0.342), nor mothers' health conditions, including perceptions of parenting difficulties (12% vs. 13%, p = 0.749). However, satogaeri was associated with increased support from the mothers' families (65% vs. 55%, p = 0.013) and decreased support from neighbors (0% vs. 3%, p = 0.013). More mothers in the satogaeri group tended to lack knowledge of the city's childcare services (16% vs. 11%, p = 0.052).

Conclusions

Satogaeri was not associated with the health status of mothers and infants at the 4-month checkup. The possible effects of satogaeri suggest the necessity for continuous support for families that select satogaeri.

目的：评价日本母亲回娘家接受围产期和产后支持的习俗satogaeri对母婴健康状况和周围环境的育儿支持的影响。方法：我们对2020年东京某城市报告的所有妊娠进行了回顾性队列研究。在有意使用萨托加利的孕妇（萨托加利组）和不打算使用萨托加利的孕妇（居住地组）之间进行倾向评分匹配，将年龄、出生顺序、父母居住地和其他怀孕时的社会心理状况作为变量进行报告。对新生儿4个月检查时母亲和婴儿的随访数据进行比较。结果：我们分析了1559名孕妇，其中399名患有satogaeri。在配对后，分别比较了270名和314名萨托加里组和居住地组的随访数据。Satogaeri与婴儿4个月的检查结果无关，包括儿科医生的评估（无异常：Satogaeri组54%对居住组46%，p = 0.342），也与母亲的健康状况无关，包括对育儿困难的看法（12%对13%，p = 0.749）。然而，satogaeri与母亲家庭的支持增加（65%对55%，p = 0.013）和邻居的支持减少（0%对3%，p = 0.013）有关。satogaeri组中更多的母亲往往缺乏对城市托儿服务的了解（16%对11%，p = 0.052）。结论：Satogaeri与母亲和婴儿在4个月体检时的健康状况无关。萨托加利可能产生的影响表明，有必要为选择萨托加利的家庭提供持续的支持。

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引用次数: 0

Letter to “Fertility-Sparing Trachelectomy With Sentinel Node Mapping in Early-Stage Cervical Cancer: Oncological Safety and Obstetric Outcomes From a Single-Institution Study” 致“早期宫颈癌保留生育能力的前哨淋巴结切除术：来自单一机构研究的肿瘤安全性和产科结果”的信。

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-12-14 DOI: 10.1111/jog.70165

Yi Xuan, Min Liu, Lei Gao

引用次数: 0

Perivascular Epithelioid Cell Neoplasm of the Uterus: A Case Report 子宫血管周围上皮样细胞瘤1例报告。

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-12-12 DOI: 10.1111/jog.70169

Lazar Nejković, Ana Đorđević, Smiljana Donić, Marijana Cimbaljević, Aleksandar Rakić

Perivascular epithelioid cell neoplasms (PEComas) represent a rare category of mesenchymal tumors, with the gastrointestinal and gynecological systems being the most frequently affected sites. A 46-year-old patient was referred to our clinic due to prolonged menstrual bleeding, without additional symptoms. Histopathological analysis of the specimens collected through exploratory curettage demonstrated the presence of uterine PEComa, characterized by positive immunohistochemical markers including HMB-45, TFE3, Cathepsin K, and ER. The patient underwent laparoscopic hysterectomy with bilateral adnexectomy. No recurrence of the disease was observed during the subsequent examinations. This case underscores a common diagnostic pitfall: the absence of a distinct mass on imaging. It highlights that a PEComa can present with only non-specific endometrial thickening, making preoperative diagnosis exceptionally challenging and reliant on histopathology. Laparoscopic surgery in our case provided the patient with quick recovery and a less invasive approach with satisfying results and the absence of recurrent disease during a one-year follow-up period. Future multicenter studies should facilitate a deeper comprehension and undoubtedly lead to a more effective management of a rare and enigmatic condition that is uterine PEComa.

血管周围上皮样细胞肿瘤（PEComas）是一类罕见的间充质肿瘤，胃肠道和妇科系统是最常见的受累部位。患者46岁，因经期出血时间延长，无其他症状。通过探查性刮取标本的组织病理学分析显示存在子宫PEComa，其特征是免疫组织化学标志物包括HMB-45， TFE3， Cathepsin K和ER阳性。患者行腹腔镜子宫切除术并双侧附件切除术。在随后的检查中未观察到疾病复发。本病例强调了一个常见的诊断缺陷：影像学上没有明显的肿块。它强调PEComa可以只呈现非特异性子宫内膜增厚，使得术前诊断非常具有挑战性和依赖于组织病理学。在我们的病例中，腹腔镜手术为患者提供了快速恢复和微创的方法，结果令人满意，并且在一年的随访期间没有复发疾病。未来的多中心研究应促进对子宫PEComa这一罕见而神秘的疾病的更深入的理解和更有效的治疗。

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引用次数: 0

Short-Term Indomethacin Use Reduces Preterm Premature Rupture of Membranes After Fetoscopic Laser Surgery for Twin-to-Twin Transfusion Syndrome 短期使用吲哚美辛减少胎镜激光手术治疗双胎输血综合征后胎膜过早破裂。

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-12-12 DOI: 10.1111/jog.70166

Mayu Tachihara, Mayumi Takano, Junya Sakuma, Sumito Nagasaki, Masahiko Nakata

Aims

Preterm labor is a severe problem after fetoscopic laser surgery (FLS), which often requires multiple tocolytic agents. We investigated the utility of indomethacin as a tocolytic agent after FLS.

Methods

This study included monochorionic diamniotic twin pregnancies who underwent FLS for twin-to-twin transfusion syndrome at our hospital from 2015 to 2023. Medical records of all cases were reviewed retrospectively. Since indomethacin has been used routinely since 2020, all cases were divided into the control group (without indomethacin) and IND group (with indomethacin). Indomethacin was administered until 48 h postoperatively. This study was approved by the ethics committee of our hospital, and written informed consent for indomethacin use was obtained from all patients.

Results

Fifty-seven patients were in the IND group and 97 were in the control group. No fetal adverse effects were observed in the IND group. Median gestational age at delivery did not differ between the groups (p = 0.670). pPROM within 14 days after FLS occurred more frequently in the control group (8.2%) than in the IND group (0%) (p = 0.022). The IND group had a shorter median duration of magnesium sulfate use (3 days [2–12]) than the control group (8 days [2–81]) (p < 0.001), and less frequent use of nifedipine (42% vs. 80%, p < 0.001).

Conclusion

The short-term administration of indomethacin was not associated with fetal adverse events, and it may be useful in postoperative management by reducing immediate postoperative pPROM and the need for other tocolytic agents.

目的：早产是胎儿镜激光手术（FLS）后的一个严重问题，通常需要多种抗胎药。我们探讨了吲哚美辛作为FLS后的抗胎药的效用。方法：本研究纳入2015年至2023年在我院因双胎输血综合征接受FLS治疗的单绒毛膜双羊双胎妊娠患者。回顾性分析所有病例的医疗记录。由于自2020年起常规使用吲哚美辛，所有病例分为对照组（不使用吲哚美辛）和IND组（使用吲哚美辛）。术后48 h给予吲哚美辛。本研究经我院伦理委员会批准，所有患者均获得了使用吲哚美辛的书面知情同意书。结果：IND组57例，对照组97例。IND组未见胎儿不良反应。分娩时中位胎龄组间差异无统计学意义（p = 0.670）。FLS后14天内pPROM的发生率在对照组（8.2%）高于IND组（0%）（p = 0.022）。IND组使用硫酸镁的中位时间（3天[2-12]）短于对照组（8天[2-81]）(p结论：短期给药吲哚美辛与胎儿不良事件无关，可能有助于术后治疗，减少术后即刻pPROM和对其他溶栓药物的需求。

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引用次数: 0

Factors Affecting Sleep Quality Among Pregnant Women: A Propensity Score-Matched Analysis 影响孕妇睡眠质量的因素：倾向评分匹配分析。

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-12-11 DOI: 10.1111/jog.70167

Yinxia Zheng, Tian Chen, Reyila Yalihong, Moli Duan

Objective

To assess sleep quality in pregnant women and analyze its influencing factors based on lifestyle, stress levels, physical activity, and other relevant aspects.

Methods

From August 2022 to July 2024 in Urumqi, Xinjiang, a random sampling method was used to assess sleep quality using the pittsburgh sleep quality index (PSQI). General demographic characteristics were collected from 3508 pregnant women. A 1:1 propensity score matching method was used to match participants with good and poor sleep quality, resulting in 1402 pregnant women in each group. The factors influencing sleep quality were analyzed using least absolute shrinkage and selection operator-logistic regression.

Results

Logistic regression analysis revealed that higher monthly income, no history of abortion, and lower exposure to passive smoking before pregnancy were protective factors for sleep quality, while high stress levels and conception via ART (assisted reproductive technology) were identified as risk factors.

Conclusion

Stress and lifestyle habits significantly affect the sleep quality of pregnant women in Urumqi, Xinjiang. Reducing psychological stress through health education and encouraging the development of healthy behavioral habits potentially enhance sleep outcomes. However, due to the regional specificity of the sample, these findings should not be generalized to pregnant women in other regions with different ethnic, cultural, or environmental characteristics.

目的：从生活方式、压力水平、体力活动等方面评价孕妇睡眠质量，并分析其影响因素。方法：2022年8月至2024年7月，在新疆乌鲁木齐市采用随机抽样方法，采用匹兹堡睡眠质量指数（PSQI）评价睡眠质量。收集3508名孕妇的一般人口统计学特征。采用1:1的倾向评分匹配方法，将睡眠质量好的和睡眠质量差的参与者进行匹配，每组1402名孕妇。采用最小绝对收缩法和选择算子logistic回归法对影响睡眠质量的因素进行分析。结果：Logistic回归分析显示，较高的月收入、无流产史和较低的孕前被动吸烟暴露是睡眠质量的保护因素，而高压力水平和通过辅助生殖技术受孕是睡眠质量的危险因素。结论：压力和生活习惯对新疆乌鲁木齐市孕妇睡眠质量有显著影响。通过健康教育和鼓励养成健康的行为习惯来减少心理压力可能会提高睡眠质量。然而，由于样本的区域特异性，这些发现不应推广到其他具有不同种族、文化或环境特征的地区的孕妇。

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引用次数: 0