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Objectives: This study aimed to investigate factors associated with sleep quality in healthcare students and to determine whether depressive and anxiety symptoms may explain some of the associations between sleep quality and self-rated health. Study design: This is a cross-sectional study at wave one. Methods: A total of 637 healthcare students were recruited via a stratified random sampling method in Hangzhou, China. The Sleep Quality Questionnaire (SQQ) and the four-item Patient Health Questionnaire (PHQ-4) were used to assess sleep quality, depressive, and anxiety symptoms, respectively. Self-rated health was assessed via a self-developed questionnaire of both physical and psychological health. Structural equation modeling was used to examine the direct and indirect effects of sleep quality on self-rated health through depressive and anxiety symptoms. Results: Students engaged in part-time employment (p = 0.022), who had poor perceived employment prospects (p = 0.009), and who did not participate in recreational sports (p = 0.008) had worse sleep quality. Structural equation modeling revealed a significant total effect of sleep quality on self-rated health (b = 0.592, p < 0.001), a significant direct effect of both sleep quality and depressive and anxiety symptoms on self-rated health (b = 0.277, 95% CI: 0.032–0.522), and a significant indirect effect of sleep quality on self-rated health through depressive and anxiety symptoms (b = 0.315, 95% CI: 0.174–0.457). Conclusions: Depressive and anxiety symptoms partially explain the association between sleep quality and self-rated health. Intervening upon sleep quality, depressive, and anxiety symptoms may bolster the self-rated health of healthcare students. [ABSTRACT FROM AUTHOR]

Background: A retrospective cohort study was conducted to collect the data of pregnant women who received hospital delivery in Hangzhou Women's Hospital from January 2018 to December 2020, and who participated in the second trimester (15–20+6 weeks) of free beta human chorionic gonadotropin (free β-hCG). And the study was conducted to explore the relationship between maternal serum free β-hCG and adverse pregnancy outcomes (APO). Methods: We retrospectively analyzed the clinical data of 1,978 women in the elevated maternal serum free β-hCG group (free β-hCG ≥ 2.50 multiples of the median, MoM) and 20,767 women in the normal group (0.25 MoM ≤ free β-hCG < 2.50 MoM) from a total of 22,745 singleton pregnancies, and modified Poisson regression analysis was used to calculate risk ratios (RRs) and 95% confidence intervals (CI) of the two groups. Results: The gravidity and parity in the elevated free β-hCG group were lower, and the differences between the groups were statistically significant (all, P < 0.05). The risks of polyhydramnios, preeclampsia, and hyperlipidemia, were increased in women with elevated free β-hCG levels (RRs: 1.996, 95% CI: 1.322–3.014; 1.469, 95% CI: 1.130–1.911 and 1.257, 95% CI: 1.029–1.535, respectively, all P < 0.05), intrauterine growth restriction (IUGR) and female infants were also likely to happen (RRs = 1.641, 95% CI: 1.103–2.443 and 1.101, 95% CI: 1.011–1.198, both P < 0.05). Additionally, there was an association between elevated AFP and free β-hCG levels in second-trimester (RR = 1.211, 95% CI: 1.121–1.307, P < 0.001). Conclusions: APOs, such as polyhydramnios, preeclampsia, and hyperlipidemia, were increased risks of elevated free β-hCG levels, IUGR and female infants were also likely to happen. Furthermore, there was an association between elevated AFP levels and elevated free β-hCG levels in second-trimester. We recommend prenatal monitoring according to the elevated maternal serum free β-hCG level and the occurrence of APO. [ABSTRACT FROM AUTHOR]