Trajectory of gestational weight gain is related to birthweight: The TAWS cohort study in China.

Few studies have reported the timing and amount of gestational weight gain (GWG) to prevent large-for-gestational-age (LGA) or small-for-gestational-age (SGA). This study aimed to evaluate the association of GWG velocity in each trimester with LGA or SGA based on data from the Taicang and Wuqiang cohort study (TAWS, n = 2008). We used a linear mixed model to evaluate the association of trimester-specific GWG velocity with birthweight categories and stratified by prepregnancy body mass index category and parity. For normal-weight pregnant women, mothers with LGA births had higher GWG velocities than mothers with appropriate-for-gestational-age (AGA) births in the first trimester (0.108 vs. 0.031 kg/week, p < 0.01), second trimester (0.755 vs. 0.631 kg/week, p < 0.01) and third trimester (0.664 vs. 0.594 kg/week, p < 0.01); in contrast, mothers with SGA births had lower GWG velocities than mothers with AGA births in the second trimester (0.528 vs. 0.631 kg/week, p < 0.01) and third trimester (0.541 vs. 0.594 kg/week, p < 0.01). For normal-weight pregnant women with AGA births, multiparous women had lower GWG velocities than primiparous women in the second (0.602 vs. 0.643 kg/week, p < 0.01) and third trimesters (0.553 vs. 0.606 kg/week, p < 0.01). Therefore, for normal-weight women, LGA prevention would begin in early pregnancy and continue until delivery and the second and third trimesters may be critical periods for preventing SGA; in addition, among normal-weight pregnant women with AGA births, multiparous women tend to have lower weight gain velocities than primiparous women.

[Changing trend of children's malnutrition and anemia rate from 2009 to 2015 in Taicang City, Jiangsu Province].

OBJECTIVE: To analyze the changing trend of children's malnutrition and anemia rate in Taicang City, Jiangsu Province from 2009 to 2015. METHODS: Data of medical examination on children under 3 was retrived from Electronic Health Care Records in Taicang, Jiangsu, and children's malnutrition and anemia rates were assessed based on WHO children's growth standard in 2006 and anemia diagnosis standard in 2001. The differences of children's malnutrition and anemia rates from 2009 to 2015 were analyzed based on the data. The Mantel-Haenszel Estimation Method was used to standardize themalnutrition rate and the anemia rate. Mantel-Haenszel Chi-square test was used to compare the differences of count data. RESULTS: The average WAZ, HAZ and WHZ scores were 0. 51, 0. 23 and 0. 56, and the average rates of low weight, stunting, wasting, overweight and obesity were 0. 65%, 1. 54%, 0. 56%, 6. 37% and 1. 03%, respectively. The rates of low weight, wasting, overweight and obesity remained stable from 2009 to 2015. The overweight rate increased from 5. 84% in 2009 to 6. 99% in2012, and dropped to 6. 12% in 2015( MH χ~2= 5. 41, P < 0. 05). The boys had a higher malnutrition rate than the girls, and the migrant children had worse conditions in stunting, overweight and obesity than local children. The anemia rate in children under 3 declined from 24. 02% in 2009 to 9. 25% in 2015( Cochran-Armitage Z = 29. 41, P < 0. 05). The boys had a higher anemia rate than the girls, and the local children had a higher anemia rate than the migrant children. CONCLUSION: The growth status of children under 3 in Taicang from 2009 to 2015 is better than the WHO reference standards. The overweight rates increase from 2009 to 2012 and decline from 2012 to 2015. The anemia rate in children decline from 2009 to 2015. This study indicates that controlling the high overweight rate and high anemia rate in young children under 3 are two predominating working directions in Taicang, Jiangsu.

Cohort profile: the Taicang and Wuqiang mother-child cohort study (TAWS) in China.

PURPOSE: The Taicang and Wuqiang cohort study (TAWS) was established to examine the association between early-life nutrition and children's health, and to explore the potential roles of maternal health, metabolites and microbiota in children's health in two different regions of China. PARTICIPANTS: A total of 7041 mother-child pairs were recruited during early pregnancy (n=4035, 57.3%) or delivery phase (n=3006, 42.7%) from health centres or hospitals in Taicang and Wuqiang. Mother-child pairs were followed up three times during pregnancy, once during delivery, and 7-10 times in the 3 years after delivery. Questionnaires were used to collect data on diet, supplementary intake, physical activity, depression scale, disease occurrence, feeding practice and development quotient of children. Anthropometric measurements of mothers and their children were assessed at each visit. Pregnancy outcomes were extracted from medical records. Biospecimens were collected and stored, including venous blood, cord blood, urine, stool, breast milk, cord and placenta. FINDINGS TO DATE: Data from the TAWS cohort showed different baseline characteristics of participants at the two sites of TAWS. Abnormal metabolism occurred among newborns whose mothers were diagnosed with gestational diabetes mellitus. Maternal serum folic acid above 14.5 ng/mL at early pregnancy was associated with a reduced risk of delivering small-for-gestational-age newborns. FUTURE PLANS: The association between maternal nutrition and the health of offspring will be examined at various follow-up visits. Biomarkers will be analysed to assess the associations between early-life nutrition and child development, immunity and health. Strategic recommendations for optimal infant feeding practices, obesity prevention and routine healthcare items will be developed and proposed based on the findings from the study. Children in this prospective cohort study will be followed up once a year until age 12 years to further examine the relationships between early-life nutrition and children's long-term development and health.