Pregnancy Loss in Relation to the Risks of Female-Specific Cancers in a Population-Based Cohort and Mendelian Randomization Study - China, 2004-2017.

What is already known about this topic?: Limited evidence exists regarding the relationship between pregnancy loss and female-specific cancers within the Chinese population from prospective cohort studies. What is added by this report?: Terminations were associated with a 13% lower risk of endometrial cancer, whereas stillbirths were related to an 18% higher risk of cervical cancer. Rural residents with a history of pregnancy loss experienced a 19% and 38% increased risk of breast and cervical cancers, respectively, compared to their urban counterparts. Moreover, a positive graded relationship between live births and pregnancy loss on cervical cancer was observed. What are the implications for public health practice?: This study has significant implications for identifying women at an increased risk for breast and genital cancers and contributes to the development of effective public health strategies for female cancer prevention. Future research on reproductive history, particularly in rural areas, should be given priority in efforts to improve female cancer screening and early detection.

Pre-pregnancy body mass index and risk of maternal or infant complications with gestational diabetes mellitus as a mediator: A multicenter, longitudinal cohort study in China.

AIMS: We explored the complex relationships between pre-pregnancy body mass index (pBMI) and maternal or infant complications and the mediating role of gestational diabetes mellitus (GDM) in these relationships. METHODS: Pregnant women from 24 hospitals in 15 different provinces of China were enrolled in 2017 and followed through 2018. Propensity score-based inverse probability of treatment weighting, logistic regression, restricted cubic spline models, and causal mediation analysis were utilized. In addition, the E-value method was used to evaluate unmeasured confounding factors. RESULTS: A total of 6174 pregnant women were finally included. Compared to women with a normal pBMI, obese women had a higher risk for gestational hypertension (odds ratio [OR] = 5.38, 95% confidence interval [CI]: 3.48-8.34), macrosomia (OR = 2.65, 95% CI: 1.83-3.84), and large for gestational age (OR = 2.05, 95% CI: 1.45-2.88); 4.73% (95% CI: 0.57%-8.88%), 4.61% (95% CI: 0.51%-9.74%), and 5.02% (95% CI: 0.13%-10.18%) of the associations, respectively, were mediated by GDM. Underweight women had a high risk for low birth weight (OR = 1.42, 95% CI: 1.15-2.08) and small for gestational age (OR = 1.62, 95% CI: 1.23-2.11). Dose-response analyses indicated that 21.0 kg/m2 may be the appropriate tipping point pBMI for risk for maternal or infant complications in Chinese women. CONCLUSION: A high or low pBMI is associated with the risk for maternal or infant complications and partly mediated by GDM. A lower pBMI cutoff of 21 kg/m2 may be appropriate for risk for maternal or infant complications in pregnant Chinese women.

Multi-Stage Thermal Modelling of Extrusion-Based Polymer Additive Manufacturing.

Additive manufacturing is one the most promising fabrication strategies for the fabrication of bone tissue scaffolds using biodegradable semi-crystalline polymers. During the fabrication process, polymeric material in a molten state is deposited in a platform and starts to solidify while cooling down. The build-up of consecutive layers reheats the previously deposited material, introducing a complex thermal cycle with impacts on the overall properties of printed scaffolds. Therefore, the accurate prediction of these thermal cycles is significantly important to properly design the additively manufactured polymer scaffolds and the bonding between the layers. This paper presents a novel multi-stage numerical model, integrating a 2D representation of the dynamic deposition process and a 3D thermal evolution model to simulate the fabrication process. Numerical simulations show how the deposition velocity controls the spatial dimensions of the individual deposition layers and the cooling process when consecutive layers are deposited during polymer printing. Moreover, numerical results show a good agreement with experimental results.

Longitudinal association of maternal dietary patterns with antenatal depression: Evidence from the Chinese Pregnant Women Cohort Study.

BACKGROUND: Limited evidence to show the longitudinal associations between maternal dietary patterns and antenatal depression (AD) from cohort studies across the entire gestation period. METHODS: Data came from the Chinese Pregnant Women Cohort Study. The qualitative food frequency questionnaire (Q-FFQ) and Edinburgh Postnatal Depression Scale (EPDS) were used to collect diet and depression data. Dietary patterns were derived by using factor analysis. Generalized estimating equation models were used to analyze the association between diet and AD. RESULTS: A total of 4139 participants finishing 3-wave of follow-up were finally included. Four constant diets were identified, namely plant-based, animal-protein, vitamin-rich and oily-fatty patterns. The prevalence of depression was 23.89%, 21.12% and 22.42% for the first, second and third trimesters. There were reverse associations of plant-based pattern (OR:0.85, 95%CI:0.75-0.97), animal-protein pattern (OR:0.85, 95%CI:0.74-0.99) and vitamin-rich pattern (OR:0.58, 95%CI:0.50-0.67) with AD, while a positive association between oily-fatty pattern and AD (OR:1.47, 95%CI:1.29-1.68). Except for the plant-based pattern, other patterns had linear trend relationships with AD (Ptrend < 0.05). Moreover, a 1-SD increase in vitamin-rich pattern scores was associated with a 20% lower AD risk (OR:0.80, 95%CI:0.76-0.84), while a 1-SD increase in oily-fatty pattern scores was associated with a 19% higher risk (OR:1.19, 95%CI:1.13-1.24). Interactions between dietary patterns and lifestyle habits were observed. LIMITATIONS: The self-reported Q-FFQ and EPDS may cause recall bias. CONCLUSIONS: There are longitudinal associations between maternal dietary patterns and antenatal depression. Our findings are expected to provide evidence for a dietary therapy strategy to improve or prevent depression during pregnancy.

Cohort profile: the Chinese Pregnant Women Cohort Study and Offspring Follow-up (CPWCSaOF).

PURPOSE: A multicentre prospective cohort study, known as the Chinese Pregnant Women Cohort Study (CPWCS), was established in 2017 to collect exposure data during pregnancy (except environmental exposure) and analyse the relationship between lifestyle during pregnancy and obstetric outcomes. Data about mothers and their children's life and health as well as children's laboratory testing will be collected during the offspring follow-up of CPWCS, which will enable us to further investigate the longitudinal relationship between exposure in different periods (during pregnancy and childhood) and children's development. PARTICIPANTS: 9193 pregnant women in 24 hospitals in China who were in their first trimester (5-13 weeks gestational age) from 25 July 2017 to 26 November 2018 were included in CPWCS by convenience sampling. Five hospitals in China which participated in CPWCS with good cooperation will be selected as the sample source for the Chinese Pregnant Women Cohort Study (Offspring Follow-up) (CPWCS-OF). FINDINGS TO DATE: Some factors affecting pregnancy outcomes and health problems during pregnancy have been discovered through data analysis. The details are discussed in the 'Findings to date' section. FUTURE PLANS: Infants and children and their mothers who meet the criteria will be enrolled in the study and will be followed up every 2 years. The longitudinal relationship between exposure (questionnaire data, physical examination and biospecimens, medical records, and objective environmental data collected through geographical information system and remote sensing technology) in different periods (during pregnancy and childhood) and children's health (such as sleeping problem, oral health, bowel health and allergy-related health problems) will be analysed. TRAIL REGISTRATION NUMBER: CPWCS was registered with ClinicalTrials.gov on 18 January 2018: NCT03403543. CPWCS-OF was registered with ClinicalTrials.gov on 24 June 2020: NCT04444791.

Influence of residential greenness on adverse pregnancy outcomes: A systematic review and dose-response meta-analysis.

BACKGROUND: With the development of urbanization, there is a decreasing tendency for people contact with natural greenness. Whether maternal exposure to greenness has an impact on pregnancy complications and pregnancy outcomes remains to be confirmed. OBJECTIVES: To estimate the association and dose-response relationship between residential greenness and pregnancy outcomes. DATA SOURCES: PubMed, Embase, Ovid, Scopus and Web of Science from inception to 1st December 2019 were searched. SYNTHESIS METHODS: The summary regression coefficient (ß) and odds ratio (OR) with corresponding 95% confidence interval (95%CI) were calculated. The linear dose-response relationship between greenness and adverse pregnancy outcomes was also investigated. RESULTS: Overall, 36 studies with a total of 11,983,089 participants were included. Birth weight was significantly higher in highest level of greenness exposure group compared to lowest level group (e.g. ß:20.22, 95%CI:13.50-26.93 at 100 m buffer). The odds of low birth weight (LBW) decreased in the highest level of group compared to lowest level group (e.g. OR:0.86, 95%CI:0.75-0.99 at 100 m buffer). The odds of small for gestational age (SGA) also decreased in the highest group (OR:0.93, 95%CI:0.88-1.00 at 100 m buffer). In addition, maternal exposure to greenness was associated with increased head circumference and decreased mental disorders. The dose-response models showed a 2% decrease risk of LBW per 0.1 normalized difference vegetation index (NDVI) increase within 300 m buffer (OR:0.98, 95%CI:0.97-0.99, P < 0.001) and a 1% decrease risk of SGA per 0.1 NDVI increase within 300 m buffer (OR:0.99, 95%CI:0.98-1.00, P = 0.037). No significant associations were found on preterm birth, gestational age, gestational diabetes mellitus, gestational hypertension or preeclampsia. CONCLUSIONS: This review confirms an inverse association between residential greenness and adverse pregnancy outcomes. Findings of our study provide evidences for pregnant women to increase greenness exposure.