RESUMEN
BACKGROUND: It is unclear whether the effects of abnormal gestational weight gain (GWG) on birth outcomes are differently in women with different maternal ages. This study aimed to investigate maternal age-specific association between GWG and adverse birth weights in Chinese women older than 30. METHODS: 19,854 mother-child dyads were selected from a prospective cohort study in Southwest China between 2019 and 2022. Logistic regression model was used to assess the association between GWG, which defined by the 2009 Institute of Medicine guidelines, and adverse birth weights including large- and small-for-gestational-age (LGA and SGA), stratified by maternal age (31-34 years and ≥ 35 years). RESULTS: In both maternal age groups, excessive and insufficient GWG were associated with increased odds of LGA and SGA, respectively. After women were categorized by pre-pregnancy body mass index, the associations remained significant in women aged 31-34 years, whereas for women aged ≥ 35 years, the association between excessive GWG and the risk of LGA was only significant in normal weight and overweight/obese women, and the significant effect of insufficient GWG on the risk of SGA was only observed in underweight and overweight/obese women. Moreover, among overweight/obese women, the magnitude of the association between insufficient GWG and the risk of SGA was greater in those aged ≥ 35 years (31-34 years: OR 2.08, 95% CI 1.19-3.55; ≥35 years: OR 2.65, 95% CI 1.47-4.74), while the impact of excessive GWG on the risk of LGA was more pronounced in those aged 31-34 years (31-34 years: OR 2.18, 95% CI 1.68-2.88; ≥35 years: OR 1.71, 95% CI 1.30-2.25). CONCLUSIONS: The stronger associations between abnormal GWG and adverse birth weights were mainly observed in women aged 31-34 years, and more attention should be paid to this age group.
Asunto(s)
Ganancia de Peso Gestacional , Estados Unidos , Embarazo , Femenino , Humanos , Peso al Nacer , Edad Materna , Estudios Prospectivos , Sobrepeso , Obesidad/epidemiología , China/epidemiologíaRESUMEN
RATIONALE: Congenital pulmonary airway malformation (CPAM) is a rare congenital dysplastic malformation and accounts for 25% of congenital lung lesions. Commonly, it is diagnosed prenatally in ultrasound. The CPAM volume ratio (CVR) is a well-recognized predictor of fetal prognosis, and when the CVR is >1.6 cm2, the fetus is very likely to develop hydrops and even intrauterine deaths. However, the association of CVR with a wide range of complications and neonatal prognosis is unclear. PATIENT CONCERNS: Cystic lesions in the right thorax of the fetus detected by ultrasound at 19 weeks of gestation, with a CVR of 0.88 cm2. The CVR grew progressively with increasing gestational weeks, reaching a maximum of 5.2 cm2 at 35 gestational weeks. However, there were no complications with the fetus other than polyhydramnios. DIAGNOSIS: Imaging and pathological findings confirmed the diagnosis of CPAM. INTERVENTIONS: During pregnancy, a multidisciplinary team was involved in the management and the prenatal visits increased to weekly from 31 weeks of gestation. During the cesarean section, neonatologists and pediatric surgeons were present for timely evaluation of newborns. The neonate was admitted to the neonatal intensive care unit for monitoring immediately after birth and underwent thoracoscopic right lower lobectomy at 57th days old. OUTCOMES: The neonate recovered without any respiratory symptoms and no abnormality on chest computed tomography (CT) at the 3-month postoperative follow-up. LESSONS: During pregnancy, in addition to monitoring CVR, a multidisciplinary team should join in the management of CPAM patients. And as for the fetus with increased CVR, a closely monitoring after birth is necessary even if the general condition of the pregnancy is well. In particular, timely intervention should be made at the onset of respiratory symptoms.
Asunto(s)
Malformación Adenomatoide Quística Congénita del Pulmón , Enfermedades del Recién Nacido , Niño , Humanos , Recién Nacido , Embarazo , Femenino , Cesárea , Ultrasonografía Prenatal/métodos , Malformación Adenomatoide Quística Congénita del Pulmón/diagnóstico por imagen , Malformación Adenomatoide Quística Congénita del Pulmón/cirugía , Pulmón/diagnóstico por imagen , Pulmón/anomalías , Atención Prenatal , Estudios RetrospectivosRESUMEN
Objective: To compare the pregnancy outcomes of pregnancy outcomes after selective fetal reduction treatment in monochorionic, dichorionic, and trichorionic triplet pregnancies. Methods: We conducted a retrospective analysis of the clinical data of 118 pregnant women carrying triplets. All subjects underwent regular prenatal check-ups and were admitted for delivery at West China Second University Hospital, Sichuan University between January 1, 2012 and January 31, 2021. According to the chorionicity, the subjects were divided into a monochorionic group ( n=13), a dichorionic group ( n=44), and a trichorionic group ( n=61). Within each group, the subjects were further divided into two subgroups, a reduction group and an expectant treatment group, according to whether they underwent fetal reduction or not. The clinical data and pregnancy outcomes were compared between the subgroups within each group. Results: In the monichorionic group, the reduction subgroup had a lower preterm birth rate and higher neonatal birth body mass than those of the expectant management subgroup, but the differences were not statistically significant. In the dichorionic and trichorionic groups, the rates of preterm delivery, neonatal hospitalization, and serious complications of the reduction subgroups were lower than those of the expectant subgroups ( P<0.05), while the neonatal birth body mass was higher in the reduction subgroups than that in the expectant subgroups ( P<0.05). In the dichorionic group, the incidence of intrahepatic cholestasis during pregnancy was lower in the reduction subgroup than that in the expectant treatment subgroup. In all 3 groups, there was no statistically significant difference between the subgroups in the incidence of gestational diabetes, hypertensive disorders of pregnancy, premature rupture of membranes, and postpartum hemorrhage. The survival curve analysis showed that women receiving fetal reduction during the first trimester had a lower risk of pregnancy loss and more significant prolonged of gestational age than those undergoing the procedure during the second trimester. Conclusion: Fetal reduction of triplets can significantly prolong the gestational age and improve the perinatal prognosis. In addition, selective reduction in the first trimester may lead to greater benefits than selective reduction in the second trimester does.
Asunto(s)
Embarazo Triple , Nacimiento Prematuro , Embarazo , Femenino , Recién Nacido , Humanos , Resultado del Embarazo , Reducción de Embarazo Multifetal , Estudios Retrospectivos , Nacimiento Prematuro/epidemiología , Edad Gestacional , Embarazo GemelarRESUMEN
BACKGROUND: Gestational weight gain (GWG) criteria recommended by the Institute of Medicine may not be appropriate for Asians. Our aims are to investigate the association between GWG and adverse pregnancy outcomes, and to propose optimal total GWG and rates of GWG for Chinese women. METHODS: Prospective data of 51,125 mother-child pairs from 27 hospitals and community health care centers from Guizhou, Yunnan and Sichuan provinces in China between 2014 and 2018 were analyzed. Generalized Additive Models were performed to determine the associations of GWG with the risk of aggregated adverse outcomes (gestational diabetes mellitus, preeclampsia, cesarean delivery, stillbirth, preterm birth, macrosomia, large for gestational age, and small for gestational age). The range that did not exceed a 2.5% increase from the lowest risk of aggregated adverse outcomes was defined as the optimal GWG range. RESULTS: Among all participants, U-shaped prospective association was found between GWG and the risk of aggregated adverse pregnancy outcomes. The optimal GWG range of 8.2-13.0 kg was proposed for underweight, 7.3-12.5 kg for normal weight, and 2.0-9.4 kg for overweight/obese women. Meanwhile, a higher GWG rate in the first two trimesters than that in the last trimester was suggested, except for overweight/obese women. After stratified by maternal age, mothers ≥35 years were suggested to gain less weight compared to younger mothers. CONCLUSIONS: To keep a balance between maternal health and neonatal growth, optimal GWG ranges based on Asia-specific BMI categories was suggested for Chinese women with different pre-gravid BMIs and maternal ages.
Asunto(s)
Sobrepeso , Nacimiento Prematuro , Femenino , Embarazo , Recién Nacido , Humanos , Adulto , Sobrepeso/complicaciones , Mujeres Embarazadas , Pueblos del Este de Asia , China/epidemiología , Nacimiento Prematuro/epidemiología , Aumento de Peso , Obesidad/epidemiología , Obesidad/complicaciones , Resultado del Embarazo/epidemiología , Índice de Masa CorporalRESUMEN
BACKGROUND: Intrahepatic cholestasis of pregnancy is one of the common complications during pregnancy, and ursodeoxycholic acid has been recommended as the first-line drug. However, if the assisted reproductive technology may increase adverse perinatal outcomes of twin pregnancies complicated by intrahepatic cholestasis is disputed, we aimed to investigate perinatal outcomes between twin pregnancies by assisted reproductive technology versus spontaneous conception, based on these women accepted ursodeoxycholic acid treatment. METHODS: From January 2014 to January 2019, we retrospectively analysed the clinical data of twin pregnant women with intrahepatic cholestasis, excluding those who did not receive ursodeoxycholic acid treatment. In total, 864 women were included, among whom 500 conceived by assisted reproductive technology and 364 conceived by spontaneous conception. The primary assessment for perinatal outcomes included premature birth, meconium-stained amniotic fluid, low Apgar score, neonatal intensive care unit and still birth, and secondary indicators were serum bile acid and liver enzymes level during medication, so we also finished subgroup analysis based on different elevated bile acid level and drug usage. The statistical analysis was performed by SPSS 22.0. RESULTS: The study demonstrated that compared to spontaneous conception, assisted reproductive technology conceived twin pregnancies diagnosed as intrahepatic cholestasis earlier (p = 0.003), and lower birth weight (p = 0.001), less incidence of preterm delivery (p = 0.000) and neonatal intensive care unit admission (p = 0.001), but the rate of meconium-stained amniotic fluid, low Apgar score and still birth have no statistic differences. Moreover, the subgroup analysis showed no significant difference in elevated bile acid levels and medication between assisted reproductive technology and spontaneous conception groups. CONCLUSIONS: The assisted reproductive technology may increase the risk of early-onset intrahepatic cholestasis in twin pregnancies, but it does not seem to increase adverse effects on bile acid levels and perinatal outcomes. Regardless of ursodeoxycholic acid used alone or combination, the effect of bile acid reduction and improving perinatal outcomes in twin pregnancies is limited. Our conclusions still need more prospective randomized controlled studies to confirm.
Asunto(s)
Colestasis Intrahepática , Embarazo Gemelar , Colestasis Intrahepática/epidemiología , Femenino , Humanos , Recién Nacido , Embarazo , Resultado del Embarazo/epidemiología , Estudios Prospectivos , Técnicas Reproductivas Asistidas/efectos adversos , Estudios RetrospectivosRESUMEN
INTRODUCTION: Preeclampsia (PE) is a pregnancy specific disorder which is significantly associated with maternal and neonatal morbidity and mortality. This study aimed to explore the potential role of circRNAs in PE. METHODS: The mRNA, miRNA, and circRNA expression profiles of PE were downloaded from GEO database. Bioinformatics analysis was conducted to characterize differentially expressed mRNAs (DEmRNAs), miRNAs (DEmiRNAs) and circRNAs (DEcircRNAs) in the placental tissues of women with PE versus normal pregnancies. Then, expression validation of the mRNAs, miRNAs and circRNAs were performed with RT-qPCR and GEO datasets. RESULTS: A total of 1645 DEmRNAs, 41 DEmiRNAs and 2432 DEcircRNAs were acquired. The ceRNA network contained 4 circRNA-miRNA pairs and 64 miRNA-mRNA pairs, including 3 circRNAs, 3 miRNAs, and 63 mRNAs. Validation in RT-qPCR and GEO were generally in line with our integrated analysis results. DISCUSSION: In conclusion, we speculated that hsa_circRNA_0001687/hsa-miR-532-3p/MMP14/AXL, hsa_circ_0001513/hsa-miR-188-5p/HMGCS1 and hsa_circ_0001513/hsa_circ_0001329/hsa-miR-760/MAP1LC3B axes may participate in the pathological process of PE.
Asunto(s)
Preeclampsia/metabolismo , ARN Circular/metabolismo , Estudios de Casos y Controles , Femenino , Redes Reguladoras de Genes , Humanos , Embarazo , TranscriptomaRESUMEN
OBJECTIVE: To study the effect of using ursodeoxycholic acid (UDCA) to treat monochorionic and dichorionic twin pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP) and to examine the differences in perinatal outcomes. METHODS: A total of 406 twin-carrying pregnant women who had ICP and received care at West China Second Hospital, Sichuan University between January 1, 2015 and November 1, 2018 were included in the study. The clinical data of monochorionic diamniotic (MCDA) and dichorionic diamniotic (DCDA) twins with ICP were analyzed. Analysis was done to compare the treatment effect for lowering serum total bile acid (TBA) and the perinatal outcomes with simple UDCA medication or combination medication. RESULTS: There were no statistically significant differences in TBA levels, early-onset ICP, simple UDCA medication or combination medication, neonatal Apgar score, birth weight, length of hospital stay, C-section rate, and perinatal mortality between the MCDA and the DCDA twin groups with ICP. However, maternal age, BMI, scarred uterus, in vitro fertilization-embryo transfer, preeclampsia, twin comorbidity rate of the two groups showed statistical differences. Further comparison between twin pregnancies with mildly-elevated TBA and those with severely-elevated TBA showed significant difference in preterm birth rate ( P<0.05). CONCLUSION: Simple UDCA medication or combination medication may have the same therapeutic effect on MCDA and DCDA twin pregnancies with ICP. Monochorionic twin pregnancy, twin comorbidities and pregnancy complications were still important factors affecting pregnancy outcomes of twin pregnancies with ICP. Twin pregnancies with slightly elevated TBA have been managed as severe ICP, which may be associated with increased iatrogenic preterm births.
Asunto(s)
Colestasis Intrahepática , Nacimiento Prematuro , Colestasis Intrahepática/complicaciones , Colestasis Intrahepática/tratamiento farmacológico , Femenino , Humanos , Recién Nacido , Embarazo , Complicaciones del Embarazo , Resultado del Embarazo , Embarazo Gemelar , Estudios Retrospectivos , Ácido Ursodesoxicólico/uso terapéuticoRESUMEN
OBJECTIVE: To provide evidence for the diagnosis of listeriosis through a retrospective study of clinical features and results of pregnant women infected with listeriosis. METHODS: Twenty-nine pregnant women infected with listeriosis visiting West China Second University Hospital affiliated to Sichuan University from July 2010 to February 2019 were included in the retrospective analysis. Data like general information, clinical symptoms, laboratory results, and pathogen detection were analyzed to conclude clinical characteristics. RESULTS: The median age of 29 patients was 28 (18.0-42.0). Nine individuals visited in the second trimester, while 20 in the last trimester. The median course before visiting was 3.4 (0.1-19) days. The main symptoms of the first attendance were fever (21/29), increased white blood cells (26/29), abdominal pain (16/29), and decreased or vanished fetal movements (7/29). Samples where listeria were identified were maternal blood (14 cases), excreta from birth canal (24 cases), placenta (one case), newborn blood (seven cases), newborn sputum (eight cases), newborn excreta from auditory meatus (three cases), cerebrospinal fluid (two cases) and ocular discharge (one case). Inflammation was detected in pathological examination of placenta in all subjects. Among them, three were diagnosed with mild chorioamnionitis; five with moderate chorioamnionitis; nine with moderate-to-severe chorioamnionitis and 12 with severe chorioamnionitis. Among 33 fetuses carried by 29 subjects, fetal outcomes include six miscarriages, nine stillbirths, four newborn deaths immediately after birth and four after treatment discontinuation, nine discharges after successful treatment in hospital, and one death after treatment. As for maternal outcomes, 29 pregnant women all recovered after delivery. CONCLUSION: With the acute onset, high incidence of adverse pregnancy outcomes and low coverage of initial treatment, clinical physicians need to raise the awareness of listeriosis during pregnancy.
Asunto(s)
Listeria monocytogenes , Listeriosis , Complicaciones Infecciosas del Embarazo , Femenino , Humanos , Listeriosis/diagnóstico , Listeriosis/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/epidemiología , Resultado del Embarazo , Estudios RetrospectivosRESUMEN
AIM: Gestational diabetes mellitus is common during pregnancy, impacting maternal health and fetal development. The aim of this study was to identify potential long non-coding RNAs (lncRNAs) and mRNAs in gestational diabetes mellitus. METHODS: The placenta tissues from four women patients with gestational diabetes mellitus and three healthy pregnant women were used for RNA sequencing. Differentially expressed lncRNAs and mRNAs were obtained. Then, interaction networks of lncRNA-nearby targeted mRNA and lncRNA-co-expressed mRNA were constructed, followed by functional annotation of co-expressed mRNAs. Third, GSE51546 dataset was utilized to validate the expression of selected co-expressed mRNAs. In addition, in vitro experiment was applied to expression validation of lncRNAs and mRNAs. Finally, GSE70493 dataset was utilized for diagnostic analysis of selected co-expressed mRNAs. RESULTS: A total of 78 differentially expressed lncRNAs and 647 differentially expressed mRNAs in gestational diabetes mellitus were obtained. Several interaction pairs of lncRNA-co-expressed mRNA including LINC01504-CASP8, FUT8-AS1-TLR5/GDF15, GATA2-AS1-PQLC3/KIAA2026, and EGFR-AS1-HLA-G were identified. Endocytosis (involved HLA-G) and toll-like receptor signaling pathway (involved TLR5 and CASP8) were remarkably enriched signaling pathways of co-expressed mRNAs. It is noted that CASP8, TLR5, and PQLC3 had a significant prognosis value for gestational diabetes mellitus. CONCLUSIONS: Our study identified several differentially expressed lncRNAs and mRNAs, and their interactions, especially co-expression, may be associated with gestational diabetes mellitus.
Asunto(s)
Diabetes Gestacional , ARN Largo no Codificante , Femenino , Humanos , Embarazo , ARN Largo no Codificante/genética , ARN Largo no Codificante/metabolismo , ARN Mensajero/metabolismo , Diabetes Gestacional/genética , Redes Reguladoras de Genes , Perfilación de la Expresión Génica , Antígenos HLA-G , Receptor Toll-Like 5/genética , Análisis de Secuencia de ARNRESUMEN
INTRODUCTION: Little attention has been paid to the interacting effect of specific intensities of physical activities (PAs) and sedentary lifestyle, like television watching, and genetic predisposition on body composition indices among Chinese adults. Herein, we aimed to examine whether specific types of PAs and sedentary behaviors (SBs) were associated with body composition indices among Chinese adults and to further explore whether these associations interacted with the genetic predisposition to high BMI. METHODS: Cross-sectional data regarding PAs and time spent on SBs and dietary intake of 3,976 Chinese adults (54.9% women) aged 25-65 years in Southwest China were obtained via questionnaires in 2013-2015. Weight, height, and waist circumference (WC) were measured, and BMI, percentage of body fat (%BF), fat mass index (FMI), and fat-free mass index (FFMI) of the participants were calculated. Genetic risk score (GRS) was calculated on 9 established BMI-associated SNPs among Chinese adults. RESULTS: When the participants were stratified by GRS for BMI, significant associations were only found for adults with high GRS for BMI: moderate-to-vigorous physical activity (MVPA) was negatively associated with WC and %BF and positively related to FFMI. The adjusted positive relationship of time spent watching television with BMI, WC, %BF, and FMI were also just found between adults with high weighted GRS for high BMI: for every 1 h increment in television watching, the BMI, WC, %BF, and FMI of the participants increased by 0.2 kg/m2, 0.9 cm, 0.3%, and 0.1 kg/m2, respectively (p < 0.02). CONCLUSION: MVPA may be a protective factor against obesity, and prolonged television watching may accentuate adiposity. These putative effects may be more pronounced among individuals with a high genetic risk of a high BMI.
Asunto(s)
Predisposición Genética a la Enfermedad , Conducta Sedentaria , Tejido Adiposo , Adulto , Índice de Masa Corporal , China , Estudios Transversales , Ejercicio Físico , Femenino , Humanos , MasculinoRESUMEN
BACKGROUND & AIMS: To date, the prevalence of Gestational diabetes mellitus (GDM) in China was 17.5%. Given the substantial relevance of GDM for medium- and long-term health of both mother and offspring and the paucity of existing data on the link between maternal diet and glucose homeostasis during pregnancy in Asian population, additional studies are needed. To examine the relevance of dietary glycemic index (GI), glycemic load (GL) and fiber intake before and during pregnancy for the development of GDM and glucose homeostasis over the course of pregnancy. METHODS: Cox proportional hazards analysis and linear mixed effects regressions were performed on data from 9317 women for whom three food frequency questionnaires (pre-pregnancy, 1st and 2nd trimesters) and biochemical measures during pregnancy were available. Investigated outcome variables included GDM risk, fasting plasma glucose (FPG), glycated hemoglobin (HbA1C), and homeostasis model assessment insulin resistance (HOMA-IR) in the 1st, 2nd and 3rd trimesters. RESULTS: Women in the highest tertile of dietary GI (or GL) before pregnancy, in the 1st, or the 2nd trimester respectively had a 12% (15%), 25% (23%) or 29% (25%) higher risk of developing GDM than those in the lowest tertile (all p for trend ≤ 0.02). Women with the highest dietary fiber intake before pregnancy, in the 1st or 2nd trimester had a 11%, 17% or 18% lower GDM risk (all p for trend ≤ 0.03). Moreover, increases in GI or GL and decreases in fiber intake over the course of pregnancy (1st to 3rd trimesters) were independently associated with adverse concurrent developments in FPG, HbA1C and HOMA-IR (p ≤ 0.03). CONCLUSIONS: Our study indicates that dietary GI, GL and fiber intake before and during pregnancy affects glucose homeostasis of pregnant Chinese women.
Asunto(s)
Diabetes Gestacional/prevención & control , Fibras de la Dieta , Glucosa/metabolismo , Índice Glucémico , Carga Glucémica , Pueblo Asiatico , Glucemia , China , Estudios de Cohortes , Dieta , Femenino , Hemoglobina Glucada/metabolismo , Homeostasis , Humanos , Resistencia a la Insulina , Embarazo , Modelos de Riesgos Proporcionales , Estudios ProspectivosRESUMEN
The relevance of pregestational body mass index (BMI) on adverse pregnancy outcomes remained unclear in Southwest China. This study aimed to investigate the overall and age-category specific association between pre-gestational BMI and gestational diabetes mellitus (GDM), preeclampsia, cesarean delivery, preterm delivery, stillbirth, macrosomia, and small-for-gestational age (SGA) or large-for-gestational age (LGA) neonates in Southwest China. Furthermore, it explores the relative importance of influence of pregravid BMI and maternal age on pregnancy outcomes. 51,125 Chinese singleton pregnant women were recruited as study subjects. Multiple logistic regression models were used to examine the influence of pre-pregnancy BMI on adverse pregnancy outcomes. Gradient boosting machine was used to evaluate the relative importance of influence of pregravid BMI and maternal age on pregnancy outcomes. It is found that women who were overweight or obese before pregnancy are at higher risk of adverse pregnancy outcomes except for SGA neonates, while pre-pregnancy underweight is a protective factor for GDM, preeclampsia, cesarean delivery, macrosomia and LGA, but not SGA. Younger mothers are more susceptible to GDM and macrosomia neonates, while older mothers are more prone to preeclampsia. Pre-pregnancy BMI has more influence on various pregnancy outcomes than maternal age. To improve pregnancy outcomes, normal BMI weight as well as relatively young maternal ages are recommended for women in child-bearing age.
Asunto(s)
Índice de Masa Corporal , Complicaciones del Embarazo/prevención & control , Resultado del Embarazo/epidemiología , Adulto , Pueblo Asiatico/genética , Cesárea , China/epidemiología , Diabetes Gestacional , Femenino , Macrosomía Fetal , Humanos , Recién Nacido Pequeño para la Edad Gestacional/metabolismo , Edad Materna , Persona de Mediana Edad , Obesidad/metabolismo , Sobrepeso/metabolismo , Preeclampsia , Embarazo/fisiología , Nacimiento Prematuro/prevención & control , Estudios Prospectivos , Factores de Riesgo , Delgadez/metabolismo , Aumento de Peso/fisiologíaRESUMEN
PURPOSE: Studies regarding the association between dietary fat intake and gestational diabetes mellitus (GDM) are limited and provide conflicting findings. Thus, the study aims to examine the association of dietary fat intake in the year preceding pregnancy and during pregnancy with the risk of GDM, taking the relevance of dietary protein intake on GDM into consideration. METHODS: A prospective study was conducted in 6299 singleton pregnancies, using the data from the Nutrition in Pregnancy and Growth in Southwest China (NPGSC). A validated food frequency questionnaire was used to assess dietary fat intake in the year preceding pregnancy and during the first and second trimesters of pregnancy. Logistic regression analysis was used to assess the prospective associations of dietary fat intake and the type and source of dietary fats in different time windows with GDM risk. RESULTS: Higher intake of total fat [OR (95% CI): 2.21 (1.19-4.20), P = 0.02] during 12-22 weeks of gestation was associated with higher GDM risk. However, adjustment for animal protein intake greatly attenuated this association [OR (95% CI): 1.81 (0.93, 3.64), P = 0.11]. Total fat intake neither in the year preceding pregnancy nor during the early pregnancy was associated with GDM risk. Moreover, insignificant associations were observed between intakes of vegetable fat, animal fat, cholesterol, saturated fatty acid, monounsaturated fatty acid and polyunsaturated fatty acid one year before pregnancy and during the first and second trimesters and GDM risk. CONCLUSION: Our study indicated that dietary fat intake one year before pregnancy and across the two pregnancy trimesters preceding the diagnosis of GDM has no relevance on GDM risk among Chinese women, particularly those with normal BMI, low, or normal calorie intake.
Asunto(s)
Diabetes Gestacional , Animales , Diabetes Gestacional/epidemiología , Dieta , Grasas de la Dieta , Proteínas en la Dieta , Femenino , Humanos , Embarazo , Estudios Prospectivos , Factores de RiesgoRESUMEN
BACKGROUND: Early age at menarche is associated with risk of several chronic diseases. Prospective study on the association between dietary pattern and timing of menarche is sparse. We examined whether dietary patterns prior to the menarche onset were prospectively associated with menarcheal age in Chinese girls. METHODS: One thousand one hundred eighteen girls aged 6-13 y in the China Health and Nutrition Survey (CHNS) with three-day 24-h recalls and information on potential confounders at baseline were included in the study. Dietary patterns were identified using principal component analysis. Age at menarche was self-reported at each survey. Cox proportional hazard regression models were performed to examine the associations of premenarcheal dietary patterns and menarcheal timing. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. RESULTS: Three major dietary patterns were identified: modern dietary pattern, animal food pattern, and snack food pattern. After adjustment for age at baseline, region, ethnicity, maternal education level, energy intake at baseline, and body mass index Z-score at baseline, girls in the highest quartile of modern dietary pattern score had a 33% higher probability of experiencing menarche at an earlier age than those in the lowest quartile (HR: 1.33, 95% CI: 1.002-1.77, p for trend = 0.03). No significant association was found for the animal food pattern or snack food pattern. CONCLUSIONS: Higher adherence to modern dietary pattern during childhood is associated with an earlier menarcheal age. This association was independent of premenarcheal body size.
Asunto(s)
Dieta , Menarquia , Animales , Índice de Masa Corporal , China/epidemiología , Femenino , Humanos , Encuestas Nutricionales , Estudios ProspectivosRESUMEN
Interleukin-32 (IL-32) as a pro-inflammatory cytokine participates in the progression of inflammation and cancer. Ovarian cancer (OC) accounts for a considerable mortality rate, but research on IL-32 and OC is almost nil. Our study aims to explore the association between IL-32 and the progression as well as prognosis of OC initially. This hospital-based case-control study enrolled 147 OC patients and 337 healthy controls, and we used the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method to distribute the genotypes. The results showed that the homozygous genotype (TT) of rs28372698 SNP was significantly higher in patients compared to controls (12.9% vs. 6.2%, P = 0.018, OR (95% CI) = 2.23 (1.16-4.29)). This revealed that TT genotype might be a risk factor in OC progression. This present study indicates that IL-32 gene polymorphism relates to an increased OC susceptibility, and IL-32 may be a marker for OC progression.
RESUMEN
Females are highly predisposed to the occurrence of migraine, a recurrent neurovascular headache disorder. Although migraine improves or disappears during pregnancy, a significant association between migraine and hypertension (i.e., pre-eclampsia) or vascular complications (i.e., stroke) during gestation has been determined. Low-dose aspirin exerts an antithrombotic effect and can improve vascular resistance by regulating endothelial function, which are implicated in the pathogenesis of migraine, pre-eclampsia, and other vascular complications during pregnancy. Low-dose aspirin is widely used prophylactically in the general population who are at higher risk of developing stroke or in pregnant women at higher risk of pre-eclampsia. In this paper we discuss the recent trends in research on the relationship between migraine and pre-eclampsia, an issue of paramount importance in obstetric care, and the potential relationship between migraine and vascular complications in pregnant women. In addition, the potential validity of low-dose aspirin prophylaxis in pregnant women with migraine is explored.
Asunto(s)
Aspirina/uso terapéutico , Trastornos Migrañosos/tratamiento farmacológico , Inhibidores de Agregación Plaquetaria/uso terapéutico , Preeclampsia/tratamiento farmacológico , Complicaciones Cardiovasculares del Embarazo/tratamiento farmacológico , Accidente Cerebrovascular/prevención & control , Esquema de Medicación , Cálculo de Dosificación de Drogas , Endotelio Vascular/efectos de los fármacos , Endotelio Vascular/fisiopatología , Femenino , Humanos , Trastornos Migrañosos/complicaciones , Trastornos Migrañosos/fisiopatología , Preeclampsia/fisiopatología , Embarazo , Complicaciones Cardiovasculares del Embarazo/fisiopatología , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/fisiopatologíaRESUMEN
BACKGROUND: Pregnancy and birth cohorts addressing maternal nutrition and its impact on health outcomes have been rare in China, especially in Southwest China. OBJECTIVES: To describe the design, implementation, baseline characteristics, and initial results of the Nutrition in Pregnancy and Growth in Southwest China (NPGSC) cohort. POPULATION: Pregnant women with their children in Southwest China. DESIGN: NPGSC participants have been prospectively recruited since 2014. Pregnant women were invited to participate in the study at their first routine ultrasound examination in gestational weeks 9-11. Data were assessed three times during pregnancy (9-11, 20-22, and 33-35 gestation weeks), and eight times in infants and toddlers. METHODS: Pre-pregnancy body weight and height were self-reported; gestational weight gain was measured at regular intervals. Both food frequency questionnaires (FFQ) and 24-hour dietary recalls were used to collect dietary intakes during pregnancy, and FFQ for diet before pregnancy. Information on pregnancy outcomes was extracted from the medical birth registry. Anthropometry of children in the first 3 years of life was measured by trained investigators. Other child outcomes, including feeding practices (self-reported by mothers) and cognitive development (assessed by the Chinese version of Ages and Stages Questionnaire), were recorded. PRELIMINARY RESULTS: Between 2014 and 2018, 12 989 pregnant women were enrolled, and 2296 children completed the 3 years follow-up. Among them, 115 pregnancies ended in stillbirth. Mean maternal pre-pregnancy BMI was 21.1 kg/m2 and mean gestational weight gain was 13.5 kg 18.6% of mothers developed gestational diabetes and 1.5% of mothers were diagnosed with preeclampsia. Mean birthweight and birth length of children were, respectively, 3329 g and 49.4 cm. CONCLUSION: We built a prospective cohort in Southwest China, which can provide valuable data to investigate the relevance of nutrition for the health of mothers and children.
Asunto(s)
Resultado del Embarazo , Aumento de Peso , Peso al Nacer , China/epidemiología , Femenino , Humanos , Embarazo , Resultado del Embarazo/epidemiología , Estudios ProspectivosRESUMEN
Using the nanoindentation technique, we probed the mechanical properties of tape cast and sintered thin doped Li7La3Zr2O12 garnet electrolytes. For comparison, a bulk garnet sample fabricated by die pressing and sintering was also studied. The results indicate that the thin sample has a significantly higher elastic modulus (â¼155 GPa), hardness (â¼11 GPa), and indentation fracture toughness (â¼1.12 ± 0.12 MPa·m1/2) than the bulk sample (â¼142 GPa, â¼10 GPa, and â¼0.97 ± 0.10 MPa·m1/2, respectively). The above results demonstrate that the thin sample can more effectively prevent lithium dendrite penetration due to its better mechanical properties. Deformation and creep behavior analysis further indicates that the thin sample (1) has a higher resistance to withhold the charge/discharge stress and consequently deformation and (2) a lower creep exponent and likely high resistance to brittle failure.
RESUMEN
OBJECTIVE: We aim to explore the relationship between nocturnal sleep duration (NSD) and midday nap duration (MND) with body composition among Southwest Chinese adults. METHODS: Data on sleep duration of 3145 adults in Southwest China (59.4% women) were obtained between 2014 and 2015 through questionnaires. Height, weight, and waist circumference (WC) were measured to calculate body composition (body mass index (BMI), percentage of body fat (%BF), and fat mass index (FMI)). Linear regression models were used to assess gender-specific associations between NSD and body composition. The relationship between MND with the odds of overweight and central obesity has been evaluated by logistic regression models. RESULTS: NSD has the inverse relation with males' BMI, WC, %BF and FMI after adjusting for all covariates (all P <0.0007), exclusive of females' (all P >0.4). After adjustment for potential confounders, compared to the subjects in the no midday nap group, the subjects who napped 0.1-1 hour were independently associated with a less prevalence of overweight in both women (OR: 0.72, 95%CI: 0.55-0.95) and men (OR: 0.71, 95%CI: 0.52-0.98). MND was not associated with central obesity. CONCLUSIONS: Among Southwest Chinese adults, lower NSD might be related to higher BMI, WC, %BF and FMI among men. Additionally, MND is associated with overweight in adults.
Asunto(s)
Pueblo Asiatico , Composición Corporal , Sueño , Tejido Adiposo , Pesos y Medidas Corporales , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Vigilancia en Salud PúblicaRESUMEN
OBJECTIVE: To determine the associations of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with gestational diabetes mellitus (GDM). METHODS: A prospective cohort of pregnant women were screened for GDM at 24-28 weeks of gestation between 2013 and 2015, resulting in a sample of 3 593 with GDM and 15 346 without GDM. The body mass, plasma glucose, and height data of the participants were collected by the local medical workers. Multivariate logistic regression analyses were performed to determine the associations of pre pregnancy body mass index and weight gain during pregnancy with GDM. RESULTS: The participants with pre pregnancy overweight [odds ratio(OR)=2.44, 95% cofidence interval(CI)1.98-2.99] and obesity (OR=4.98, 95%CI 2.52-9.91) were more likely to develop GDM. According to the Institute of Medicine (IOM) criteria, excessive GWG in the first trimester occurred in 8.46% of the women, compared with 55.07% in the second trimester. After adjustment for age at delivery and pre pregnancy BMI, high GWG in the first trimesters in advanced maternal age (age at delivery≥35 yr.) group (OR=1.42, 95%CI 1.02-2.28) was a risk factor for GDM while the OR value of the non-advanced maternal age (age at delivery≤35 yr.) group was not statistically significant. In second trimesters, both advanced maternal age group (OR=1.59, 95%CI 1.14-1.88) and non-advanced maternal age group (OR=1.49, 95%CI 1.20-1.72) in high GWG were associated with high risk of GDM. CONCLUSION: Pre pregnancy overweight and obesity and excessive GWG during early and second trimesters of pregnancy may increase the risk of GDM in women in Southwestern China.