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2021年发表文章中英文摘要

题目: 应谨慎考虑用于终止不明部位持续妊娠干预措施的安全性
Pubmed: https://pubmed.ncbi.nlm.nih.gov/34905038/
Date: 2021-12-14
顶级医学杂志JAMA近期发表一项临床试验研究《Effect of an Active vs Expectant Management Strategy on Successful Resolution of Pregnancy Among Patients With a Persisting Pregnancy of Unknown Location: The ACT or NOT Randomized Clinical Trial》,报道了与期待治疗相比,积极治疗策略(包括必要时使用甲氨蝶呤的子宫排空术组和经验性使用甲氨蝶呤组)能更有效地终止不明部位的持续妊娠;此外,经验性使用甲氨蝶呤组的治疗效果不比子宫排空术组差。
对该项研究报道,我们在JAMA杂志上发表了评论《Active vs Expectant Management of Persisting Pregnancy of Unknown Location》,指出应该慎重考虑该干预措施的安全性。首先,该研究的样本量设计并不是为了比较干预组和对照组之间的不良反应,因此没有足够的统计效能比较组间的不良反应发生率。然而,该研究的数据显示(表2),积极治疗组发生严重或非严重不良事件的比例高于对照组。其次,我们指出,应警惕甲氨蝶呤更严重但罕见的副作用。甲氨蝶呤可能导致严重的不良后果,如骨髓抑制、肺炎和急性肾功能衰竭,尤其是甲氨蝶呤敏感个体。甲氨蝶呤高敏感性是甲氨蝶呤应用于异位妊娠治疗的禁忌症之一。然而,在临床实际应用甲氨蝶呤之前,往往缺乏对甲氨蝶呤敏感性的客观评价。



题目: 胎儿生长模式与脐血心血管代谢因子的关系
Pubmed: https://pubmed.ncbi.nlm.nih.gov/34956083/
Date: 2021-12-09
背景: 出生体重与出生时心血管代谢因子水平存在关联。然而,这些关联发生在哪个妊娠阶段尚不清楚。本研究目的是探讨不同妊娠期的胎儿生长与脐血心血管代谢因子之间的关联性。
方法: 我们纳入1458名来自中国广州出生队列研究的新生儿。基于超声测量的胎儿生长数据,采用multilevel linear spline模型估算孕22周、22-27周、28-36周和≥37周的胎儿生长情况(体重、腹围和股骨长)。采用多元线性回归分析胎儿生长变量与脐血心血管代谢因子z评分之间的关系。
结果: 各个孕期的胎儿体重与脐血胰岛素水平呈正相关,且与较早的孕期相比,28-36周 (β, 0.31;95% CI, 0.23 ~ 0.39)和≥37周(β, 0.15;95% CI, 0.10 ~ 0.20)的胎儿体重与胰岛素的关联性更强。28-36周 (β,−0.32;95% CI,−0.39 ~ −0.24)和≥37周(β,−0.26;95% CI,−0.31 ~ −0.21)的胎儿体重与脐血甘油三酯水平呈负相关,而28-36周体重与高密度脂蛋白水平呈正相关(β, 0.12;95% CI, 0.04 ~ 0.20)。胎儿腹围与脐血心血管代谢因子的关联性与胎儿体重的结果相似。22周和22-27周胎儿股骨长与脐血胰岛素、葡萄糖和高密度脂蛋白水平呈正相关。
结论: 各个妊娠阶段的胎儿生长与出生时心血管代谢因子水平存在关联,提示胎儿生长与心血管代谢因子的相互作用可能始于妊娠早期。



题目: 足月婴儿的婴儿期体重增加和神经发育:一项大型前瞻性队列研究的结果
Pubmed: https://pubmed.ncbi.nlm.nih.gov/34846268/
Date: 2021-11-30
本文的目的是研究足月出生婴儿婴儿期体重增加与神经发育之间的关系。本研究纳入广州出生队列5837名单胎足月婴儿。体重增加绝对值通过计算从出生到 12个月的体重差异来获得。主要结局是一岁时的神经发育,包括五个发育能区,其中超过3个能区出现发育迟缓则被判断为整体发育迟缓。采用logistics回归分析分析婴儿体重增加与神经发育之间的关联。结果发现,与体重增加 6001-7000 g 的婴儿(对照组)相比,体重增加 5000 g 的婴儿在适应性、大运动、精细动作、社交和整体发育迟缓方面的延迟几率更高,体重增加 5001-6000 g 的婴儿出现大运动延迟和社交延迟的几率较高。性别分层分析显示,与对照组相比,男孩体重增加 ≤ 5000 g 与精细动作延迟的发生有关,而女孩体重增加 >7000 g 则与精细动作延迟的发生有关。结论:在足月出生的婴儿中,婴儿期体重增加不足与一岁时神经发育不良的几率较高有关。



题目: 母亲体重状态和子代1岁湿疹及喘息发生风险的关联关系
Pubmed: https://pubmed.ncbi.nlm.nih.gov/34806795/
Date: 2021-11-22
背景: 母亲孕前BMI和孕期增重被认为可能与子代过敏性疾病发生相关。然而,既往相关研究结论并不一致,其关联关系可能受未测量的家庭因素影响。本研究拟使用父亲BMI作为阴性对照探讨母亲体重与子代过敏性疾病的关系。
方法: 本研究纳入广州出生队列2012年-2017年期间共10522例母子对数据进行分析。母亲的体重信息来源于问卷和产检资料,父亲的体重由问卷收集。子代1岁时的湿疹和喘息来自父母报告的诊断信息。相对危险度使用log-binominal回归计算,并对父母亲体重状态作相互校正。
结果: 子代1岁的湿疹和喘息发生率分别为16.2%和7.9%。当母亲孕前BMI作为连续型变量时,与子代湿疹发生不存在关联;相比于孕前体重正常妈妈,孕前超重/肥胖妈妈的子代发生湿疹的风险升高;未观察到父亲体重与子代湿疹存在相关。母亲孕前BMI和父亲体重均与子代喘息呈正相关。母亲孕期增重与子代湿疹和喘息不相关。
结论: 研究结果提示母亲孕前超重/肥胖可能通过宫内环境增加子代湿疹的发生风险,而母亲体重与子代喘息的关联则可能是受到未知的家庭因素的影响。我们的发现对过敏性疾病的早期预防具有重要意义。



题目: 基于前瞻性队列研究分析空气污染物联合暴露对妊娠期糖尿病的影响
Pubmed: https://pubmed.ncbi.nlm.nih.gov/34798119/
Date: 2021-11-17
妊娠期暴露于多种空气污染物与妊娠期糖尿病(GDM)的发病风险有关,但其联合暴露对GDM影响尚不清楚。 本项目拟评估从孕前及孕期臭氧(O3)、二氧化氮(NO2)、二氧化硫(SO2)、可吸入颗粒物(PM10)和细颗粒物(PM2.5)五种空气污染物与妊娠糖尿病的联合关联。基于自广州出生队列 (BIGCS) 本项目纳入了2015年9月至2018年9月招募的20113名孕妇。 利用反距离加权方法根据家庭住址评估每位孕妇孕前一年(分别为:孕前0-3月,孕前3-6月,6-9月,9-12月)、孕早期(0-13周)及孕中期(14-27周)空气污染物的平均浓度。利用广义估计方程估计了空气污染物与GDM之间的不同时期空气污染物暴露对GDM影响,并使用相对超额风险(RERI)和联合相对风险(JRR)评估了其联合效应。 在20113名参与者中,3440名女性(17.1%)被诊断为GDM。 在调整后的模型中,孕前O3、SO2浓度以及孕早期O3、PM10暴露与GDM的发生有关。孕早期SO2、NO2和PM10的联合暴露增加的GDM风险最高 (JRR = 1.32, 95% CI: 1.10, 1.59)。 O3和SO2的联合效应小于其相加效应[RERI =-0.25(-0.47, -0.04),交互作用P = 0.048]。 空气污染物与GDM的关系因孕前BMI和季节的不同而有所不同。 这项研究为多种空气污染物对GDM的联合作用提供了新的证据。 为减少空气污染对孕妇的不利影响提供数据支持。



题目: CircRNF220调节儿童急性髓系白血病细胞生长并与其复发相关
Pubmed: https://pubmed.ncbi.nlm.nih.gov/34702297/
Date: 2021-10-26
背景: 环状RNA (circRNAs)构成了一个具有独特结构的转录本家族,并已被证实在肿瘤发生中至关重要,是潜在的生物标志物或治疗靶点。然而,只有少数circRNA在儿童急性髓细胞白血病(AML)中得到了功能表征。
方法: 本研究中我们使用circRNA芯片研究了儿童AML中circRNA的表达模式。评估了circRNF220的特点、潜在的诊断价值和预后意义。我们进行了一系列功能实验来研究circRNF220在儿童原发性AML细胞中的作用。然后,我们通过RNA-seq研究了circRNF220在AML原代细胞中调控的异常转录网络。此外,我们还进行了生物素RNA下拉实验来验证circRNF220和miR-30a之间的关系。
结果: 我们鉴定了一种circRNA——circRNF220,在儿童AML患者的外周血和骨髓中特异性丰富和积累。对鉴别诊断AML与ALL及其他血液系统恶性肿瘤具有较高的敏感性和特异性。值得注意的是,circRNF220高表达是独立预测预后复发的生物标志物。此外,我们对circRNF220的功能进行了表征,发现特异性下调circRNF220后可抑制AML细胞增殖并促进其凋亡。在机制上,circRNF220可能作为miR-30a的内源性海绵,隔离miR-30a并抑制其活性,从而增加其靶蛋白MYSM1和IER2的表达,从而参与儿童AML进展过程。
结论: 研究发现表明circRNF220可以高效和特异性地准确诊断儿童AML,并对复发有预测意义。



题目: 新冠肺炎大流行与婴儿神经发育之间的关系:新冠肺炎之前和期间的比较
Pubmed: https://pubmed.ncbi.nlm.nih.gov/34692602/
Date: 2021-10-06
目的: 调查2019年冠状病毒病(COVID-19)大流行与6个月和1岁儿童神经发育之间的关系,并探讨出生顺序与神经发育之间的差异。
方法: 本研究纳入中国广州出生队列研究。暴露组包括2020年3月1日至5月15日期间参加神经发育评估的546名6个月大和285名1岁儿童,非暴露组包括2015年至2019年同期的3009名6个月大和2214名1岁儿童。6个月和1岁时的神经发育使用年龄和阶段问卷(ASQ-3)和Gesell发育量表(GDS)进行评估。
结果: Covid-19的经历与一岁时精细运动(经调整的OR:2.50,95%CI:1.25,4.99)和语言(经调整的RR[aRR]:1.13,95%CI:1.02,1.25)领域的延迟风险较高有关。COVID-19与1岁时语言发育延迟之间的关联仅存在于第一胎儿童(aRR:1.15,95%可信区间:1.03,1.30),而不存在于晚出生儿童(aRR:1.02,95%可信区间:0.84,1.25)。在六个月大的婴儿中,没有观察到任何领域的联系。
结论: 经历Covid-19大流行可能与1岁儿童精细运动发育和语言发育迟缓的风险相关;这种关联在语言发育迟缓方面仅存在于第一胎儿童。



题目: 自闭症谱系障碍中癫痫的患病率:系统回顾和荟萃分析
Pubmed: https://pubmed.ncbi.nlm.nih.gov/34510916/
Date: 2021-09-13
通过亚群分析和元回归模型对自成立以来到2020年关于自闭症患者癫痫患病率的原始文献进行了系统的回顾和进一步的探索。 本系统综述已在PROSPERO注册(CRD42020179725)。 其中包括53篇文章中的66篇研究。 最新的自闭症患者癫痫总患病率为10% (95%CI: 6%-14%)。 在基于临床样本的横断面研究中,癫痫的患病率分别为19% (95%CI: 6%-35%),队列研究中为7% (95%CI: 3%-11%),而在基于人群的横断面研究中为9% (95%CI: 5%-15%)。 自闭症儿童癫痫的总患病率为7% (95%CI: 4%-11%),自闭症成人癫痫的总患病率为19% (95%CI: 14%-24%)。 与学龄组相比,青春期组(OR:1.15, 95%CI:1.06-1.25)和学龄前组(OR:1.06, 95%CI:0.94-1.19)与癫痫患病率呈正相关。 年龄、国家的人类发展指数(HDI)、性别和智力功能是异质性的主要调节因子。 患病率估计与年龄、女性率、智力残疾率和各国的人类发展指数有关。 大约每10个自闭症患者中就有1个同时发生癫痫,但在临床人群、青少年、成人、女性或智力残疾人群中更常见。



题目: 婴儿早期湿疹发生率和产前危险因素 — 中国广东广州,2018-2019 年
Pubmed: https://pubmed.ncbi.nlm.nih.gov/34594970/
Date: 2021-08-13
关于这个主题已经知道什么?: 湿疹是儿童常见的过敏性疾病,严重影响儿童及其家人的生活质量。
此报告添加了哪些内容?: 结果显示,极早发型湿疹的发病率为12.4%。初产与湿疹风险较高相关[RR(95%CI):1.23(1.06-1.42)]。
对公共卫生实践有何影响?: 极早发型湿疹很常见。鉴于其对儿童健康和生活质量的不利影响,这一以前被忽视的公共卫生问题需要得到优先考虑。此外,孕妇产次为初产可作为婴儿湿疹风险评估和预测的指标。



题目: 在妊娠期糖尿病孕妇中识别与出生体重相关的连续血糖监测指标
Pubmed: https://pubmed.ncbi.nlm.nih.gov/34125410/
Date: 2021-07-14
目的: 确定与子代出生体重百分位数相关的妊娠期糖尿病(GDM)母亲的连续血糖监测(CGM)血糖指标。
方法: 本队列研究在2017年1月至2018年11月期间招募单胎GDM孕妇进行5-14天的连续血糖监测(平均28.8孕周)。采用CGM数据计算常用的反映单一血糖指标的血糖暴露(平均水平)指标(包括平均24小时、白天和夜间的血糖水平)和血糖变异性指标(包括J-指数和血糖波动的平均振幅)。利用光谱聚类方法,计算全新的综合血糖指标——每天处于血糖高变异模式下的小时数(HSSV)。该指标能综合反映了血糖暴露水平和变异水平。使用多元线性回归模型估计性别和胎龄调整的出生体重百分位数与这些CGM参数的相关性。
结果: 本研究纳入97名GDM,共127,279个血糖测量值。母亲夜间平均血糖水平和HSSV每增加1个标准差,子代新生儿出生体重百分位数分别增加6.0 (95% CI 0.4, 11.5)和6.3 (95% CI 0.4, 12.2)个百分点。其他血糖指标和出生体重百分位之间没有发现关联。
结论: 夜间平均血糖水平与HSSV与胎儿生长相关的效应值相当,提示内源性高血糖可能驱动母亲高血糖与出生体重之间的关系。需要进一步研究降低夜间血糖水平和/或HSSV对预防GDM孕妇的胎儿过度生长的作用。



题目: 血小板参数与妊娠高血压性疾病之间的关系:经倾向性评分调整的分析
Pubmed: https://pubmed.ncbi.nlm.nih.gov/34223796/
Date: 2021-07-05
已有研究报道了血小板在心血管疾病发生中的可能作用,但血小板与妊娠期高血压疾病之间的关系尚不清楚。本研究的目的是探讨孕20周前血小板指标与妊娠期高血压疾病之间的关系,包括子痫前期/子痫和妊娠期高血压。本研究基于广州出生队列,纳入了12053名在孕14-19周期间有血小板检测记录的孕妇,检测的血小板指标包括血小板计数(PC),血小板平均宽度(MPV),血小板压积(PCT)以及血小板分布宽度(PDW)。采用限制性立方样条函数和倾向性评分矫正的Logistics回归模型分析血小板指标与妊娠期高血压疾病的关系。限制性立方样条函数分析显示子痫前期/子痫发生风险与PC呈线性关系,与PCT呈非线性关系。妊娠期高血压发生风险与PC、MPV和PCT成线性关系,而与PDW呈非线性关系。当将血小板指标转换为五分类变量后,孕20周前PC和/或PCT更高的孕妇,发生子痫前期/子痫和妊娠期高血压的风险均增加。其中,与PCT的关系更为显著,孕妇PCT位于60%(≥ 0.23 %)以上者,疾病发生风险增加至2倍。孕妇MPV超过人群40%(≥ 8.8 fL) 以上者,妊娠期高血压发生风险增加,而与子痫前期/子痫的风险无统计学关系。孕20周前,较高水平的PC和/或PCT与子痫前期/子痫和妊娠期高血压的发生风险均相关,而MPV只与妊娠期高血压相关。



题目: 中国3-24个月社会退缩倾向的患病率和特征:一项初步研究
Pubmed: https://pubmed.ncbi.nlm.nih.gov/34220558/
Date: 2021-06-16
背景: 持续性退缩行为是儿童发展的一个障碍。本研究旨在使用“婴幼儿社交退缩行为量表”(ADBB)对中国幼儿社会退缩倾向的患病率进行初步评估,并描述社交退缩倾向儿童的特征。
方法: 这是一项横断面分析,作为前瞻性队列研究的一部分,共纳入114名3-24个月大的儿童。使用以下工具:中文版ADBB、年龄与发育进程问卷(ASQ-3)、年龄与发育进程问卷:社交-情绪(ASQ:SE)。使用ADBB评估儿童的社交退缩倾向。社交退缩被定义为ADBB得分为5分或以上。进行Student t检验、χ2检验和Fisher精确检验,以确定有和无社交退缩儿童之间母子特征的差异。
结果: 约16.7%的儿童在社交方面退缩倾向。与没有社交退缩的儿童相比,有社交退缩的儿童年龄更大,男孩比例更高(68.4%对42.1%),社交情感发展延迟。
结论: 通过ADBB评估,中国幼儿社会退缩倾向的患病率与欧洲人群中报告的相似;社交退缩儿童的社交情绪发展较差。需要进一步的大样本研究来验证该量表并证实这些发现。



题目: 孕早期SARS-CoV-2无症状感染对孕妇、胎盘以及新生儿的影响:病例报告
Pubmed: https://pubmed.ncbi.nlm.nih.gov/33968612/
Date: 2021-05-04
妊娠早期SARS-CoV-2感染对孕妇和胎儿的影响尚不清楚。我们描述了一例妊娠早期无症状SARS-CoV-2感染孕妇的随访结局。这名妇女在怀孕第七周时,鼻咽拭子检测出SARS-CoV-2病毒RNA阳性,并被送往当地医院接受治疗。尽管该妇女的体重指数高于28,妊娠期体重增加21公斤,但未发现与SARS-CoV-2相关的妊娠并发症或严重并发症。孕22周胎儿超声检查未发现异常。足月(37周)分娩,新生儿出生体重为3100克。胎盘组织学检查提示胎盘功能不全,但这种改变与SARS-CoV-2感染无关。胎盘和脐带SARS-CoV-2 RNA、spike蛋白1和核衣壳蛋白的原位杂交和免疫组化试验均为阴性。然而,ACE-2在胎盘、脐带和胎膜样本中呈阳性。婴儿出生后随访至10天,生长正常。我们的结果表明,妊娠早期无症状的SARS-CoV-2感染可能对母亲和发育中的胎儿没有明显不良影响。我们的研究发现需要人群研究进一步验证。



题目: 围产期叶酸补充与子代ASD的发生风险:Meta分析和Meta回归分析
Pubmed: https://pubmed.ncbi.nlm.nih.gov/33743119/
Date: 2021-03-20
我们系统综述了母亲孕期叶酸补充与子代孤独症发生风险关联的文献。纳入了10篇文献的23个研究(含9795孤独症患者)。孕早期的叶酸补充减少子代ASD发生风险[OR 0.57, 95% CI:0.41–0.78]。每天至少摄入来自膳食或者补充剂中的400ug叶酸可以减少子代ASD的发生风险[OR 0.55, 95% CI 0.36–0.83]。本研究提出了关键有效的叶酸补充策略,如服用孕期和服用剂量,以上策略将可能有效地助于降低子代ASD的发生风险。本研究提供了预防子代ASD发生风险的新方向。



题目: 广州先天性小头畸形患病率及其围产危险因素
Pubmed: https://pubmed.ncbi.nlm.nih.gov/33731027/
Date: 2021-03-17
背景: 在没有寨卡病毒流行的人群中,新生儿小头畸形的患病率很小。该研究旨在报告寨卡病毒爆发潜在高风险地区先天性小头畸形的基线患病率及其与产前因素的关系。
方法: 本研究纳入2017-2018年在广州4家医院出生且出生胎龄超过24孕周的46610名单胎活产婴儿。小头畸形的定义是出生时的头围低于同性别和同胎龄的头围平均值3个标准差以上。采用二项精确法估计小头畸形的患病率。采用多变量logistic回归分析产前因素与小头畸形的关系。计算相关危险因素的人群归因比例。
结果: 在46610例活产婴儿中,有154例(3.3,95% CI 2.8-3.9 ,每 1000个活产)被发现患有小头症。母体乙型肝炎病毒携带者(HBV,OR 1.80, 95%置信区间1.05-3.10)和初产妇(OR 2.68,95%置信区间1.89-3.81)生小头症婴儿的风险较高。早产(OR 1.98, 95%置信区间1.17-3.34)和胎儿生长受限(OR 16.38,95%置信区间11.81-22.71)的孕妇有较高的小头畸形发生率。四个因素(乙型肝炎病毒携带、初产、早产和胎儿生长迟缓)贡献了66.4%的小头畸形风险。
结论: 广州市小头畸形患病率高于预期。这项研究确定了四种产前风险因素,它们共同贡献了2/3的小头畸形风险。本研究首次报道了母亲乙肝病毒携带与小头畸形之间的关系。



题目: 孕期不同阶段胎儿生长发育与儿童生长受限、低体重和肥胖之间的关系:一项前瞻性队列研究
Pubmed: https://pubmed.ncbi.nlm.nih.gov/33690938/
Date: 2021-03-10
目的: 研究不同孕期的胎儿生长与不良儿童生长结局的关联性,并评估母体代谢因素是否会改变这种关联性。
研究设计: 前瞻性队列研究。
研究人群: 来自广州出生队列研究的4818对母子。
方法: 利用22周至出生前的超声检查评估胎儿体重,采用multilevel linear spline models,估计胎儿在22周的大小,以及在22-27周、28-36周和37周后的生长速率。同时,随访儿童至3岁,收集体格生长数据。 主要结局指标:儿童生长迟缓;体重不足;超重/肥胖;以及3岁时年龄别身长/身高z分(LAZ/HAZ)、体重z分(WAZ)和体质指数(BMIZ)z分。使用泊松或线性回归分析胎儿生长与儿童生长指标的关联性。
结果: 22周的胎儿大小、22-27周及28-36周生长速率与儿童超重/肥胖风险呈正相关,即胎儿生长越快,发生儿童超重/肥胖风险越高。另外,各个阶段的胎儿生长与儿童期生长迟缓及低体重风险呈负相关,尤其是孕早期和孕中期的胎儿生长。以LAZ/HAZ、WAZ、BMIZ作为结局指标的分析结果相似。体重不足或超重/肥胖母亲的胎儿生长与儿童期超重/肥胖的关联性强于正常体重母亲。
结论: 妊娠37周前胎儿生长过快可增加儿童期肥胖发生风险,而28周前胎儿生长和儿童期生长迟缓及低体重最为相关。




2020年发表文章中英文摘要

题目: 孕妇饮食模式与孕期抑郁症状:广州出生队列研究
Pubmed: https://pubmed.ncbi.nlm.nih.gov/33384181/
Date: 2020-12-07
背景与目的: 孕期抑郁影响母婴健康。营养和心理之间的相互影响可能发挥关键作用。但来自整个孕期的纵向研究的证据仍然不足。这项研究的目的是探究孕期饮食模式与抑郁症状之间的关系。
方法: 本研究基于广州出生队列。在妊娠中期用食物频率问卷收集饮食情况,通过聚类分析确定饮食模式,并根据现有饮食指南的标准制定了健康饮食评分。采用抑郁自评量表(SDS)分别对妊娠早期和晚期的抑郁症状进行测量,SDS评分≥53分定义为有抑郁症状。用混合线性模型检验饮食模式与SDS评分的关系;用混合效应logistic模型检验饮食模式与抑郁症状风险的关系。本研究还进一步探讨了健康饮食评分与饮食模式和抑郁症状的关系。
结果: 在17430名孕妇中发现了六种饮食模式,即“多样型”(n = 3902, 22.4%),“蔬菜型”(n = 3269, 18.8%),“肉类型”(n = 2951, 16.9%),“谷物型”(n = 2719, 15.6%),“牛奶型”(n = 2377, 13.6%),和“水果型”(n = 2212, 12.7%)。妊娠早期和晚期分别有19.3%和15.7%的孕妇有抑郁症状。与“多样型”模式相比,除“谷物型”外所有其他饮食模式都与孕期更低的SDS评分有关(“蔬菜型”:调整后β [aβ] −0.78,95% CI −1.16, −0.40;“肉类型”:aβ −0.48,95% CI −0.87, −0.09;“牛奶型”:aβ −0.52,95% CI −0.94, −0.10;“水果型”:aβ −0.85,95% CI −1.27, −0.42)。“蔬菜型”(调整后OR [aOR] 0.79,95% CI 0.67, 0.93),“牛奶型”(aOR 0.76,95% CI 0.63, 0.91)和“水果型”(aOR 0.77,95% CI 0.64, 0.93)饮食模式与孕期更低的抑郁症状风险相关。健康饮食评分结果显示“蔬菜型”、“水果型”和“牛奶型”是较为健康的饮食模式,并支持了健康饮食模式与孕期抑郁症状之间的负相关关系。
结论: 在整个孕期,富含蔬菜、水果、坚果和乳制品的饮食模式与抑郁症状呈负相关关系。我们的研究结果支持了现有的饮食指南,即健康的饮食可能也对产妇的心理健康有潜在的好处。



题目: 2001-2016年广州250万新生儿早产发生率的增长趋势:年龄-时期-队列分析
Pubmed: https://pubmed.ncbi.nlm.nih.gov/33148212/
Date: 2020-11-04
背景: 近年来,在中国和许多其他国家,早产(PTB,<37周)的发病率呈上升趋势,但原因尚不清楚。本研究的目的是分析中国广州地区产妇年龄、分娩时间和产妇出生队列对早产长期趋势的影响。
方法: 在一项基于人群的回顾性研究中,收集了2001年至2016年期间广州市妇幼健康监测系统记录的2,535,000例出生孕周为20-43周的单胎活产儿数据。按产次分层,采用年龄-时期-队列模型研究早产发生率的趋势变化。
结果: 早产发生率从2001年的5.1%稳步上升至2016年的5.9%,其中初产妇(由5.0上升至5.9%)的增幅高于经产妇(由5.6上升至5.9%)。在初产妇和经产妇中年龄与早产的关系分别呈J型和V型。初产妇出生年份与早产风险呈线性关系,与1981年出生的初产妇相比,1961年出生的初产妇发生早产的风险最低[风险比(RR) = 0.81, 95%可信区间(CI): 0.74 - 0.89],而1997年出生的初产妇发生早产的风险最高(RR = 1.06, 95% CI: 1.00 - 1.13)。经产妇出生年份与早产风险呈倒U型相关。经产妇早产趋势在2001-2012年均有较弱的下降趋势,这在极早早产(<27周)或早期早产(28-31周)的初产、经产妇中也有同样的趋势。
结论: 我们的研究结果表明,在过去的16年里,广州早产发生率一直在上升,孕产妇年龄和队列效应对这种趋势变化有重要作用。建议进一步研究产妇年龄和产次的改变对早产的影响,以及相应的公共教育和公共卫生政策。



题目: 孕期抑郁与子代湿疹的关系:广州出生队列研究
Pubmed: https://pubmed.ncbi.nlm.nih.gov/32301157/
Date: 2020-04-16
背景: 湿疹危害婴儿健康,然而母亲孕期抑郁在湿疹早期发病风险中的作用尚不清楚。本研究旨在探讨不同时点孕期抑郁与婴儿湿疹的关系。
方法: 本研究基于广州出生队列研究开展。通过问卷调查母亲孕早期和孕晚期的抑郁情况以及1岁时的婴儿湿疹的诊断信息。采用多变量逻辑回归模型。
结果: 7.7%的母亲在孕期有持续抑郁症状,10.1%的母亲仅在孕早期有抑郁症状,8.4%的母亲仅在妊娠晚期有抑郁症状。孕期有持续抑郁状态的母亲,其子代在1岁患湿疹的风险是孕期没有抑郁状态的1.55倍(95% CI 1.19-2.03)。这种关联在父母亲没有过敏性疾病的家庭中更明显。
结论: 母亲在怀孕期间持续的抑郁症状增加婴儿湿疹的发生风险,尤其是在没有过敏性疾病家族史的儿童。如果这种关联被证明是因果关系,孕期抑郁可作为干预的目标,不仅改善妇女的健康,而且还可以降低子代湿疹的发生风险。



题目: 新生儿脐带血中的葡萄糖,胰岛素和脂质及其与出生体重的关系:大于胎龄儿和小于胎龄儿的代谢差异风险
Pubmed: https://pubmed.ncbi.nlm.nih.gov/32093929/
Date: 2020-02-21
目标: 调查出生体重百分比与脐带血糖,脂质和胰岛素水平的关系。
研究设计: “广州出生队列”中1522名新生儿的数据被应用于该项研究。使用广义加性模型和多元线性回归模型探讨出生体重与脐带血代谢指标之间的非线性和线性关系,并评估代谢指标Z分数在大于胎龄儿,正常胎龄儿和小于胎龄儿的差别。
结果: 出生体重Z分数与脐血胰岛素Z分数增加呈线性相关(调整后的β= 0.30; 95%CI,0.22-0.37)。与正常胎龄儿的婴儿相比,胎龄小的新生儿脐带血甘油三酸酯的Z评分(调整后的平均差异[MDadj]为0.60; 95%CI为0.40-0.79)明显较高,脐带血胰岛素较低(MDadj为− 0.37; 95%CI,-0.57至-0.16),高密度脂蛋白胆固醇(MDadj,-0.34; 95%CI,-0.55至-0.13),总胆固醇(MDadj,-0.26; 95%CI,-0.47至-0.05)和低密度脂蛋白(MDadj,-0.23; 95%CI,-0.43至-0.02)Z评分,以及大于胎龄儿的新生儿脐血胰岛素Z评分较高(MDadj,0.31; 95) %CI,0.09至0.52)。
结论: 我们的发现支持以下假设:小于胎龄儿和大于胎龄儿暴露于不同的子宫内环境,这可能会导致脂肪堆积方式的改变,从而引发以后生命中代谢功能障碍的风险。有必要考虑开发量身定制的干预策略,以防止这些婴儿的成年后代谢功能障碍。



题目: 妊娠期糖尿病孕期瘦素特征谱
Pubmed: https://pubmed.ncbi.nlm.nih.gov/32006645/
Date: 2020-01-29
目的: 评估患有妊娠糖尿病(GDM)的孕妇与正常对照孕妇体内的瘦素特征谱差异。
方法: 采用巢式病例对照研究,基于广州出生队列研究,共纳入198例GDM病例和192例对照。孕妇血浆瘦素谱定义为在妊娠早期(基线)和妊娠晚期测量的瘦素浓度,以及妊娠晚期与基线时的浓度比(RL1 / L0)。利用一般线性回归模型评估GDM和对数转换的瘦素浓度之间的关联。
结果: 与对照组孕妇相比, GDM孕妇基线时的瘦素浓度更高,而RL1 / L0更低。GDM诊断与基线时的对数转换瘦素浓度(β:0.19,95%CI:0.04,0.34)和RL1 / L0(β:-0.22,95%CI:-0.41,-0.03)相关。此外,GDM和对照组孕妇的RL1 / L0随着1小时葡萄糖水平的增加以及1小时和空腹血糖水平之差而明显下降。
结论: GDM孕妇具有特殊的外周血循坏瘦素浓度特征谱,其在基线时的瘦素浓度较高,但整个孕妇的增加值较少,这可能意味着胰岛素抵抗增加而带来的代偿受损。




往年研究结果摘要

中国孕妇参加出生队列研究的意愿调查

目的:调查中国广州孕妇参加大型出生队列研究的意愿情况。
方法:采用横断面研究设计对第一次参加广州市妇女儿童医疗中心产前学习班的孕妇进行调查。从2011年9月21日至2011年11月15日共调查526名孕妇,收集人口学特征、参加生队列研究的意愿、愿意接受的数据收集方式以及激励措施的偏好等数据。
结果:47.9%的孕妇愿意参加出生队列研究,而23.0%拒绝和29.1%不确定。除了粪便收集,95.2%-98.4%愿意参与出生队列研究的孕妇能接受非侵入性的数据收集方式;85.9%孕妇愿意其子女参加长期随访。当孕妇给予非金钱的激励措施时,愿意参加出生队列研究的孕妇比例上升至85.2%。最受欢迎的激励措施是儿童发育评估。
结论:中国广州孕妇参加长期观察性研究的意愿与高收入国家相似。非金钱的激励措施能提高意愿水平。这一发现会对低收入和中等收入国家孕产妇和儿童健康研究的研究对象招募有提示意义。

Willingness of pregnant women to participate in a birth cohort study in China.

Qiu X, He J, Qiu L, Larson CP, Xia H, Lam KB. Int J Gynaecol Obstet. 2013 Sep;122(3):216-8.

OBJECTIVE:
To determine the willingness of pregnant women in Guangzhou, China, to participate in a large-scale birth cohort study.
METHODS:
A cross-sectional survey was conducted of 526 pregnant women who attended their first prenatal class at Guangzhou Women and Children's Medical Center, Guangzhou, China, between September 21 and November 15, 2011. Information on demographic characteristics, willingness to participate, and preferences regarding collection procedures and incentives were analyzed.
RESULTS:
In all, 47.9% of the women were willing to participate in a birth cohort study, whereas 23.0% refused and 29.1% were unsure. The majority of the women willing to participate (95.2%-98.4%) accepted the use of non-invasive data collection methods except for stool collection, and 85.9% would allow their offspring to participate in long-term follow-up. Willingness to participate rose to 85.2% when non-monetary incentives were offered. The most popular incentive was assessment of child development.
CONCLUSION:
The willingness of pregnant Chinese women to participate in long-term observational research was similar to that reported in high-income countries. Non-monetary incentives improved their level of willingness, a finding that might inform future maternal and child health research in low- and middle-income countries.

脐血adropin水平与胎儿生长的关系

  Adropin是一种新近发现的多肽,参与能量平衡和血管功能的调节。本研究的目的是探讨人脐带血adropin水平与胎儿生长之间的关系。共纳入159新生儿,其中早产(PTD)72例,足月分娩87例。采用酶联免疫检测试剂盒(ELISA)测定脐血adropin水平,同时收集胎儿生长的临床资料。 PTD婴儿的adropin水平(中位数为2028; 25th ~ 75th,1413 ~ 2484 pg/ml)明显低于足月分娩婴儿(中位数,2305; 25th ~ 75th,1960 ~ 2684 pg/ml,P = 0.01)。在足月分娩组中,出生体重和身长的Z评分、Ponderal指数、胎盘长度、宽度、厚度、表面积、体积和密度与adropin水平无显著相关。然而,在PTD组中,我们发现adropin浓度与胎龄(Spearman相关系数=0.35,P <0.01)和胎盘重量(Spearman相关系数=0.24,P=0.04)呈正相关。我们还发现,在PTD组中,男孩的adropin水平比女孩低(P = 0.01)。当分析扩展到整个人群(合并PTD组和足月分娩组),所得结果与PTD组的相似。在调整了年龄产妇和新生儿性别后,adropin水平的升高能降低早产的风险(每增加100 pg/ml的比值比为0.95; 95%可信区间为0.91~0.99)。我们的研究表明脐血adropin水平与胎龄及胎盘重量呈正相关,但其他的胎儿生长参数无关。 

Relationship between human cord blood adropin levels and fetal growth.

Qiu X, He JR, Zhao MG, Kuang YS, Xu SQ, Zhang HZ, Hu SP, Chen J, Xia HM. Peptides. 2014 Feb;52:19-22

Adropin is a recently identified peptide and participates in the regulation of energy homeostasis and vascular function. The aim of this study was to examine the relationships between human cord blood adropin levels and fetal growth. A total of 159 newborns [preterm delivery (PTD), n=72; term delivery, n=87] were recruited. Adropin levels in cord blood were determined using enzyme-linked immunosorbent assay kits. Clinical information on fetal growth was collected. Adropin levels in PTD babies (median, 2028; 25th-75th, 1413-2484pg/ml) were lower than those in term delivery babies (median, 2305; 25th-75th, 1960-2684pg/ml, P=0.01). Birth weight and length z score, Ponderal index, placental length, breadth, thickness, surface area, volume and density were not significantly correlated to adropin concentrations in term delivery group. However, we found adropin concentrations were significantly correlated to gestational age at birth (Spearman's correlation coefficient=0.35, P<0.01) and placental weight (Spearman's correlation coefficient=0.24, P=0.04) in PTD group. We also found that boys had lower adropin levels than girls in PTD group (P=0.01). When the analysis was extended to the whole group (PTD and term deliveries combined), the results were similar to those for PTD group alone. After adjusting for maternal age and newborn's sex, every 100pg/ml increase of adropin concentration was significantly associated with a decreased risk of PTD (odds ratio, 0.95; 95% confidence interval, 0.91-0.99). Our study showed that cord blood adropin levels were positively correlated with gestational age and placental weight but not with other fetal growth parameters.

中国广州出生体重参考曲线及与全球标准的比较

目的:建立中国广州出生体重参考曲线,并与中国目前使用的标准及全球标准作比较。
方法:纳入广州2009至2011年围产健康与分娩监测系统所有出生孕周>26周的新生儿数据(n=510 837),并补充纳入2007-2008年出生孕周为26-33周的新生儿数据。采用Gaussian mixture models 和 robust regression剔除出生体重异常值,利用Generalized Additive Models for Location, Scale, and Shape (GAMLSS)建议按产次、婴儿性别分组的出生体重百分位曲线。
结果:被新参考曲线(广州曲线)定义为小于胎龄儿(SGA)的婴儿中,15.3-47.7%会被中国目前使用的标准判断为适于胎龄儿(AGA)。此外,被新参考曲线定义为SGA)的婴儿中,9.2%出生在34-36周婴儿和14.3%出生在37-41周的婴儿会被全球标准判断为AGA。对于50th百分位曲线,在26-33周新参考曲线与全球标准相近,而在34-40周,新参考曲线则高于全球标准。
结论:本研究的广州新参考曲线与中国目前使用的标准及全球标准不同,更适用于广州本土人群。

A new birthweight reference in Guangzhou, southern China, and its comparison with the global reference.

He JR, Xia HM, Liu Y, Xia XY, Mo WJ, Wang P, Cheng KK, Leung GM, Feng Q, Schooling CM, Qiu X. Arch Dis Child. 2014 Dec;99(12):1091-7.

OBJECTIVE:
To formulate a new birthweight reference for different gestational ages in Guangzhou, southern China, and compare it with the currently used reference in China and the global reference.
METHODS:
All singleton live births of more than 26 weeks' gestational age recorded in the Guangzhou Perinatal Health Care and Delivery Surveillance System for the years 2009, 2010 and 2011 (n=510 837) were retrospectively included in the study. In addition, the study sample was supplemented by all singleton live births (n=3538) at gestational ages 26-33 weeks from 2007 and 2008. We used Gaussian mixture models and robust regression to exclude outliers of birth weight and then applied Generalized Additive Models for Location, Scale, and Shape (GAMLSS) to generate smoothed percentile curves separately for gender and parity.
RESULTS:
Of infants defined as small for gestational age (SGA) in the new reference, 15.3-47.7% (depending on gestational age) were considered appropriate for gestational age (AGA) by the currently used reference of China. Of the infants defined as SGA by the new reference, 9.2% with gestational ages 34-36 weeks and 14.3% with 37-41 weeks were considered AGA by the global reference. At the 50th centile line, the new reference curve was similar to that of the global reference for gestational ages 26-33 weeks and above the global reference for 34-40 weeks.
CONCLUSION:
The new birthweight reference based on birthweight data for neonates in Guangzhou, China, differs from the reference currently used in China and the global reference, and appears to be more relevant to the local population.

广州市2002年与2012年新生儿出生体重变化

背景:近年来,发达国家的监测数据显示新生儿出生体重呈下降趋势。广州为中国相对发达的地区之一,本研究的目的为探索广州市2002-2012年活产儿出生体重的变化情况。
方法:我们选择广州市围产保健与分娩登记系统中28-41周分娩的活产儿为研究对象,共纳入2002年活产儿34108例,2012年活产儿54575例。分析了全人群的出生体重、小于胎龄儿(SGA)、大于胎龄儿(LGA)的变化趋势,并根据分娩孕周进行了亚组分析。
结果:平均出生体重从2002年的3162g下降到2012年3137g(粗下降差值:-25g;95%CI:-30 ~ -19);控制了产妇年龄、教育程度、分娩孕周、产次、新生儿性别及分娩方式等因素后,出生体重变化显示轻微下降(从2002年到2012年下降6g)。与2002年相比,2012年SGA和LGA的比例分别下降了0.6% 和1.5%。平均分娩孕周从2002年的39.2周下降到2012年的38.9周。根据分娩孕周分类的亚组分析发现,出生体重下降主要出现在28-31周分娩的活产儿,其他孕周分娩活产儿出生体重相对稳定。
结论:广州市2002年到2012年活产儿出生体重呈现轻微下降趋势。SGA和LGA的比例同时呈现下降趋势,提示更多新生儿出生体重为适于胎龄儿的理想体重。

Changes in birth weight between 2002 and 2012 in Guangzhou, China

Yong Guo1,2, Yu Liu1, 2, Jian-Rong He1, 2, Xiao-Yan Xia1, 2, 3, Wei-Jian Mo2, Ping Wang2, Qiong Feng2, Charles P. Larson4, Hui-Min Xia1, Xiu Qiu1, 2

Background:
Recent surveillance data suggest that mean birth weight has begun to decline in several developed countries. The aim of this study is to examine the changes in birth weight among singleton live births from 2002 to 2012 in Guangzhou, one of the most rapidly developed cities in China.
METHODS:
We used data from the Guangzhou Perinatal Health Care and Delivery Surveillance System for 34108 and 54575 singleton live births with 28–41 weeks of gestation, who were born to local mothers, in 2002 and 2012, respectively. The trends in birth weight, small (SGA) and large (LGA) for gestational age and gestational length were explored in the overall population and gestational age subgroups.
RESULTS:
The mean birth weight decreased from 3162g in 2002 to 3137g in 2012 (crude mean difference, -25g; 95% CI, -30 to -19). The adjusted change in mean birth weight appeared to be slight (-6g from 2002 to 2012) after controlling for maternal age, gestational age, educational level, parity, newborn’s gender and delivery mode. The percentages of SGA and LGA in 2012 were 0.6% and 1.5% lower than those in 2002, respectively. The mean gestational age dropped from 39.2 weeks in 2002 to 38.9 weeks in 2012. In the stratified analysis, we observed the changes in birth weight differed among gestational age groups. The mean birth weight decreased among very preterm births (28-31 weeks), while remained relatively stable among other gestational age subcategories.
CONCLUSION:
Among local population in Guangzhou from 2002 to 2012, birth weight appeared to slightly decrease. The percentage of SGA and LGA also simultaneously dropped, indicating that newborns might gain a healthier weight for gestational age.

广州气温变化与儿童呼吸道感染的关系

  本研究主要探讨广州市气温变化与儿童呼吸道感染疾病之间的关系。我们通过广州市妇女儿童医疗中心门诊系统收集了2012年1月-2013年12月儿童呼吸道感染的就诊记录,并通过广州市气象局获得了广州市同期的气温记录。气温变化设定为连续两天的平均气温差值,我们通过分布式滞后非线性模型(DLNM)分析了气温变化与儿童呼吸道感染就诊情况的关系。结果发现剧烈的气温下降与儿童呼吸道疾病就诊人数增加相关,持续效应达10天左右,气温下降(-8.8°C)对儿童呼吸道感染影响的最大效应出现在2-3天之后,1岁以下儿童是最易收到气温变化影响的群体。

Association between temperature change and outpatient visits for respiratory tract infections among children in Guangzhou, China

Yu Liu, Yong Guo, Changbing Wang, Weidong Li, Jinhua Lu, Songying Shen, Huimin Xia, Jianrong He, and Xiu Qiu

The current study examined the association between temperature change and clinical visits for childhood respiratory tract infections (RTIs) in Guangzhou, China. Outpatient records of clinical visits for pediatric RTIs which occurred from 1 January 2012 to 31 December 2013 were collected from Guangzhou Women and Children's Hospital. Records for meteorological variables during the same period were obtained from the Guangzhou Meteorological Bureau. Temperature change was defined as the difference between the mean temperatures on two consecutive days. A distributed lag non-linear model (DLNM) was used to examine the impact of temperature change on pediatric outpatient visits for RTIs. A large temperature decrease was associated with a significant risk for an RTI, with the effect lasting for ~ 10 days. The maximum effect of a temperature drop (-8.8°C) was reached at lag 2~3 days. Children aged 0-2 years, and especially those aged < 1 year were particularly vulnerable to the effects of temperature drop. An extreme temperature decrease affected the number of patient visits for both upper respiratory tract infections (URTIs) and lower respiratory tract infections (LRTIs). A temperature change between consecutive days, and particularly an extreme temperature decrease, was significantly associated with increased pediatric outpatient visits for RTIs in Guangzhou.

孕妇饮食模式与妊娠糖尿病的关系:来自中国一项大型的前瞻性队列研究

  目前仅有少量的研究探讨孕期饮食模式与妊娠糖尿病(GDM)的关系,尤其是来自非西方国家的数据十分缺乏。在本研究中,我们旨在中国人群中,探讨孕妇饮食模式与妊娠糖尿病的关系。本研究共纳入广州出生队列的3063名孕妇。在孕24-27周采用FFQ进行饮食调查。采用2小时口服糖耐量试验作GDM诊断。利用因子分析法探索饮食模式,并利用log-binomial regression model分析饮食模式与GDM发生风险的关系。在本人群中存在4种孕妇模式:蔬菜型、蛋白型、节俭型、甜食和海产品型。多因素分析显示,蔬菜摄入量多与GDM风险降低相关(与是低三分位相比,最高三分位的RR为 0•79, 95% CI 0.64, 0•97)),并与糖尿病家族史存在交互作用。甜食和海产品摄入过多则会增加GDM风险(RR 1•23, 95% CI 1•02, 1•49),而蛋白型和节俭型模式与GDM风险无关联。我们的发现可能会有助于孕期的饮食咨询。

Maternal dietary patterns and gestational diabetes mellitus: a large prospective cohort study in China.

He JR, Yuan MY, Chen NN, Lu JH, Hu CY, Mai WB, Zhang RF, Pan YH, Qiu L, Wu YF, Xiao WQ, Liu Y, Xia HM, Qiu X. Br J Nutr. 2015 Apr 28;113(8):1292-300.

Few studies have explored the relationship between dietary patterns and the risk of gestational diabetes mellitus (GDM). Evidence from non-Western areas is particularly lacking. In the present study, we aimed to examine the associations between dietary patterns and the risk of GDM in a Chinese population. A total of 3063 pregnant Chinese women from an ongoing prospective cohort study were included. Data on dietary intake were collected using a FFQ at 24-27 weeks of gestation. GDM was diagnosed using a 75 g, 2 h oral glucose tolerance test. Dietary patterns were determined by principal components factor analysis. A log-binomial regression model was used to examine the associations between dietary pattern and the risk of GDM. The analysis identified four dietary patterns: vegetable pattern; protein-rich pattern; prudent pattern; sweets and seafood pattern. Multivariate analysis showed that the highest tertile of the vegetable pattern was associated with a decreased risk of GDM (relative risk (RR) 0•79, 95% CI 0.64, 0•97), compared with the lowest tertile, whereas the highest tertile of the sweets and seafood pattern was associated with an increased risk of GDM (RR 1•23, 95% CI 1•02, 1•49). No significant association was found for either the protein-rich or the prudent pattern. The protective effect of a high vegetable pattern score was more evident among women who had a family history of diabetes (P for interaction=0•022). These findings suggest that the vegetable pattern was associated with a decreased risk of GDM, while the sweets and seafood pattern was associated with an increased risk of GDM. These findings may be useful in dietary counselling during pregnancy.

miR-181a在儿童急性髓细胞白血病中靶向调控ATM表达而促进细胞增殖

  已有的研究表明,异常表达的miRNA与人类多种肿瘤相关,miR-181a是与造血系统密切相关的“明星分子”,但是其在儿童急性髓细胞白血病(AML)的表达及功能机制还不甚清晰。本文采用荧光定量PCR法检测了46例儿童AML中miR-181a的表达,并在体内水平对miR-181a的功能和作用机制进行了研究。结果发现,与对照组相比,miR-181a在儿童AML中异常高表达。在白血病细胞系中过表达miR-181a后能促使癌细胞的周期进程加快,促进细胞增殖。而且,鉴定出了毛细血管共济失调基因ATM是miR-181a的下游靶基因,miR-181a很可能通过靶向抑制ATM发挥作用。这一结果为我们治疗儿童AML提供了新的靶点,具有潜在的临床价值。

miR-181a promotes G1/S transition and cell proliferation in pediatric acute myeloid leukemia by targeting ATM

Xiaodan Liu,Wang Liao,Hongxia Peng,Xuequn Luo,Ziyan Luo,Hua Jiang,Ling Xu

Purpose:
Abnormal expression of miRNAs is intimately related to a variety of human cancers. The purpose of this study is to confirm the expression of miR-181a and elucidate its physiological function and mechanism in pediatric acute myeloid leukemia (AML).
METHODS:
Pediatric AML patients and healthy controls were enrolled, and the expression of miR-181a and ataxia telangiectasia mutated (ATM) in tissues were examined using quantitative PCR. Moreover, cell proliferation and cell cycle were evaluated in several cell lines (HL60, NB4 and K562) by using flow cytometry after transfected with miR-181a mimics and inhibitors, or ATM siRNA and control siRNA. Finally, ATM as the potential target protein of miR-181a was examined.
RESULTS:
We found that miR-181a was significantly increased in pediatric AML, which showed an inverse association with ATM expression. Overexpressed miR- 181a in cell lines significantly enhanced cell proliferation, as well as increased the ratio of S-phase cells by miR-181a mimics transfection in vitro. Luciferase activity of the reporter construct identified ATM as the direct molecular target of miR-181a. ATM siRNA transfection significantly enhanced cell proliferation and increased the ratio of S-phase cells in vitro.
CONCLUSION:
The results revealed novel mechanism through which miR-181a regulates G1/S transition and cell proliferation in pediatric AML by regulating the tumor suppressor ATM, providing insights into the molecular mechanism in pediatric AML.

广州气温与早产风险

背景:已有大量研究报道了天气变化对人类健康的影响,但鲜有研究探讨其对发展中国家孕妇的作用。
目的:分析在广州孕期气温暴露与早产(分娩孕周<37周)风险的关系。
方法:采用Cox proportional hazards model分析孕期每周平均气温与早产风险的关系。时间窗包括:妊娠最后1周、妊娠最后4周、孕晚期(20周后)和整个孕期。每日气象数据来源于广州市气象局。
结果:本研究共纳入838,146单胎、阴道分娩活产儿,其中47,209 (5.6%)为早产儿。妊娠最后4周、孕晚期(20周后)和整个孕期的高温暴露会增加早产风险。与中位温度相比(24.4°C),妊娠最后4周的极低温(7.6°C)和极高温(31.9°C)分别增加17.9% (95% CI: 10.2, 26.2%)和10.0% (95% CI: 2.9, 17.6%)早产风险。此外,极高温的效应在20-31和 32-34周出生的婴儿中更为强烈。
结论:我们的研究对广州或其它相似气候条件地区的早产预防有重要提示意义。

Ambient Temperature and the Risk of Preterm Birth in Guangzhou, China (2001-2011).

He JR, Liu Y, Xia XY, Ma WJ, Lin HL, Kan HD, Lu JH, Feng Q, Mo WJ, Wang P, Xia HM, Qiu X, Muglia LJ. Environ Health Perspect. 2015 Dec 15.

Background:
Although effects of weather changes on human health have been widely reported, there is limited information regarding effects on pregnant women in developing countries.
OBJECTIVE:
To investigate the association between maternal exposure to ambient temperature and the risk of preterm birth (< 37 weeks of gestation) in Guangzhou, China.
METHODS:
We used a Cox proportional hazards model to estimate associations between preterm birth and average temperature during each week of gestation, with weekly temperature modeled as a time-varying exposure during four time windows: 1-week, 4-week, late pregnancy (gestational week 20 onwards), and the entire pregnancy. Information on singleton vaginal birth between 2001 and 2011 was collected. Daily meteorological data during the same period were obtained from the Guangzhou Meteorological Bureau.
RESULTS:
A total of 838,146 singleton vaginal births were included, amongst which 47,209 (5.6%) were preterm births. High mean temperatures during the previous 4 weeks, late pregnancy, and the entire pregnancy were associated with an increased risk of preterm birth. Compared with the median temperature (24.4°C), weekly exposures during the past 4 weeks to extreme cold (7.6°C, the 1st percentile) and extreme heat (31.9°C, the 99th percentile) were associated with 17.9% (95% CI: 10.2, 26.2%) and 10.0% (95% CI: 2.9, 17.6%) increased risks of preterm birth, respectively. The association between extreme heat and preterm birth was stronger for preterm births during weeks 20-31 and 32-34 than those during weeks 35-36.
CONCLUSION:
These findings might have important implications in preventing preterm birth in Guangzhou as well as other areas with similar weather conditions.

CTRP3 存在脐血中并与胎儿生成相关

目的:确定CTRP3是否存在脐血中,以及确定CTRP3与中国人群胎儿生长的关系。
方法:本研究纳入广州出生队列研究2013年1月至2015年1月入组的6617名孕妇。在孕妇孕16周左右采用问卷调查早孕期(<14周)使用孕酮情况。调整潜在混杂因素,我们采用Logistic回归分析孕妇使用孕酮与早产、小于胎龄儿、大于胎龄儿、妊娠期糖尿病、剖宫产和产后抑郁的关系。本研究获得了广州市妇女儿童医疗中心伦理委员会的同意。所有研究对象均提供一份书面的知情同意书。
结果:2787名孕妇(占42%)曾在孕早期使用孕酮。控制了潜在混杂因素后,使用孕酮的妇女发生剖宫产(OR 1.31 [95% CI 1.05-1.63], P=0.0146)和产后抑郁(OR 1.22 [95% CI 1.00-1.49], P=0.1497)的风险增加。使用孕酮对早产预防、胎儿生长和妊娠期糖尿病无影响。
结论:早孕期使用孕酮没有任何好处,甚至可能对特定妊娠结局有害。由于中国孕妇孕酮使用率很高,早孕期孕酮处方应被视为一个紧迫的公共卫生问题。下一步需要监测临床实践、研究远期健康影响和制定循证医学为基础的卫生政策。

C1q and tumor necrosis factor-related protein 3 is present in human cord blood and is associated with fetal growth

Nian-Nian Chen, Jian-Rong He, Wei-Dong Li, Ya-Shu Kuang, Ming-Yang Yuan, Xiao-Dan Liu, Hui-Zhu Zhang, Shun-Ping Hu, Hui-Min Xia, Xiu Qiu

OBJECTIVE:
To determine the presence of C1q and tumor necrosis factor-related protein 3 (CTRP3) in cord blood and its relationship with fetal growth among Chinese newborns.
METHODS:
This pilot study recruited 126 infants (small for gestational age [SGA], n=34; appropriate for gestational age [AGA], n=60; large for gestational age [LGA], n=32); cord blood CTRP3 levels were measured, and fetal growth parameters were collected.
RESULTS:
Median (25–75th percentile) CTRP3 levels in the SGA, AGA, and LGA groups were 297.2 (236.4–360.2), 297.5 (261.0–369.9), and 368.6 (298.5–507.1) ng/mL, respectively (P = 0.01). LGA infants had higher CTRP3 levels than AGA infants (multiple linear regression analysis; P = 0.01). The CTRP3 levels were positively correlated with birth weight (r = 0.25, P < 0.01), Ponderal index (r = 0.28, P < 0.01), and placental weight (r = 0.20, P = 0.03) in the total study population. In the subgroup analysis, CTRP3 levels were negatively correlated with birth length z scores (r = -0.39, P = 0.03) and were positively correlated with the Ponderal index (r = 0.43, P = 0.02) only in the SGA group; no other significant correlations were observed. The CTRP3 levels were similar between the sexes (P = 0.11).
CONCLUSION:
CTRP3 is present in cord blood and might be involved in fetal growth.

早孕期使用孕酮药物:中国前瞻性出生队列研究

背景:美国食品与药品监督管理局推荐有早产史的孕妇在孕16周之后使用孕酮,以减少早产的发生风险。因为孕酮对胎儿可能会有未知的风险,即使是美国4.5%的孕早期孕酮使用率都被认为是较高的处方率。在广州出生队列研究中,我们发现了10倍于美国的早孕期孕酮使用率。本研究目的旨在探讨早孕期使用孕酮对母婴结局的潜在影响。
方法:研究共招募了126名新生儿,其中小于胎龄儿(SGA)34名,适于胎龄儿(AGA)60名,大于胎龄儿(LGA)32名。对脐血CTRP3浓度进行测量,并收集了胎儿生长的相关指标。
结果:CTRP3在SGA,AGA和LGA的中位数浓度分别为297.2 (236.4–360.2),297.5 (261.0–369.9)和368.6 (298.5–507.1) ng/ml。LGA组比AGA组的CTRP3含量更高(多元线性回归,P=0.01)。CTRP3值与出生体重(r = 0.25, P < 0.01),重量指数(r = 0.28, P<0.01),胎盘重量(r = 0.20, P = 0.03)成正相关。分为SGA,AGA和LGA三组后,CTRP3值与出生身长z分(r = −0.39, P = 0.03)成负相关,与重量指数(r = 0.43, P = 0.02)成正相关。男女性别间的CTRP3浓度相似(P = NS)。
结论:CTRP3存在于脐血中,并且可能参与到胎儿生长中。

Progesterone use in early pregnancy: a prospective birth cohort study in China

Songying Shen*, Jinhua Lu*, Jianrong He, Yu Liu, Niannian Chen, Mingyang Yuan, Wanqing Xiao, Lan Qiu, Cuiyue Hu, Huimin Xia, Xiu Qiu

Background:
The US Food and Drug Administration recommended that the use of progesterone to reduce the risk of preterm births in women with a previous preterm birth should begin after the 16th week of gestation. In the USA, even a 4•5% reported rate of progesterone use in the first trimester is regarded as a high prescription for unknown fetal risk. Unfortunately, we identified a 10 times higher prevalence of progesterone prescription in early pregnancy in an ongoing study, the Born in Guangzhou Cohort Study (BIGCS) in China. We aimed to investigate the potential effects of progesterone use in early pregnancy on maternal and birth outcomes.
METHODS:
6617 pregnant women were included from the BIGCS between January, 2013, and January, 2015. Progesterone use during early pregnancy (<14 weeks) was assessed by questionnaires at around 16 weeks of gestation. We used a logistic regression model, adjusted for potential confounders, to study the associations between progesterone use and the risk of preterm births, small for gestational age, large for gestational age, gestational diabetes, caesarean section, and post-partum depression. This study was approved by the Institutional Review Board of Guangzhou Women and Children’s Medical Center, Guangzhou, China. Written informed consent was obtained from all participants.
Findings:
2787 (42%) women reported progesterone use in early pregnancy. After adjusting for potential confounders, women who used progesterone had significantly higher risks of caesarean section (odds ratio 1•31 [95% CI 1•05–1•63]; p=0•0146) and post-partum depression (1•22 [1•00–1•49]; p=0•0497). No effect of progesterone use was reported for preterm-birth prevention, fetal growth, and gestational diabetes.

母亲膳食模式与胎儿生长发育:中国一项大型队列研究的结果

  关于中国孕妇膳食模式和胎儿生长发育关系的研究较少,本研究旨在探讨母亲孕期膳食模式与新生儿出生体重和出生体重别胎龄的关系。本次研究共纳入广州出生队列研究的6954对母子。通过问卷收集母亲孕期饮食情况。采用聚类分析识别膳食模式。研究对象按膳食模式分为六组,分别为“谷类、蛋和汤”、“奶类”、“水果、坚果和广式糖水”、“肉类”、“蔬菜”、“多样化”组,上述六组婴儿出生体重标准分分别为0.02,0.07,0.20,0.01,0.06和0.14。相对于传统膳食组“谷类、蛋和汤”,“水果、坚果和广式糖水”和“多样化”组妈妈的孩子出生时更重。相对于 “谷类、蛋和汤”组,“多样化”组的孩子出现SGA(小于胎龄儿)的风险更低 (OR 0.77, 95% CI 0.57, 1.04, p = 0.08)。本研究结果提示,相对于传统广东饮食中富含谷类、蛋及广式汤水为主的饮食,膳食多样化,如增加蔬菜、水果等食物种类的摄入比例,能增加孩子的出生体重及降低小于胎龄儿的发病风险。

Maternal Dietary Patterns and Fetal Growth: A Large Prospective Cohort Study in China.

Journal:Nutrients
There was limited evidence revealing the association of Chinese maternal dietary patterns with fetal growth. We aimed to examine the relationship of maternal dietary patterns during pregnancy to neonatal birth weight and birth weight for gestational age in a Chinese population. A total of 6954 mother-child pairs were included from the Born in Guangzhou Cohort Study. Maternal diet during pregnancy was assessed using a self-administered food frequency questionnaire. Cluster analysis was used to identify dietary patterns.
The following six dietary patterns were identified: "Cereals, eggs, and Cantonese soups" (n 1026, 14.8%), "Dairy" (n 1020, 14.7%), "Fruits, nuts, and Cantonese desserts" (n 799, 11.5%), "Meats" (n 1066, 15.3%), "Vegetables" (n 1383, 19.9%), and "Varied" (n 1224, 17.6%). The mean neonatal birth weight Z scores of women in the above patterns were 0.02, 0.07, 0.20, 0.01, 0.06, and 0.14, respectively. Women in the "Fruits, nuts, and Cantonese desserts" and "Varied" groups had significantly heavier infants compared with those in the "Cereals, eggs, and Cantonese soups" group. Compared with women in the "Cereals, eggs, and Cantonese soups" group, those in the "Varied" group had marginally significantly lower odds of having a small-for-gestational age (SGA) infant after adjustment for other confounders (OR 0.77, 95% CI 0.57, 1.04, p = 0.08).
These findings suggest that compared to a traditional Cantonese diet high in cereals, eggs, and Cantonese soups, a diet high in fruits, nuts, and Cantonese desserts might be associated with a higher birth weight, while a varied diet might be associated with a greater birth weight and also a decreased risk of having a SGA baby.