Background Distinct characteristics of maternal inflammation at midgestation related to fetal and neonatal health are not clear.This study aims to explore the associations between the maternal circulating inflammatory...Background Distinct characteristics of maternal inflammation at midgestation related to fetal and neonatal health are not clear.This study aims to explore the associations between the maternal circulating inflammatory profile during the second trimester of pregnancy and a series of adverse birth outcomes.Methods The present study was a prospective cohort study based on the Born in Guangzhou Cohort Study conducted in Guangzhou,China.Peripheral blood samples from women were obtained during the second trimester.Adverse newborn outcomes were collected through electronic medical records at birth and within the first week after birth.We used logistic,Poisson and generalized linear regressions to assess the impact of inflammatory indicators during pregnancy on different outcomes.Results A total of 1567 singleton pregnant women were included.The proportions of preterm birth,small for gestational age(SGA),low birth weight(LBW),neonatal asphyxia and hyperbilirubinemia cases were 4.3%,6.6%,3.9%,1.1%and 12.6%,respectively.The maternal circulating level of log2-transformed interleukin(IL)-7 was positively associated with preterm birth[adjusted odds ratio(OR)=1.58,95%confidence interval(CI)=1.03–2.41].A higher level of log2-transformed IL-2 was correlated with increased LBW risk(adjusted OR=1.48,95%CI=1.09–2.02)and a decreased birth weight Z-score(adjustedβ=−0.06,95%CI=−0.11,−0.01).IL-7 was associated with an increased risk of LBW(adjusted OR=1.80,95%CI=1.14–2.86),whereas log2-transformed IL-15 was positively related to SGA(adjusted OR=1.39,95%CI=1.02–1.91).There were no significant associations of maternal inflammatory indicators with neonatal asphyxia or hyperbilirubinemia.Conclusion Maternal circulating IL-2,IL-7 and IL-15 levels during the second trimester of pregnancy were associated with preterm birth or birth weight.展开更多
Background Birth weight is a strong determinant of infant short-and long-term health outcomes.Family socioeconomic position(SEP)is usually positively associated with birth weight.Whether this association extends to ab...Background Birth weight is a strong determinant of infant short-and long-term health outcomes.Family socioeconomic position(SEP)is usually positively associated with birth weight.Whether this association extends to abnormal birth weight or there exists potential mediator is unclear.Methods We analyzed data from 14,984 mother-infant dyads from the Born in Guangzhou Cohort Study.We used multi-variable logistic regression to assess the associations of a composite family SEP score quartile with macrosomia and low birth weight(LBW),and examined the potential mediation effect of maternal pre-pregnancy body mass index(BMI)using causal mediation analysis.Results The prevalence of macrosomia and LBW was 2.62%(n=392)and 4.26%(n=638).Higher family SEP was associated with a higher risk of macrosomia(OR 1.30,95%CI 0.93-1.82;OR 1.53,95%CI 1.11-2.11;and OR 1.59,95%CI 1.15-2.20 for the 2nd,3rd,and 4th SEP quartile respectively)and a lower risk of LBW(OR 0.69,95%CI 0.55-0.86;OR 0.76,95%CI 0.61-0.94;and OR 0.61,95%CI 0.48-0.77 for the 2nd,3rd,and 4th SEP quartile respectively),compared to the 1st SEP quartile.We found that pre-pregnancy BMI did not mediate the associations of SEP with macrosomia and LBW.Conclusions Socioeconomic disparities in fetal macrosomia and LBW exist in Southern China.Whether the results can be applied to other populations should be further investigated.展开更多
Background:Effective management of imported cases is an important part of epidemic prevention and control.Hainan Province,China reported 168 coronavirus disease 2019(COVID-19),including 112 imported cases on February ...Background:Effective management of imported cases is an important part of epidemic prevention and control.Hainan Province,China reported 168 coronavirus disease 2019(COVID-19),including 112 imported cases on February 19,2020,but successfully contained the epidemic within 1 month.We described the epidemiological and clinical characteristics of COVID-19 in Hainan and compared these features between imported and local cases to provide information for other international epidemic areas.Methods:We included 91 patients(56 imported and 35 local cases)from two designated hospitals for COVID-19 in Haikou,China,from January 20 to February 19,2020.Data on the demographic,epidemiological,clinical and laboratory characteristics were extracted from medical records.Patients were followed until April 21,2020,and the levels of antibodies at the follow-ups were also analysed by the Wilcoxon matched-pairs signed ranks test.Results:Of the 91 patients,78(85.7%)patients were diagnosed within the first three weeks after the first case was identified(Day 1:Jan 22,2020),while the number of local cases started to increase during the third week No new cases occurred after Day 29.Fever and cough were two main clinical manifestations.In total,15(16.5%)patients were severe,14(15.4%)had complicated infections,nine(9.9%)were admitted to the intensive care unit,and three died.The median duration of viral shedding in feces was longer than that in nasopharyngeal swabs(19 days vs 16 days,P=0.007).Compared with local cases,imported cases were older and had a higher incidence of fever and concurrent infections.There was no difference in outcomes between the two groups.IgG was positive in 92.8%patients(77/83)in the follow-up at week 2 after discharge,while 88.4%patients(38/43)had a reduction in IgG levels in the follow-up at week 4 after discharge,and the median level was lower than that in the follow-up at week 2(10.95 S/Cut Off(S/CO)vs 15.02 S/CO,P<0.001).Conclusion:Imported cases were more severe than local cases but had similar prognoses.The level of IgG antibodies declined from week 6 to week 8 after onset.The short epidemic period in Hainan suggests that the epidemic could be quickly brought under control if proper timely measures were taken.展开更多
基金supported by the Ministry of Science and Technology of the People’s Republic of China(2022YFC2704601)the National Natural Science Foundation of China(82173525)+1 种基金the Health Commission of Guangdong Province(A2023275)the Guangzhou Municipal Science and Technology Bureau(2024A03J1104 and 2024A03J1254).
文摘Background Distinct characteristics of maternal inflammation at midgestation related to fetal and neonatal health are not clear.This study aims to explore the associations between the maternal circulating inflammatory profile during the second trimester of pregnancy and a series of adverse birth outcomes.Methods The present study was a prospective cohort study based on the Born in Guangzhou Cohort Study conducted in Guangzhou,China.Peripheral blood samples from women were obtained during the second trimester.Adverse newborn outcomes were collected through electronic medical records at birth and within the first week after birth.We used logistic,Poisson and generalized linear regressions to assess the impact of inflammatory indicators during pregnancy on different outcomes.Results A total of 1567 singleton pregnant women were included.The proportions of preterm birth,small for gestational age(SGA),low birth weight(LBW),neonatal asphyxia and hyperbilirubinemia cases were 4.3%,6.6%,3.9%,1.1%and 12.6%,respectively.The maternal circulating level of log2-transformed interleukin(IL)-7 was positively associated with preterm birth[adjusted odds ratio(OR)=1.58,95%confidence interval(CI)=1.03–2.41].A higher level of log2-transformed IL-2 was correlated with increased LBW risk(adjusted OR=1.48,95%CI=1.09–2.02)and a decreased birth weight Z-score(adjustedβ=−0.06,95%CI=−0.11,−0.01).IL-7 was associated with an increased risk of LBW(adjusted OR=1.80,95%CI=1.14–2.86),whereas log2-transformed IL-15 was positively related to SGA(adjusted OR=1.39,95%CI=1.02–1.91).There were no significant associations of maternal inflammatory indicators with neonatal asphyxia or hyperbilirubinemia.Conclusion Maternal circulating IL-2,IL-7 and IL-15 levels during the second trimester of pregnancy were associated with preterm birth or birth weight.
基金supported by National Natural Science Foundation of China(Grant Numbers 81673181,81703244,and 81803251).
文摘Background Birth weight is a strong determinant of infant short-and long-term health outcomes.Family socioeconomic position(SEP)is usually positively associated with birth weight.Whether this association extends to abnormal birth weight or there exists potential mediator is unclear.Methods We analyzed data from 14,984 mother-infant dyads from the Born in Guangzhou Cohort Study.We used multi-variable logistic regression to assess the associations of a composite family SEP score quartile with macrosomia and low birth weight(LBW),and examined the potential mediation effect of maternal pre-pregnancy body mass index(BMI)using causal mediation analysis.Results The prevalence of macrosomia and LBW was 2.62%(n=392)and 4.26%(n=638).Higher family SEP was associated with a higher risk of macrosomia(OR 1.30,95%CI 0.93-1.82;OR 1.53,95%CI 1.11-2.11;and OR 1.59,95%CI 1.15-2.20 for the 2nd,3rd,and 4th SEP quartile respectively)and a lower risk of LBW(OR 0.69,95%CI 0.55-0.86;OR 0.76,95%CI 0.61-0.94;and OR 0.61,95%CI 0.48-0.77 for the 2nd,3rd,and 4th SEP quartile respectively),compared to the 1st SEP quartile.We found that pre-pregnancy BMI did not mediate the associations of SEP with macrosomia and LBW.Conclusions Socioeconomic disparities in fetal macrosomia and LBW exist in Southern China.Whether the results can be applied to other populations should be further investigated.
基金This study was funded by the National Science and Technology Major Project(Bing-Liang Lin,2018ZX10302204,Bing-Liang Lin,2017ZX10203201003)the Emergency special program for 2019-nCoV of Guangdong province science and technology project(GDSTP-ESP)(Zhi-Liang Gao,2020B111105001)+1 种基金the Tackling of key scientific and emergency special program of Sun Yat-sen University[SYSU-TKSESP,Bing-Liang Lin]the Emergency special program for 2019-nCov of Bethune Medical Science Research Fund(Biao Wu,2020SG070DS).
文摘Background:Effective management of imported cases is an important part of epidemic prevention and control.Hainan Province,China reported 168 coronavirus disease 2019(COVID-19),including 112 imported cases on February 19,2020,but successfully contained the epidemic within 1 month.We described the epidemiological and clinical characteristics of COVID-19 in Hainan and compared these features between imported and local cases to provide information for other international epidemic areas.Methods:We included 91 patients(56 imported and 35 local cases)from two designated hospitals for COVID-19 in Haikou,China,from January 20 to February 19,2020.Data on the demographic,epidemiological,clinical and laboratory characteristics were extracted from medical records.Patients were followed until April 21,2020,and the levels of antibodies at the follow-ups were also analysed by the Wilcoxon matched-pairs signed ranks test.Results:Of the 91 patients,78(85.7%)patients were diagnosed within the first three weeks after the first case was identified(Day 1:Jan 22,2020),while the number of local cases started to increase during the third week No new cases occurred after Day 29.Fever and cough were two main clinical manifestations.In total,15(16.5%)patients were severe,14(15.4%)had complicated infections,nine(9.9%)were admitted to the intensive care unit,and three died.The median duration of viral shedding in feces was longer than that in nasopharyngeal swabs(19 days vs 16 days,P=0.007).Compared with local cases,imported cases were older and had a higher incidence of fever and concurrent infections.There was no difference in outcomes between the two groups.IgG was positive in 92.8%patients(77/83)in the follow-up at week 2 after discharge,while 88.4%patients(38/43)had a reduction in IgG levels in the follow-up at week 4 after discharge,and the median level was lower than that in the follow-up at week 2(10.95 S/Cut Off(S/CO)vs 15.02 S/CO,P<0.001).Conclusion:Imported cases were more severe than local cases but had similar prognoses.The level of IgG antibodies declined from week 6 to week 8 after onset.The short epidemic period in Hainan suggests that the epidemic could be quickly brought under control if proper timely measures were taken.
