Objective Accurately identifying the key influencing factors of psychological birth trauma in primiparous women is crucial for implementing effective preventive and intervention measures.This study aimed to develop an...Objective Accurately identifying the key influencing factors of psychological birth trauma in primiparous women is crucial for implementing effective preventive and intervention measures.This study aimed to develop and validate an interpretable machine learning prediction model for identifying the key influencing factors of psychological birth trauma in primiparous women.Methods A multicenter cross-sectional study was conducted on primiparous women in four tertiary hospitals in Sichuan Province,southwestern China,from December 2023 to March 2024.The Childbirth Trauma Index was used in assessing psychological birth trauma in primiparous women.Data were collected and randomly divided into a training set(80%,n=289)and a testing set(20%,n=73).Six different machine learning models were trained and tested.Training and prediction were conducted using six machine learning models included Linear Regression,Support Vector Regression,Multilayer Perceptron Regression,eXtreme Gradient Boosting Regression,Random Forest Regression,and Adaptive Boosting Regression.The optimal model was selected based on various performance metrics,and its predictive results were interpreted using SHapley Additive exPlanations(SHAP)and accumulated local effects(ALE).Results Among the six machine learning models,the Multilayer Perceptron Regression model exhibited the best overall performance in the testing set(MAE=3.977,MSE=24.832,R2=0.507,EVS=0.524,RMSE=4.983).In the testing set,the R2 and EVS of the Multilayer Perceptron Regression model increased by 8.3%and 1.2%,respectively,compared to the traditional linear regression model.Meanwhile,the MAE,MSE,and RMSE decreased by 0.4%,7.3%,and 3.7%,respectively,compared to the traditional linear regression model.The SHAP analysis indicated that intrapartum pain,anxiety,postpartum pain,resilience,and planned pregnancy are the most critical influencing factors of psychological birth trauma in primiparous women.The ALE analysis indicated that higher intrapartum pain,anxiety,and postpartum pain scores are risk factors,while higher resilience scores are protective factors.Conclusions Interpretable machine learning prediction models can identify the key influencing factors of psychological birth trauma in primiparous women.SHAP and ALE analyses based on the Multilayer Perceptron Regression model can help healthcare providers understand the complex decision-making logic within a prediction model.This study provides a scientific basis for the early prevention and personalized intervention of psychological birth trauma in primiparous women.展开更多
Objective To investigate the association between birth weight and dementia risk and the mediating roles of chronic diseases,and to assess potential biological pathways underlying the birth weight-associated dementia r...Objective To investigate the association between birth weight and dementia risk and the mediating roles of chronic diseases,and to assess potential biological pathways underlying the birth weight-associated dementia risk based on large-scale proteomics.Methods We used data from 279743 participants aged 40 to 69 years enrolled in the UK Biobank.Birth weight was categorized into low birth weight(≤2500 g),normal birth weight(2500-3999 g),and macrosomia(≥4000 g).Multivariable Cox proportional hazards regression models were used to assess the associations between birth weight categories and all-cause dementia and its subtypes(Alzheimer's disease and vascular dementia).Proteomics analyses were conducted to identify proteins and the potential pathways involved.Results Low birth weight was associated with higher risks for all-cause dementia and its subtypes.The hazard ratios were 1.18(95%CI,1.08-1.30)for all-cause dementia,1.14(95%CI,1.00-1.31)for Alzheimer's disease,and 1.22(95%CI,1.01-1.48)for vascular dementia.A non-linear relationship was observed between birth weight and dementia risk(P for nonlinearity<0.001).Certain cardiometabolic diseases in middle-aged adults,such as diabetes,stroke,hypertension,and dyslipidemia,played a significant mediating role in the relationship between low birth weight and dementia risk,with the mediation proportion being 6.3%to 15.8%.Proteomic analyses identified 21 proteins linked to both low birth weight and all-cause dementia risk,which were significantly enriched in the pathways for viral protein interaction with cytokines and cytokine receptors,adipocytokine signaling,and cytokine-cytokine receptor interaction.Conclusion Low birth weight is positively associated with dementia risk.Cardiometabolic diseases in middle-aged adults may mediate the relationship between low birth weight and dementia risk.A number of proteins and the associated pathways underscore the relationship between low birth weight and dementia risk.展开更多
Background: Birth weight has been identified as one of the most significant predictors of a child’s physical growth, development, and survival in later life. A quest to provide an answer on the impact of maternal ant...Background: Birth weight has been identified as one of the most significant predictors of a child’s physical growth, development, and survival in later life. A quest to provide an answer on the impact of maternal anthropometry on neonatal birth weight necessitated this study. Materials and methods: It is a cross-sectional descriptive hospital based study that involved 130 participants selected using a systematic sampling method, utilizing a semi-structured, pre-tested interviewer administered questionnaire. Data were collected using a standard procedure and were summarized using proportions, and the Chi square test was used to explore the association between categorical variables. Predictors of birth weight were determined using logistic regression. The level of statistical significance was set at p Results: Participants had a mean age of 28.6 ± 5.1 years, mean weight of 72.2 ± 11.2 kg and mean height of 1.63 ± 0.07m while the mean fetal birth weight was 3.10 ± 0.56 kg. There was a significant association between maternal delivery body mass index and neonatal birth weight (p Conclusion: The prevalence of low birth weight and macrosomia in this study population was high. The focus should be geared towards balanced nutrition support for all mothers at booking so as to mitigate the risks associated with these extremes of birth weight.展开更多
Preterm birth(PTB),defined as delivery before 37 weeks of gestation,is the most common adverse pregnancy outcome[1].PTB is a global health concern,with an estimated 13.4 million cases in 2020[1],accounting for more th...Preterm birth(PTB),defined as delivery before 37 weeks of gestation,is the most common adverse pregnancy outcome[1].PTB is a global health concern,with an estimated 13.4 million cases in 2020[1],accounting for more than one in 10 births worldwide.Compared to full-term births,PTBs are associated with a higher risk of short-and long-term complications,including bronchopulmonary dysplasia,necrotizing enterocolitis,visual impairment,and cerebral injuries[2].Despite substantial research efforts to prevent PTB,the global PTB rate has shown little improvement over the past decade[1].Therefore,identifying additional risk factors remains a critical goal in preventing PTB.展开更多
Background Birth weight is a critical economic trait in livestock production.However,its genetic architecture remains poorly understood due to historical limitations in sample size and reliance on low-density SNP arra...Background Birth weight is a critical economic trait in livestock production.However,its genetic architecture remains poorly understood due to historical limitations in sample size and reliance on low-density SNP arrays.In this study,we utilized low-coverage whole-genome sequencing(lcWGS)to genotype 3,007 Hu sheep,bypassing the cost and resolution constraints of conventional genotyping arrays while achieving scalable genome-wide variant detection.Results LcWGS with high imputation accuracy(97.8%allelic concordance)enabled genome-wide association studies(GWAS)identifying two novel quantitative trait loci(QTLs)on chromosomes 6 and 9.The chromosome 9 QTL encompassed a regulatory region functionally linked to PLAG1 expression through expression quantitative trait locus(eQTL)mapping.Compared with wild-type homozygotes,heterozygous carriers of the lead SNP(chr9:g.35920172A>G)presented a 9.85%increase in birth weight(3.35 kg vs.3.68 kg;Δ=0.33 kg).Notably,the derived allele of this SNP exhibited low frequencies of<0.1 across most global sheep breeds except Dorper,highlighting its potential for selective breeding applications.Leveraging lcWGS data,haplotype-based fine-mapping prioritized three candidate causal variants.A secondary QTL on chromosome 6 colocalized with the FecB mutation,a well-established locus associated with increased litter size.Intriguingly,individuals carrying one FecB allele showed a 6.18%reduction(0.22 kg)in birth weight,which tentatively indicates potential pleiotropic influences on both growth and reproductive traits.Conclusion This study demonstrates the utility of lcWGS as a cost-effective,high-resolution tool for dissecting complex traits in livestock.Our findings not only advance the understanding of birth weight genetics in sheep but also offer a blueprint for accelerating genetic improvement programs in global livestock production through costeffective,genome-wide approaches.展开更多
Preterm birth and suboptimal fetal growth remain significant perinatal challenges worldwide.Recent data indicate that China's perinatal profile has improved due to reductions in preterm birth rates.However,the cou...Preterm birth and suboptimal fetal growth remain significant perinatal challenges worldwide.Recent data indicate that China's perinatal profile has improved due to reductions in preterm birth rates.However,the country has a 6.5%prevalence of small-for-gestational-age(SGA),ranking fifth globally in total SGA birth numbers^([1,2]).展开更多
The association of copper(Cu)with preterm birth(PTB)and its subtypes,spontaneous preterm birth(SPB)and iatrogenic preterm birth(IPB),are still unclear.In addition,previous studies suggested that serum lipid was associ...The association of copper(Cu)with preterm birth(PTB)and its subtypes,spontaneous preterm birth(SPB)and iatrogenic preterm birth(IPB),are still unclear.In addition,previous studies suggested that serum lipid was associated with both Cu and PTB.Therefore,we explored the association of blood Cu in the first trimester with the risk of PTB and its subtypes,as well as the potential mediating effect of serum lipid using a nested case-control study.The concentrations of Cu in the serum and blood cells,and serum lipids in the first trimester were measured.The concentration of Cu in whole blood was calculated based on hematocrit.Compared to the lowest tertile of Cu concentrations in the first trimester,the highest tertile of Cu significantly increased the risk of SPB with adjusted odds ratios(AORs)of 2.75(95% confidence interval(CI):1.41-5.34)for serum and 3.75(95% CI:1.21-11.60)for whole blood,and significantly increased the risk of IPB with AORs of 3.25(95%CI:1.06-9.94)for blood cells.According to the mediation analysis,the indirect effect of triglyceride(β=0.016,95%CI:0.0002-0.042)was the only significant effect in the association between Cu and SPB,with the mediating proportion of 9.8%(95%CI:0.2%-33.4%).It suggested that a high level of serum Cu may be associated with an increased risk of SPB with a possible mediator of serum triglyceride,and a high level of blood cell Cu may be associated with an increased risk of IPB.展开更多
Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth reco...Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth record data from the Ghana Demographic and Health Surveys(2008,2014,and 2022)were used to analyse trends and determinants in neonatal mortality and preterm birth aligned with World Health Organization antenatal care(ANC)guidelines using Pearson’s Chi-square test and multivariate logistic regression with statistical significance at P<0.05 and 95%confidence intervals(CI).Results:Preterm birth rate and neonatal mortality rate decreased from 13.0%to 9.1%and 27.6 to 23.7 per 1000 live births from 2008 to 2022 respectively.Lack of iron supplementation(odds ratio[OR]1.127,95%CI:1.047 to 1.967)a nutritional intervention maternal assessments(moderate/severe anaemia(OR 1.423,95%CI:1.178 to 2.051),preventive measures(Untreated malaria(OR 1.449,95%CI:1.104 to 2.411)or deworming(OR 1.267,95%CI:0.970 to 1.645)were associated with increased preterm birth risk.Attending<8 ANC visits raised the odds of preterm birth(OR 1.24,95%CI:1.03 to 1.257)and neonatal mortality(OR 1.583,95%CI:1.120 to 2.480).Conclusion:Despite reductions in preterm birth and neonatal mortality rates,substantial gaps in antenatal care remain.Strengthening the implementation of World Health Organization ANC guidelines is critical to reducing preterm birth and neonatal mortality in Ghana.展开更多
Objectives:This study aimed to explore the perceptions and recommendations of multiparas and health-related professionals regarding appropriate birth intervals(Bis)and key determinants.Methods:In-depth semi-structured...Objectives:This study aimed to explore the perceptions and recommendations of multiparas and health-related professionals regarding appropriate birth intervals(Bis)and key determinants.Methods:In-depth semi-structured interviews were conducted between April 1 and June 30,2022.Nine multiparas and thirteen health-related professionals were purposefully sampled until data saturation was reached.A thematic analysis approach was applied to the interview transcripts,utilizing dual independent coding and consensus validation in NVivo 12.0.Results:The data generated two overarching categories:1)balanced decision-making on the appropriate birth intervals and 2)internal and external determinants integrated with health and societal considerations.Four key themes emerged following the two categories:1)consistency and discrepancy between the actual and recommended birth intervals of multiparas;2)health-and developmentoriented professional recommendations;3)internal determinants related to individual-level factors;and 4)external determinants related to child-related factors,family support,and social security.Weighing women's reproductive health and career development,multiparas and health-related professionals perceived a length between 18 and 36 months as the appropriate Bl.Conclusion:Multiparas and health-related professionals shaped their balanced recommendations on a relatively appropriate birth interval ranging from 18 to 36 months,which was influenced by women's individual-level factors,child-related factors,family support,and social security.Targeted social and healthcare services should be offered to women and their families during the Bls.展开更多
BACKGROUND Premature infant formula is based on milk and contains energy,vitamins,etc.Breast milk is rich in minerals,such as phosphorus and calcium,and proteins.Both can be used for nutritional support in preterm inf...BACKGROUND Premature infant formula is based on milk and contains energy,vitamins,etc.Breast milk is rich in minerals,such as phosphorus and calcium,and proteins.Both can be used for nutritional support in preterm infants with low-birth-weight.However,their effects on the difference in infant growth rate and postpartum depression are still unclear.AIM To explore the effect of early micro-breastfeeding on the growth rate of preterm infants with low-birth-weight and maternal postpartum depression.METHODS Data of 68 preterm infants with low-birth-weight and their mothers admitted to the Department of Neonatology,Suzhou Ninth Hospital Affiliated to Soochow University,between January 2022 and December 2024,were retrospectively collected.The infants were divided into two groups according to the different enteral feeding methods in the early stage:Control group(n=32 cases,premature infant formula feeding)and observation group(n=36 cases,micro-breastfeeding,i.e.,exclusive breastfeeding,no mixed feeding).The baseline data;feeding status;gastrointestinal adverse reactions such as vomiting,gastric retention,and abdominal distension;growth rate(body weight,body length,and head circumference);and adverse events(infection,cholestasis,hyperbilirubinemia,and necrotizing enterocolitis)were compared between the two groups.Moreover,the maternal postpartum depression status of the two groups based of infants based on the Edinburgh postpartum depression scale(EPDS)was compared.RESULTS No significant difference in baseline data was found between the two groups(P>0.05).The onset time of weight gain(6.49±0.53 days vs 7.09±0.61 days,P<0.001),time for complete meconium excretion(6.28±0.92 days vs 8.31±1.17 days,P<0.001),time for recovery to birth weight(8.81±1.40 days vs 10.95±1.64 days,P<0.001),and time to reach full enteral feeding(12.29±2.08 days vs 15.48±2.27 days,P<0.001)were compared between the observation and control groups.The incidence of vomiting,abdominal distension,and gastric retention was significantly lower in the observation group than in the control group,and the difference was significant(P<0.05).The rates of the weight growth(15.88±1.57 g/day vs 14.84±1.51 g/day,P=0.007),head circumference(0.63±0.08 cm/week vs 0.59±0.05 cm/week,P=0.018),and length(0.80±0.12 cm/week vs 0.73±0.14 cm/week,P=0.029)were compared between the observation and control groups.On hospital admission of preterm infants with low-birthweight,the mothers of the two groups did not show a significant difference in the EPDS scores for postpartum depression(P>0.05).Preterm infants with low-birth-weight were hospitalized for 2 weeks,and the EPDS score for maternal postpartum depression was significantly lower in the observation group than in the control group(8.38±1.47 vs 9.49±2.35,P=0.021).CONCLUSION Compared with preterm infant formula feeding,early micro-breastfeeding can more effectively promote the growth rate of preterm infants with low-birth-weight and reduce the gastrointestinal feeding intolerance and related complications,thereby alleviating mothers’concerns about their children and reducing the risk of postpartum depression.展开更多
The effect of prenatal exposure to ambient particulate matter(PM)on birth weight varies considerably across studies,and the findings remain inconclusive.In this study,we conducted a meta-analysis to assess the associa...The effect of prenatal exposure to ambient particulate matter(PM)on birth weight varies considerably across studies,and the findings remain inconclusive.In this study,we conducted a meta-analysis to assess the associations between exposure to PM_(2.5) and PM10 and birth weight.A total of 74 studies were identified through searches in Web of Science,PubMed,Embase,and Ovid Medline,as well as manual searches,up to October 2024.We found that for each 10μg/m^(3) increase in PM_(2.5),the risk of low birth weight(LBW)increased significantly during the entire pregnancy(odds ratio[OR]=2.41,95%confidence interval[CI]:1.99–2.91)and in all trimesters.Similarly,for every 10μg/m^(3) increase in PM10 concentration,the risk of LBW increased significantly during the entire pregnancy(OR=1.46,95%CI:1.16–1.84).Subgroup analysis by maternal age for PM_(2.5) showed that mothers aged 30 and above had a significantly higher risk of LBW(OR=3.69,95%CI:2.81–4.84),compared with those under 30.In conclusion,maternal exposure to PM_(2.5) and PM_(10) is associated with an increased risk of LBW across all trimesters.Additionally,mothers aged 30 and above are at a higher risk of LBW,compared with younger mothers.Further research is needed to clarify the biological mechanisms by which PM pollution may contribute to LBW.展开更多
Objective:To explore the association between acupuncture during controlled ovarian hyperstimulation(COH)and the live birth rate(LBR)using different propensity score methods.Methods:In this retrospective cohort study,e...Objective:To explore the association between acupuncture during controlled ovarian hyperstimulation(COH)and the live birth rate(LBR)using different propensity score methods.Methods:In this retrospective cohort study,eligible women who underwent a COH were divided into acupuncture and non-acupuncture groups.The primary outcome was LBR,as determined by propensity score matching(PSM).LBR was defined as the delivery of one or more living infants that reached a gestational age over 28 weeks after embryo transfer.The propensity score model encompassed 16 confounding variables.To validate the results,sensitivity analyses were conducted using three additional propensity score methods:propensity score adjustment,inverse probability weighting(IPW),and IPW with a"doubly robust”estimator.Results:The primary cohort encompassed 9751 patients(1830[18.76%]in the acupuncture group and7921[81.23%]in the non-acupuncture group).Following 1:1 PSM,a higher LBR was found in the acupuncture cohort(41.4%[755/1824]vs 36.4%[664/1824],with an odds ratio of 1.23[95%confidence interval,1.08-1.41]).Three additional propensity score methods produced essentially similar results.The risk of serious adverse events did not significantly differ between the two groups.Conclusion:This retrospective study revealed an association between acupuncture and an increased LBR among patients undergoing COH,and that acupuncture is a safe and valuable treatment option.展开更多
Preterm birth remains a leading cause of neonatal complications and highlights the need for early and accurate prediction techniques to improve both fetal and maternal health outcomes.This study introduces a hybrid ap...Preterm birth remains a leading cause of neonatal complications and highlights the need for early and accurate prediction techniques to improve both fetal and maternal health outcomes.This study introduces a hybrid approach integrating Long Short-Term Memory(LSTM)networks with the Hybrid Greylag Goose and Particle Swarm Optimization(GGPSO)algorithm to optimize preterm birth classification using Electrohysterogram signals.The dataset consists of 58 samples of 1000-second-long Electrohysterogram recordings,capturing key physiological features such as contraction patterns,entropy,and statistical variations.Statistical analysis and feature selection methods are applied to identify the most relevant predictors and enhance model interpretability.LSTM networks effectively capture temporal patterns in uterine activity,while the GGPSO algorithm finetunes hyperparameters,mitigating overfitting and improving classification accuracy.The proposed GGPSO-optimized LSTM model achieved superior performance with 97.34%accuracy,96.91%sensitivity,97.74%specificity,and 97.23%F-score,significantly outperforming traditional machine learning approaches and demonstrating the effectiveness of hybrid metaheuristic optimization in enhancing deep learning models for clinical applications.By combining deep learning withmetaheuristic optimization,this study contributes to advancing intelligent auto-diagnosis systems,facilitating early detection of pretermbirth risks and timely medical interventions.展开更多
目的使用河北省营养项目人群数据,探讨母亲孕期空气颗粒物(PM)暴露对新生儿体格发育状况指标的影响,并评估不同颗粒物暴露的滞后效应以确定敏感时间窗。方法本研究基于河北孕期营养干预项目数据,纳入14148对母婴数据,通过China High Air...目的使用河北省营养项目人群数据,探讨母亲孕期空气颗粒物(PM)暴露对新生儿体格发育状况指标的影响,并评估不同颗粒物暴露的滞后效应以确定敏感时间窗。方法本研究基于河北孕期营养干预项目数据,纳入14148对母婴数据,通过China High Air Pollutants(CHAP)数据库获取1 km×1 km分辨率的月均PM浓度,结合孕妇居住地址和孕周估算孕早期、孕中期、孕晚期及全孕期的PM暴露水平。新生儿体格发育状况指标根据中国标准按照不同孕周和性别标准化为Z评分。采用多元线性回归模型分析不同PM暴露与新生儿体格发育状况指标的关联,并通过分布滞后线性模型评估不同妊娠阶段的滞后效应,明确敏感时间窗。结果全孕期每增加10μg/m 3的PM 2.5、PM 10和PM_(2.5-10)暴露分别使出生体重Z评分下降0.03(95%CI:-0.04,-0.02)、0.03(95%CI:-0.04,-0.02)和0.10(95%CI:-0.12,-0.08);出生身长和头围Z评分亦呈负相关,且PM_(2.5-10)的影响最显著。分布滞后线性模型结果显示,孕早期和孕晚期为新生儿出生体重和身长的关键敏感窗口,出生头围的敏感期主要集中在孕早期。结论孕期PM暴露与新生儿体格发育状况呈显著负相关,PM_(2.5-10)的效应最为突出。孕早期和孕晚期暴露为胎儿体格发育影响的关键窗口期。本研究为空气污染防控政策及孕期健康干预提供了重要的科学依据。展开更多
基金supported by the Sichuan Province Nursing Scientific Research Project Plan(H23022)the 2022 Municipal-University Science and Technology Strategic Cooperation Special Fund of Nanchong Science and Technology Bureau(22SXQT0222)。
文摘Objective Accurately identifying the key influencing factors of psychological birth trauma in primiparous women is crucial for implementing effective preventive and intervention measures.This study aimed to develop and validate an interpretable machine learning prediction model for identifying the key influencing factors of psychological birth trauma in primiparous women.Methods A multicenter cross-sectional study was conducted on primiparous women in four tertiary hospitals in Sichuan Province,southwestern China,from December 2023 to March 2024.The Childbirth Trauma Index was used in assessing psychological birth trauma in primiparous women.Data were collected and randomly divided into a training set(80%,n=289)and a testing set(20%,n=73).Six different machine learning models were trained and tested.Training and prediction were conducted using six machine learning models included Linear Regression,Support Vector Regression,Multilayer Perceptron Regression,eXtreme Gradient Boosting Regression,Random Forest Regression,and Adaptive Boosting Regression.The optimal model was selected based on various performance metrics,and its predictive results were interpreted using SHapley Additive exPlanations(SHAP)and accumulated local effects(ALE).Results Among the six machine learning models,the Multilayer Perceptron Regression model exhibited the best overall performance in the testing set(MAE=3.977,MSE=24.832,R2=0.507,EVS=0.524,RMSE=4.983).In the testing set,the R2 and EVS of the Multilayer Perceptron Regression model increased by 8.3%and 1.2%,respectively,compared to the traditional linear regression model.Meanwhile,the MAE,MSE,and RMSE decreased by 0.4%,7.3%,and 3.7%,respectively,compared to the traditional linear regression model.The SHAP analysis indicated that intrapartum pain,anxiety,postpartum pain,resilience,and planned pregnancy are the most critical influencing factors of psychological birth trauma in primiparous women.The ALE analysis indicated that higher intrapartum pain,anxiety,and postpartum pain scores are risk factors,while higher resilience scores are protective factors.Conclusions Interpretable machine learning prediction models can identify the key influencing factors of psychological birth trauma in primiparous women.SHAP and ALE analyses based on the Multilayer Perceptron Regression model can help healthcare providers understand the complex decision-making logic within a prediction model.This study provides a scientific basis for the early prevention and personalized intervention of psychological birth trauma in primiparous women.
文摘Objective To investigate the association between birth weight and dementia risk and the mediating roles of chronic diseases,and to assess potential biological pathways underlying the birth weight-associated dementia risk based on large-scale proteomics.Methods We used data from 279743 participants aged 40 to 69 years enrolled in the UK Biobank.Birth weight was categorized into low birth weight(≤2500 g),normal birth weight(2500-3999 g),and macrosomia(≥4000 g).Multivariable Cox proportional hazards regression models were used to assess the associations between birth weight categories and all-cause dementia and its subtypes(Alzheimer's disease and vascular dementia).Proteomics analyses were conducted to identify proteins and the potential pathways involved.Results Low birth weight was associated with higher risks for all-cause dementia and its subtypes.The hazard ratios were 1.18(95%CI,1.08-1.30)for all-cause dementia,1.14(95%CI,1.00-1.31)for Alzheimer's disease,and 1.22(95%CI,1.01-1.48)for vascular dementia.A non-linear relationship was observed between birth weight and dementia risk(P for nonlinearity<0.001).Certain cardiometabolic diseases in middle-aged adults,such as diabetes,stroke,hypertension,and dyslipidemia,played a significant mediating role in the relationship between low birth weight and dementia risk,with the mediation proportion being 6.3%to 15.8%.Proteomic analyses identified 21 proteins linked to both low birth weight and all-cause dementia risk,which were significantly enriched in the pathways for viral protein interaction with cytokines and cytokine receptors,adipocytokine signaling,and cytokine-cytokine receptor interaction.Conclusion Low birth weight is positively associated with dementia risk.Cardiometabolic diseases in middle-aged adults may mediate the relationship between low birth weight and dementia risk.A number of proteins and the associated pathways underscore the relationship between low birth weight and dementia risk.
文摘Background: Birth weight has been identified as one of the most significant predictors of a child’s physical growth, development, and survival in later life. A quest to provide an answer on the impact of maternal anthropometry on neonatal birth weight necessitated this study. Materials and methods: It is a cross-sectional descriptive hospital based study that involved 130 participants selected using a systematic sampling method, utilizing a semi-structured, pre-tested interviewer administered questionnaire. Data were collected using a standard procedure and were summarized using proportions, and the Chi square test was used to explore the association between categorical variables. Predictors of birth weight were determined using logistic regression. The level of statistical significance was set at p Results: Participants had a mean age of 28.6 ± 5.1 years, mean weight of 72.2 ± 11.2 kg and mean height of 1.63 ± 0.07m while the mean fetal birth weight was 3.10 ± 0.56 kg. There was a significant association between maternal delivery body mass index and neonatal birth weight (p Conclusion: The prevalence of low birth weight and macrosomia in this study population was high. The focus should be geared towards balanced nutrition support for all mothers at booking so as to mitigate the risks associated with these extremes of birth weight.
基金supported by the National Natural Science Foundation of China(8200340181972981)+1 种基金the Scientific and Technological Project of Henan Province(222102310150,China)the Open Research Fund of the National Health Commission Key Laboratory of Birth Defects Prevention(NHCKLBDP202504,China).
文摘Preterm birth(PTB),defined as delivery before 37 weeks of gestation,is the most common adverse pregnancy outcome[1].PTB is a global health concern,with an estimated 13.4 million cases in 2020[1],accounting for more than one in 10 births worldwide.Compared to full-term births,PTBs are associated with a higher risk of short-and long-term complications,including bronchopulmonary dysplasia,necrotizing enterocolitis,visual impairment,and cerebral injuries[2].Despite substantial research efforts to prevent PTB,the global PTB rate has shown little improvement over the past decade[1].Therefore,identifying additional risk factors remains a critical goal in preventing PTB.
基金supported by the Biological Breeding-National Science and Technology Major Project(2022ZD0401403)Shaanxi Provincial Key Research and Development Program(2024NC2-GJHX-15)Shaanxi Livestock and Poultry Breeding Double-chain Fusion Key Project(2022GD-TSLD-46-0401).
文摘Background Birth weight is a critical economic trait in livestock production.However,its genetic architecture remains poorly understood due to historical limitations in sample size and reliance on low-density SNP arrays.In this study,we utilized low-coverage whole-genome sequencing(lcWGS)to genotype 3,007 Hu sheep,bypassing the cost and resolution constraints of conventional genotyping arrays while achieving scalable genome-wide variant detection.Results LcWGS with high imputation accuracy(97.8%allelic concordance)enabled genome-wide association studies(GWAS)identifying two novel quantitative trait loci(QTLs)on chromosomes 6 and 9.The chromosome 9 QTL encompassed a regulatory region functionally linked to PLAG1 expression through expression quantitative trait locus(eQTL)mapping.Compared with wild-type homozygotes,heterozygous carriers of the lead SNP(chr9:g.35920172A>G)presented a 9.85%increase in birth weight(3.35 kg vs.3.68 kg;Δ=0.33 kg).Notably,the derived allele of this SNP exhibited low frequencies of<0.1 across most global sheep breeds except Dorper,highlighting its potential for selective breeding applications.Leveraging lcWGS data,haplotype-based fine-mapping prioritized three candidate causal variants.A secondary QTL on chromosome 6 colocalized with the FecB mutation,a well-established locus associated with increased litter size.Intriguingly,individuals carrying one FecB allele showed a 6.18%reduction(0.22 kg)in birth weight,which tentatively indicates potential pleiotropic influences on both growth and reproductive traits.Conclusion This study demonstrates the utility of lcWGS as a cost-effective,high-resolution tool for dissecting complex traits in livestock.Our findings not only advance the understanding of birth weight genetics in sheep but also offer a blueprint for accelerating genetic improvement programs in global livestock production through costeffective,genome-wide approaches.
基金funded by the Natural Science Foundation of Hunan Province(grant number 2024JJ5283 to XH)。
文摘Preterm birth and suboptimal fetal growth remain significant perinatal challenges worldwide.Recent data indicate that China's perinatal profile has improved due to reductions in preterm birth rates.However,the country has a 6.5%prevalence of small-for-gestational-age(SGA),ranking fifth globally in total SGA birth numbers^([1,2]).
基金supported by Beijing Natural Science Foundation(No.7222248)the National Natural Science Foundation of China(No.81673177).
文摘The association of copper(Cu)with preterm birth(PTB)and its subtypes,spontaneous preterm birth(SPB)and iatrogenic preterm birth(IPB),are still unclear.In addition,previous studies suggested that serum lipid was associated with both Cu and PTB.Therefore,we explored the association of blood Cu in the first trimester with the risk of PTB and its subtypes,as well as the potential mediating effect of serum lipid using a nested case-control study.The concentrations of Cu in the serum and blood cells,and serum lipids in the first trimester were measured.The concentration of Cu in whole blood was calculated based on hematocrit.Compared to the lowest tertile of Cu concentrations in the first trimester,the highest tertile of Cu significantly increased the risk of SPB with adjusted odds ratios(AORs)of 2.75(95% confidence interval(CI):1.41-5.34)for serum and 3.75(95% CI:1.21-11.60)for whole blood,and significantly increased the risk of IPB with AORs of 3.25(95%CI:1.06-9.94)for blood cells.According to the mediation analysis,the indirect effect of triglyceride(β=0.016,95%CI:0.0002-0.042)was the only significant effect in the association between Cu and SPB,with the mediating proportion of 9.8%(95%CI:0.2%-33.4%).It suggested that a high level of serum Cu may be associated with an increased risk of SPB with a possible mediator of serum triglyceride,and a high level of blood cell Cu may be associated with an increased risk of IPB.
文摘Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth record data from the Ghana Demographic and Health Surveys(2008,2014,and 2022)were used to analyse trends and determinants in neonatal mortality and preterm birth aligned with World Health Organization antenatal care(ANC)guidelines using Pearson’s Chi-square test and multivariate logistic regression with statistical significance at P<0.05 and 95%confidence intervals(CI).Results:Preterm birth rate and neonatal mortality rate decreased from 13.0%to 9.1%and 27.6 to 23.7 per 1000 live births from 2008 to 2022 respectively.Lack of iron supplementation(odds ratio[OR]1.127,95%CI:1.047 to 1.967)a nutritional intervention maternal assessments(moderate/severe anaemia(OR 1.423,95%CI:1.178 to 2.051),preventive measures(Untreated malaria(OR 1.449,95%CI:1.104 to 2.411)or deworming(OR 1.267,95%CI:0.970 to 1.645)were associated with increased preterm birth risk.Attending<8 ANC visits raised the odds of preterm birth(OR 1.24,95%CI:1.03 to 1.257)and neonatal mortality(OR 1.583,95%CI:1.120 to 2.480).Conclusion:Despite reductions in preterm birth and neonatal mortality rates,substantial gaps in antenatal care remain.Strengthening the implementation of World Health Organization ANC guidelines is critical to reducing preterm birth and neonatal mortality in Ghana.
基金supported by the Key Discipline Program of the Fifth Round of the Three-Year Public Health Action Plan(2020-2022 Year)of Shanghai,China(GWV-10.1-XK08).
文摘Objectives:This study aimed to explore the perceptions and recommendations of multiparas and health-related professionals regarding appropriate birth intervals(Bis)and key determinants.Methods:In-depth semi-structured interviews were conducted between April 1 and June 30,2022.Nine multiparas and thirteen health-related professionals were purposefully sampled until data saturation was reached.A thematic analysis approach was applied to the interview transcripts,utilizing dual independent coding and consensus validation in NVivo 12.0.Results:The data generated two overarching categories:1)balanced decision-making on the appropriate birth intervals and 2)internal and external determinants integrated with health and societal considerations.Four key themes emerged following the two categories:1)consistency and discrepancy between the actual and recommended birth intervals of multiparas;2)health-and developmentoriented professional recommendations;3)internal determinants related to individual-level factors;and 4)external determinants related to child-related factors,family support,and social security.Weighing women's reproductive health and career development,multiparas and health-related professionals perceived a length between 18 and 36 months as the appropriate Bl.Conclusion:Multiparas and health-related professionals shaped their balanced recommendations on a relatively appropriate birth interval ranging from 18 to 36 months,which was influenced by women's individual-level factors,child-related factors,family support,and social security.Targeted social and healthcare services should be offered to women and their families during the Bls.
文摘BACKGROUND Premature infant formula is based on milk and contains energy,vitamins,etc.Breast milk is rich in minerals,such as phosphorus and calcium,and proteins.Both can be used for nutritional support in preterm infants with low-birth-weight.However,their effects on the difference in infant growth rate and postpartum depression are still unclear.AIM To explore the effect of early micro-breastfeeding on the growth rate of preterm infants with low-birth-weight and maternal postpartum depression.METHODS Data of 68 preterm infants with low-birth-weight and their mothers admitted to the Department of Neonatology,Suzhou Ninth Hospital Affiliated to Soochow University,between January 2022 and December 2024,were retrospectively collected.The infants were divided into two groups according to the different enteral feeding methods in the early stage:Control group(n=32 cases,premature infant formula feeding)and observation group(n=36 cases,micro-breastfeeding,i.e.,exclusive breastfeeding,no mixed feeding).The baseline data;feeding status;gastrointestinal adverse reactions such as vomiting,gastric retention,and abdominal distension;growth rate(body weight,body length,and head circumference);and adverse events(infection,cholestasis,hyperbilirubinemia,and necrotizing enterocolitis)were compared between the two groups.Moreover,the maternal postpartum depression status of the two groups based of infants based on the Edinburgh postpartum depression scale(EPDS)was compared.RESULTS No significant difference in baseline data was found between the two groups(P>0.05).The onset time of weight gain(6.49±0.53 days vs 7.09±0.61 days,P<0.001),time for complete meconium excretion(6.28±0.92 days vs 8.31±1.17 days,P<0.001),time for recovery to birth weight(8.81±1.40 days vs 10.95±1.64 days,P<0.001),and time to reach full enteral feeding(12.29±2.08 days vs 15.48±2.27 days,P<0.001)were compared between the observation and control groups.The incidence of vomiting,abdominal distension,and gastric retention was significantly lower in the observation group than in the control group,and the difference was significant(P<0.05).The rates of the weight growth(15.88±1.57 g/day vs 14.84±1.51 g/day,P=0.007),head circumference(0.63±0.08 cm/week vs 0.59±0.05 cm/week,P=0.018),and length(0.80±0.12 cm/week vs 0.73±0.14 cm/week,P=0.029)were compared between the observation and control groups.On hospital admission of preterm infants with low-birthweight,the mothers of the two groups did not show a significant difference in the EPDS scores for postpartum depression(P>0.05).Preterm infants with low-birth-weight were hospitalized for 2 weeks,and the EPDS score for maternal postpartum depression was significantly lower in the observation group than in the control group(8.38±1.47 vs 9.49±2.35,P=0.021).CONCLUSION Compared with preterm infant formula feeding,early micro-breastfeeding can more effectively promote the growth rate of preterm infants with low-birth-weight and reduce the gastrointestinal feeding intolerance and related complications,thereby alleviating mothers’concerns about their children and reducing the risk of postpartum depression.
文摘The effect of prenatal exposure to ambient particulate matter(PM)on birth weight varies considerably across studies,and the findings remain inconclusive.In this study,we conducted a meta-analysis to assess the associations between exposure to PM_(2.5) and PM10 and birth weight.A total of 74 studies were identified through searches in Web of Science,PubMed,Embase,and Ovid Medline,as well as manual searches,up to October 2024.We found that for each 10μg/m^(3) increase in PM_(2.5),the risk of low birth weight(LBW)increased significantly during the entire pregnancy(odds ratio[OR]=2.41,95%confidence interval[CI]:1.99–2.91)and in all trimesters.Similarly,for every 10μg/m^(3) increase in PM10 concentration,the risk of LBW increased significantly during the entire pregnancy(OR=1.46,95%CI:1.16–1.84).Subgroup analysis by maternal age for PM_(2.5) showed that mothers aged 30 and above had a significantly higher risk of LBW(OR=3.69,95%CI:2.81–4.84),compared with those under 30.In conclusion,maternal exposure to PM_(2.5) and PM_(10) is associated with an increased risk of LBW across all trimesters.Additionally,mothers aged 30 and above are at a higher risk of LBW,compared with younger mothers.Further research is needed to clarify the biological mechanisms by which PM pollution may contribute to LBW.
基金funded by the National Natural Science Foundation of China(No.81973966)。
文摘Objective:To explore the association between acupuncture during controlled ovarian hyperstimulation(COH)and the live birth rate(LBR)using different propensity score methods.Methods:In this retrospective cohort study,eligible women who underwent a COH were divided into acupuncture and non-acupuncture groups.The primary outcome was LBR,as determined by propensity score matching(PSM).LBR was defined as the delivery of one or more living infants that reached a gestational age over 28 weeks after embryo transfer.The propensity score model encompassed 16 confounding variables.To validate the results,sensitivity analyses were conducted using three additional propensity score methods:propensity score adjustment,inverse probability weighting(IPW),and IPW with a"doubly robust”estimator.Results:The primary cohort encompassed 9751 patients(1830[18.76%]in the acupuncture group and7921[81.23%]in the non-acupuncture group).Following 1:1 PSM,a higher LBR was found in the acupuncture cohort(41.4%[755/1824]vs 36.4%[664/1824],with an odds ratio of 1.23[95%confidence interval,1.08-1.41]).Three additional propensity score methods produced essentially similar results.The risk of serious adverse events did not significantly differ between the two groups.Conclusion:This retrospective study revealed an association between acupuncture and an increased LBR among patients undergoing COH,and that acupuncture is a safe and valuable treatment option.
基金funded by the National Plan for Science,Technology and Innovation(MAARIFAH)-King Abdulaziz City for Science and Technology-The Kingdom of Saudi Arabia-award number(13-MAT377-08).
文摘Preterm birth remains a leading cause of neonatal complications and highlights the need for early and accurate prediction techniques to improve both fetal and maternal health outcomes.This study introduces a hybrid approach integrating Long Short-Term Memory(LSTM)networks with the Hybrid Greylag Goose and Particle Swarm Optimization(GGPSO)algorithm to optimize preterm birth classification using Electrohysterogram signals.The dataset consists of 58 samples of 1000-second-long Electrohysterogram recordings,capturing key physiological features such as contraction patterns,entropy,and statistical variations.Statistical analysis and feature selection methods are applied to identify the most relevant predictors and enhance model interpretability.LSTM networks effectively capture temporal patterns in uterine activity,while the GGPSO algorithm finetunes hyperparameters,mitigating overfitting and improving classification accuracy.The proposed GGPSO-optimized LSTM model achieved superior performance with 97.34%accuracy,96.91%sensitivity,97.74%specificity,and 97.23%F-score,significantly outperforming traditional machine learning approaches and demonstrating the effectiveness of hybrid metaheuristic optimization in enhancing deep learning models for clinical applications.By combining deep learning withmetaheuristic optimization,this study contributes to advancing intelligent auto-diagnosis systems,facilitating early detection of pretermbirth risks and timely medical interventions.
文摘目的使用河北省营养项目人群数据,探讨母亲孕期空气颗粒物(PM)暴露对新生儿体格发育状况指标的影响,并评估不同颗粒物暴露的滞后效应以确定敏感时间窗。方法本研究基于河北孕期营养干预项目数据,纳入14148对母婴数据,通过China High Air Pollutants(CHAP)数据库获取1 km×1 km分辨率的月均PM浓度,结合孕妇居住地址和孕周估算孕早期、孕中期、孕晚期及全孕期的PM暴露水平。新生儿体格发育状况指标根据中国标准按照不同孕周和性别标准化为Z评分。采用多元线性回归模型分析不同PM暴露与新生儿体格发育状况指标的关联,并通过分布滞后线性模型评估不同妊娠阶段的滞后效应,明确敏感时间窗。结果全孕期每增加10μg/m 3的PM 2.5、PM 10和PM_(2.5-10)暴露分别使出生体重Z评分下降0.03(95%CI:-0.04,-0.02)、0.03(95%CI:-0.04,-0.02)和0.10(95%CI:-0.12,-0.08);出生身长和头围Z评分亦呈负相关,且PM_(2.5-10)的影响最显著。分布滞后线性模型结果显示,孕早期和孕晚期为新生儿出生体重和身长的关键敏感窗口,出生头围的敏感期主要集中在孕早期。结论孕期PM暴露与新生儿体格发育状况呈显著负相关,PM_(2.5-10)的效应最为突出。孕早期和孕晚期暴露为胎儿体格发育影响的关键窗口期。本研究为空气污染防控政策及孕期健康干预提供了重要的科学依据。
