首页 > 研究进展 > 研究结果

 

1.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。

1.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.

2.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。 

2.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.

3.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。

3.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.

4.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。

4.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.

5.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。

5.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.

6.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。

6.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.

7.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。

7.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.

8.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。

8.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.

9.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。

9.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.

10.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。

10.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.

11.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。

11.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.