Trimester-specific effects of maternal exposure to organophosphate flame retardants on offspring size at birth: A prospective cohort study in China

Organophosphate flame retardants (OPFRs) are substantially applied as flame retardants and plasticizers in consumer products. Although the embryonic developmental toxicity of OPFRs has been reported, human data are limited and the critical windows of susceptibility to OPFRs exposure urgently need to be identified. Here, we investigated the trimester-specific associations between prenatal OPFR exposure and birth size for the first time. The concentrations of 15 OPFR metabolites and tris(2-chloroethyl) phosphate were repeatedly determined in urine samples of 213 pregnant women collected in the first, second, and third trimesters in Wuhan, China, and anthropometric data were retrieved from medical records. In multiple informant models, urinary concentrations of bis(1,3-dichloro-2-propyl) phosphate (BDCIPP) and bis(2-butoxyethyl) phosphate (BBOEP) in the third trimester, 4-hydroxyphenyl-diphenyl phosphate (4-HO-DPHP) in the second trimester, and diphenyl phosphate (DPHP) in the first trimester were negatively associated with birth weight, among which a significant difference in exposure-effect relationships across the three trimesters was observed for BDCIPP. BBOEP concentrations in the third trimester were negatively correlated to birth length with significant varying exposure effects. Our results suggest that prenatal exposure to certain OPFRs may impair fetal growth, and the fetus is vulnerable to the developmental toxicity of BDCIPP and BBOEP in the third trimester.

The association between prenatal exposure to thallium and shortened telomere length of newborns

BACKGROUND

Thallium is a widely known toxic heavy metal that has been reported have embryo toxicity.

OBJECTIVE

We aimed to investigate the relationship of prenatal thallium exposure with neonatal telomere length.

METHODS

A total of 746 mother-newborn pairs were recruited from Wuhan Children Hospital between November 2013 and March 2015 in Wuhan City, China. Maternal thallium exposure levels were measured in spot urine samples collected during the three trimesters and during hospital delivery using inductively coupled plasma mass spectrometry. Neonatal relative telomere length (rTL) was measured by a real-time quantitative polymerase chain reaction assay in cord blood. Multiple informant models were used to evaluate the association of maternal thallium exposure with neonatal rTL.

RESULTS

After adjustment for multiple potential confounders, each 25% incremental increase of maternal thallium exposure, measured in urine samples collected during hospital delivery, was associated with a 1.85% shortened neonatal rTL (95% CI: -3.62%, -0.05%; P = 0.044). Similarly, mothers in the highest quartile of urinary thallium exposure had a 11.74% (95% CI: -21.57%, -0.68%; P = 0.038) shorter cord blood leukocyte rTL than those in the lowest quartile. However, no significant association was found between neonatal rTL and maternal thallium exposure measured in urine samples collected during the three trimesters of pregnancy.

CONCLUSIONS

This study reveals that prenatal thallium exposure was related to shortened neonatal telomere length in Chinese population, pointing to the important role of thallium exposure in accelerating biological aging.

Prenatal exposure to bisphenol S and altered newborn mitochondrial DNA copy number in a baby cohort study: Sex-specific associations

Bisphenol S (BPS) is a main substitute for bisphenol A, which are ubiquitous in human daily products. Newborn mitochondrial DNA copy number (mtDNAcn) is considered as a marker for biological aging and human health, and has been related to diseases in later life. We recruited 762 mother-newborn pairs in a birth cohort study between 2013 and 2015 in Wuhan, China. Urinary BPS concentrations were detected using ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). MtDNAcn from cord blood was measured by quantitative real-time polymerase chain reaction (qPCR). We applied multiple informant models based on generalized estimating equations to assess the associations between prenatal BPS exposure and mtDNAcn. The median urine concentrations of BPS were 0.32 μg/L, 0.34 μg/L, and 0.36 μg/L in the first, second, and third trimesters, respectively. In the multiple informant models, we observed significant associations between BPS and mtDNAcn among male newborns. Compared with the lowest quarters, the second, third, and the highest quarter of BPS level were associated with 58.00% (95% CI: 76.58%, -24.66%), 64.65% (95% CI: 79.40%, -39.33%) and 59.07% (95% CI: 75.16%, -32.58%) reductions of mtDNAcn in the first trimester, respectively. No significant associations were found in the second and third trimesters. The associations between BPS and mtDNAcn were not found among female newborns. Findings from this study suggested that BPS exposure was related to decreased mtDNAcn in male newborns. The first trimester was identified as the critical windows for BPS exposure during pregnancy.

Associations between prenatal and postnatal lead exposure and preschool children humoral and cellular immune responses

Studies have shown that lead exposure affected the immune function, but few studies have examined the relationships between in utero lead exposure, a sensitive period that is important for immune development, and later immune responses. To investigate the effects of prenatal and childhood lead exposure on the preschool-aged children's immune responses, a prospective birth cohort study was established in Wuhan, China, in which lead concentrations were analyzed in maternal urine during the third trimester and in plasma samples from children aged about 3 years. We assessed immune responses by measuring immune cytokines in the children's plasma (n = 326) and peripheral blood T lymphocyte subsets (n = 394) at 3 years of age. Each unit increase in maternal urinary lead concentration (μg/g creatinine) was associated with reduced IL-10 (β = -5.93%, 95%CI: -11.82%, -0.03%) and reduced IL-4 levels (β = -5.62%, 95%CI: -10.44%, -0.80%). Lead in children's plasma (μg/L) was associated with significant increase in TNF-α (β = 10.78%, 95%CI: 3.97%, 17.59%). No statistically significant relationship of childhood lead exposure with T lymphocyte subsets was observed. The study suggested prenatal and childhood lead exposure was associated with changes in preschool children's plasma cytokine levels.

A 9-month-old Chinese patient with Gabriele-de Vries syndrome due to novel germline mutation in the YY1 gene

BACKGROUND

Gabriele-de Vries syndrome (GADEVS), also known as YY1 haploinsufficiency syndrome, is a very rare autosomal dominant neurodevelopmental disorder (NDD) due to YY1 mutation characterized by mild-to-profound developmental delay (DD)/intellectual disability (ID), a wide spectrum of functional and morphologic abnormalities, and intrauterine growth restriction or low birth weight and feeding difficulties are common in the patients. However, NDDs, such as language development disorder and ID, could hardly be assessed in patients younger than 2 years old.

METHODS

We describe a 9-month-old female with DD, failure to thrive, and facial dysmorphism. Genetic analysis was conducted by whole exome sequencing (WES) and confirmed by Sanger sequencing.

RESULTS

In addition to DD and dysmorphic facial features, this patient had urinary tract infection, acute pyelonephritis, bilateral vesicoureteral reflux (grade III), gastroesophageal reflux, and malnutrition. She was found to have foramen ovale or atrial septal defect, and enlarged left lateral ventricle in the brain. After performing WES, a novel heterozygous mutation NM_003403.5:c.1124G>A, p.Arg375Gln in the YY1 gene was identified.

CONCLUSION

Our findings suggest that genetic tests are critical technique for diagnosis of GADEVS, especially in patients with early-childhood, unexplained developmental or growth disorders, thus, the prevalence of GADEVS may be underestimated. The clinical features and identified YY1 mutation in our patient expand the spectra of phenotypes and genotypes of GADEVS, respectively.

Pregnant women with COVID-19 and risk of adverse birth outcomes and maternal-fetal vertical transmission: a population-based cohort study in Wuhan, China

BACKGROUND

The coronavirus disease 2019 (COVID-19) outbreak is evolving rapidly worldwide. However, little is known about the association between pregnant women with COVID-19 and the risk of adverse birth outcomes.

METHOD

We conducted a retrospective cohort study based on the Maternal and Child Health Information System (MCHIMS) of Wuhan, China. All pregnant women with singleton live birth recorded by the system between January 13 and March 18, 2020, were included. The adverse birth outcomes were preterm birth, low birth weight, neonatal asphyxia, premature rupture of membrane (PROM), and cesarean section delivery. Multivariate logistic regression was used to evaluate the associations between maternal COVID-19 diagnosis and adverse birth outcomes.

RESULTS

Out of 11,078 pregnant women, 65 were confirmed with coronavirus disease 2019 (COVID-19). No deaths occurred from these confirmed cases or their newborns. Compared to pregnant women without COVID-19, pregnant women with a confirmed COVID-19 diagnosis had an increased risk of preterm birth (OR 3.34, 95% CI 1.60-7.00) and cesarean section (OR 3.63, 95% CI 1.95-6.76). There was no statistical difference in low birth weight, neonatal asphyxia, and PROM between the mothers with and without COVID-19. Among these newborns that were born to mothers with confirmed COVID-19, none was tested severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive or had abnormal CT results. Only one had diarrhea and three had a fever.

CONCLUSIONS

This population-based cohort study suggests that COVID-19 during the later pregnancy is associated with an increased risk of adverse birth outcomes, including iatrogenic preterm birth and cesarean section delivery. Our data provide little evidence for maternal-fetal vertical transmission of SARS-CoV-2. It is important to monitor the long-term health effects of SARS-CoV-2 infection on pregnant women and their children.

Association between changes in gestational blood pressure and vanadium exposure in China

OBJECTIVE

To investigate the association between urinary vanadium concentrations and blood pressure (BP) changes in Chinese pregnant women.

METHODS

This longitudinal study included 716 pregnant women who visited our hospital in Wuhan, China, from 2014 to 2016. Urinary sample collection and BP measurements were performed at 9-15, 21-27, and 34-40 weeks of gestation. Outcomes were repeated BP measurements (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], and mean arterial pressure [MAP]) during pregnancy.

RESULTS

The geometric mean of urinary vanadium concentrations was 0.65 μg/g creatinine. After adjusting for potential confounders, each threefold increase in urinary vanadium concentration was observed to be associated with a 1.06 mmHg decrease in SBP (95 % confidence interval [CI]: -1.80, -0.32), a 0.68 mmHg decrease in DBP (95 % CI: -1.32, -0.04), and a 0.81 mmHg decrease in MAP (95 % CI: -1.42, -0.19). Cross-sectional analysis showed a negative association between urinary vanadium concentrations and BP in the third trimester. Specifically, each threefold increase in urinary vanadium concentration in the second trimester was associated with decreases in SBP, DBP, PP, and MAP by 2.72 mmHg (95 % CI: -4.02, -1.41), 1.57 mmHg (95 % CI: -2.72, -0.42), 1.14 mmHg (95 % CI: -2.15, -0.14), and 1.95 mmHg (95 % CI: -3.06, -0.85), respectively, in the third trimester.

CONCLUSION

To the best of our knowledge, this is the first longitudinal study that suggests the negative association between vanadium exposure and BP among pregnant women in China.

Association of prenatal exposure to rare earth elements with newborn mitochondrial DNA content: Results from a birth cohort study

BACKGROUND

Rare earth elements (REE) have been widely used in industry and agriculture. Mitochondria are susceptible to environmental exposure and the change of mitochondrial DNA (mtDNA) content is a proxy indicator of mitochondrial response to damage. However, no study has explored the associations between prenatal repeated REE exposure and newborn mtDNA content.

OBJECTIVES

We aimed to investigate the trimester-specific associations between prenatal REE exposure and newborn mtDNA content.

METHODS

A total of 587 mother-newborn pairs were recruited from Wuhan Children's Hospital between November 2013 and March 2015 in Wuhan, China. Urinary concentrations of REE collected during 3 trimesters were measured by inductively coupled plasma mass spectrometry (ICP-MS). Quantitative real-time polymerase chain reaction (qPCR) was used to measure relative cord blood mtDNA content. We evaluated the trimester-specific associations between prenatal REE exposure and relative cord blood mtDNA content with multiple informant models. False discovery rate (FDR) was used to correct for multiple testing.

RESULTS

After adjustment for potential confounders, prenatal exposure to REE [gadolinium (Gd), dysprosium (Dy), erbium (Er), praseodymium (Pr)] during the third trimester were positively related to cord blood mtDNA content, and the positive associations with cord blood mtDNA content were still observed in Dy, Er, and Pr after FDR correction.

CONCLUSIONS

This prospective study demonstrated that maternal REE exposure during the third trimester was associated with the increased newborn mtDNA content, and the third trimester might be a potential window for sensitivity of newborn mtDNA content to REE exposure. The results might provide evidence of the potential health effects of environmental REE exposure.

A Comparison Between Chinese Children Infected with Coronavirus Disease-2019 and with Severe Acute Respiratory Syndrome 2003

OBJECTIVES

To compare the clinical and laboratory features of severe acute respiratory syndrome 2003 (SARS) and coronavirus disease 2019 (COVID-19) in 2 Chinese pediatric cohorts, given that the causative pathogens and are biologically similar.

STUDY DESIGN

This is a cross-sectional study reviewing pediatric patients with SARS (n = 43) and COVID-19 (n = 244) who were admitted to the Princess Margaret Hospital in Hong Kong and Wuhan Children's Hospital in Wuhan, respectively. Demographics, hospital length of stay, and clinical and laboratory features were compared.

RESULTS

Overall, 97.7% of patients with SARS and 85.2% of patients with COVID-19 had epidemiologic associations with known cases. Significantly more patients with SARS developed fever, chills, myalgia, malaise, coryza, sore throat, sputum production, nausea, headache, and dizziness than patients with COVID-19. No patients with SARS were asymptomatic at the time of admission, whereas 29.1% and 20.9% of patients with COVID-19 were asymptomatic on admission and throughout their hospital stay, respectively. More patients with SARS required oxygen supplementation than patients with COVID-19 (18.6 vs 4.7%; P = .004). Only 1.6% of patients with COVID-19 and 2.3% of patients with SARS required mechanical ventilation. Leukopenia (37.2% vs 18.6%; P = .008), lymphopenia (95.4% vs 32.6%; P < .01), and thrombocytopenia (41.9% vs 3.8%; P < .001) were significantly more common in patients with SARS than in patients with COVID-19. The duration between positive and negative nasopharyngeal aspirate and the length in hospital stay were similar in patients with COVID-19, regardless of whether they were asymptomatic or symptomatic, suggesting a similar duration of viral shedding.

CONCLUSIONS

Children with COVID-19 were less symptomatic and had more favorable hematologic findings than children with SARS.

Bradymonabacteria, a novel bacterial predator group with versatile survival strategies in saline environments

BACKGROUND

Bacterial predation is an important selective force in microbial community structure and dynamics. However, only a limited number of predatory bacteria have been reported, and their predatory strategies and evolutionary adaptations remain elusive. We recently isolated a novel group of bacterial predators, Bradymonabacteria, representative of the novel order Bradymonadales in δ-Proteobacteria. Compared with those of other bacterial predators (e.g., Myxococcales and Bdellovibrionales), the predatory and living strategies of Bradymonadales are still largely unknown.

RESULTS

Based on individual coculture of Bradymonabacteria with 281 prey bacteria, Bradymonabacteria preyed on diverse bacteria but had a high preference for Bacteroidetes. Genomic analysis of 13 recently sequenced Bradymonabacteria indicated that these bacteria had conspicuous metabolic deficiencies, but they could synthesize many polymers, such as polyphosphate and polyhydroxyalkanoates. Dual transcriptome analysis of cocultures of Bradymonabacteria and prey suggested a potential contact-dependent predation mechanism. Comparative genomic analysis with 24 other bacterial predators indicated that Bradymonabacteria had different predatory and living strategies. Furthermore, we identified Bradymonadales from 1552 publicly available 16S rRNA amplicon sequencing samples, indicating that Bradymonadales was widely distributed and highly abundant in saline environments. Phylogenetic analysis showed that there may be six subgroups in this order; each subgroup occupied a different habitat.

CONCLUSIONS

Bradymonabacteria have unique living strategies that are transitional between the "obligate" and the so-called facultative predators. Thus, we propose a framework to categorize the current bacterial predators into 3 groups: (i) obligate predators (completely prey-dependent), (ii) facultative predators (facultatively prey-dependent), and (iii) opportunistic predators (prey-independent). Our findings provide an ecological and evolutionary framework for Bradymonadales and highlight their potential ecological roles in saline environments. Video abstract.

CircPSMC3 alleviates the symptoms of PCOS by sponging miR-296-3p and regulating PTEN expression

Polycystic ovary syndrome (PCOS), the most common female endocrine disease that causes anovulatory infertility, still lacks promising strategy for the accurate diagnosis and effective therapeutics of PCOS attributed to its unclear aetiology. In this study, we determined the abnormal reduction in circPSMC3 expression by comparing the ovarian tissue samples of PCOS patients and normal individuals. The symptom relief caused by up-regulation of circPSMC3 in PCOS model mice suggested the potential for further study. In vitro functional experiments confirmed that circPSMC3 can inhibit cell proliferation and promote apoptosis by blocking the cell cycle in human-like granular tumour cell lines. Mechanism study revealed that circPSMC3 may play its role through sponging miR-296-3p to regulate PTEN expression. Collectively, we preliminarily characterized the role and possible insights of circPSMC3/miR-296-3p/PTEN axis in the proliferation and apoptosis of KGN cells. We hope that this work provides some original and valuable information for the research of circRNAs in PCOS, not only to better understand the pathogenesis but also to help provide new clues for seeking for the future therapeutic target of PCOS.

Associations of per-/polyfluoroalkyl substances with glucocorticoids and progestogens in newborns

BACKGROUND

Exposure to per-/polyfluoroalkyl substances (PFASs) can disrupt endocrine hormones in humans. Prior studies have focused on the harmful effects of the two traditional per-/polyfluoroalkyl substances (PFASs), perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). Other PFASs, used as the replacements of PFOS and PFOA, are widely and increasingly detected in humans. Whether these replacements influence glucocorticoids and progestogens in newborns remains unknown.

OBJECTIVE

To investigate the associations between exposures of PFOS, PFOA and their replacements and glucocorticoids and progestogens in newborns.

METHODS

We measured the concentrations of 13 PFASs, 3 glucocorticoids (11-deoxycortisol, cortisol and cortisone) and 2 progestogens [progesterone, 17-hydroxyprogesterone (17OHP)] in the cord sera of 374 neonates in a birth cohort from Wuhan, China, between 2013 and 2014. We evaluated the associations of each PFAS with glucocorticoids and progestogens using multiple linear regression models, and multiple comparisons were additionally corrected via false discovery rates (FDR).

RESULTS

Out of the 13 PFASs, 9 were detected in over 95% of cord sera. The Chinese specific PFOS replacement - 6:2 chlorinated polyfluorinated ether sulfonate (6:2 Cl-PFESA, trade name F-53B) was positively associated with 13.13% change in cortisol in girls (95% CI = 4.47%, 22.52%, for each IQR increase in 6:2 Cl-PFESA). Seven PFASs had positive associations with the precursor of cortisol, namely 11-deoxycortisol (percent change ranged from 6.41% to 11.24%, for each IQR increase in PFASs). Perfluorobutane sulfonate (PFBS) in cord sera was positively associated with progesterone in the linear model, whereas PFOS and perfluorohexane sulfonate (PFHxS) levels were associated with progesterone in the quartile models. No PFASs were related to 17OHP or cortisone.

CONCLUSIONS

In this study, PFOS, PFOA and/or their replacements were positively associated with progesterone, cortisol and 11-deoxycortisol in newborns. These results suggested that not only PFOS and PFOA, but also other PFASs have potential impacts on glucocorticoids and progestogens in newborns.

Haematological and immunological data of Chinese children infected with coronavirus disease 2019

Haematological and immunological data of children with COVID-19 infection is lacking. Between 21st January and 20th March 2020, 244 children who were confirmed to have COVID-19 infection and admitted to the Wuhan Children's Hospital, China were retrospectively reviewed. 193 children were considered as symptomatic, which was defined as having either the presence of clinical symptoms or the presence of CT thorax abnormalities. Their haematological and immunological profiles, including complete blood counts, lymphocyte subsets (T, B and NK cell counts), immunoglobulin (Ig) profiles (IgG, IgA and IgM) and cytokine profiles were analysed and compared between the symptomatic and asymptomatic groups. The median values and the interquartile ranges were calculated. Comparison was made using the Mann–Whitney U test. Children with symptomatic COVID-19 infection had significantly lower haemoglobin levels, but higher absolute lymphocyte and monocyte counts, IgG and IgA levels, as well as interleukin 6 (IL-6), IL-10, tumour necrosis factor alpha and interferon gamma levels. The obtained data will be utilized for further studies in comparing children and adults with COVID-19 infections in other parts of the world and with different severity .

Laboratory data on long-term sealing behaviors of two water-swelling materials for shield tunnel gasket

This article provides comprehensive experimental data of two water-swelling materials, water swelling rubber (WSR) and water-swelling polyurethane (WSP). Swelling tests, Dynamic Mechanical Analyzer (DMA) and Scanning Electron Microscope (SEM) were performed. Sealing properties of WSR and WSP were characterized by the data of swelling ratios (Sw and Sa), storage moduli (E') and images of micro-damage morphologies. These data can be useful for the prediction of the long-term waterproof performance of water-swelling materials and provide reference for material selection. The data presented herein was used for the article, titled "Laboratory evaluation of long-term sealing behaviors of two water-swelling materials for shield tunnel gasket" [1].

Aluminum Exposure and Gestational Diabetes Mellitus: Associations and Potential Mediation by n-6 Polyunsaturated Fatty Acids

As the earth's third most abundant element with various industrial applications, aluminum (Al) has received increasing concerns over its potential adverse health effects. Although Al exposure has been suggested to increase the risks of type 2 diabetes, little has been done to explore Al exposure in pregnant women and potential impact on the incidence of gestational diabetes mellitus (GDM). Our present study demonstrated positive associations between Al concentrations in maternal plasma collected in the first trimester of pregnancy and GDM risks (P_trend < 0.001) based on a nested case-control study from Wuhan, China, including 305 GDM cases and 305 healthy controls. The highest tertile of plasma Al concentrations corresponded to an odds ratio of 4.03 (95% confidence interval: [2.14, 7.58]) relative to the lowest tertile, after the adjustment for established GDM risk factors and other plasma metals. We also observed significant correlations between plasma Al and several plasma polyunsaturated fatty acids (PUFA; e.g., linoleic acid 18:2 n-6) levels. In addition, mediation effects on the associations of Al exposure with GDM risks were observed for n-6 PUFAs (estimated mediation percentage: 48.3%) and total PUFAs (48.9%). Our study is not only by far the largest study of its kind to demonstrate maternal Al exposure and the association with GDM risks, but it also offers an insight into the potential mediation roles of n-6 PUFAs in an epidemiological setting. These findings contribute to a better understanding of perinatal Al exposure and GDM risks.

Association of urinary cadmium, circulating fatty acids, and risk of gestational diabetes mellitus: A nested case-control study in China

BACKGROUND

Previous studies have observed that cadmium (Cd) exposure of pregnant women was associated with increased risk of gestational diabetes mellitus (GDM). However, the potential mechanism still remains unclear. In addition, various animal studies have suggested that Cd exposure could affect fatty acids (FAs) metabolism, but data on humans are scant.

OBJECTIVES

We conducted a nested case-control study to investigate the associations of urinary Cd concentrations with levels of circulating FAs and risk of GDM in pregnant women, and further to examine the role of FAs in mediating the relationship between Cd exposure and risk of GDM.

METHODS

A total of 305 GDM cases were matched to 305 controls on pregnant women's age (±2 years) and infant's gender from a birth cohort study conducted in Wuhan, China. Urinary Cd concentrations and levels of plasma FAs between 10 and 16 gestational weeks were measured using inductively coupled plasma mass spectrometry and gas chromatography-mass spectrometry, respectively. Conditional logistic regressions models were used to estimate the associations of Cd concentrations and levels of FAs with the risk of GDM. Multiple linear regression models were applied to estimate the associations between Cd concentrations and levels of FAs. Mediation analysis was used to assess the mediating role of FAs in the association of Cd with the risk of GDM.

RESULTS

Urinary concentrations of Cd in cases (median: 0.69 μg/L) were significantly higher than controls (median: 0.59 μg/L, P < 0.05). Cd concentrations were positively associated with the risk of GDM (P_trend = 0.003). Compared to the first tertile of Cd, the adjusted odds ratios (95% confidence intervals) of GDM risk were 2.08 (1.29, 3.36) for the second tertile and 2.09 (1.32, 3.33) for the third tertile. Cd concentrations were positively correlated with levels of eicosadienoic acid and arachidonic acid/eicosapentaenoic acid ratio, but negatively correlated with levels of stearic acid, eicosapentaenoic acid, total odd-chain saturated fatty acids, total n-3 polyunsaturated fatty acids (PUFAs), and n-3 PUFAs/n-6 PUFAs ratio. We did not observe evidence that the association of Cd exposure and risk of GDM was mediated through FAs.

CONCLUSIONS

Our findings confirmed the association of higher Cd exposure with increased risk of GDM in pregnant women, and provided forceful epidemiological evidence for the relation of Cd concentrations and levels of FAs.

Prenatal Exposure to Organophosphate Flame Retardants and the Risk of Low Birth Weight: A Nested Case-Control Study in China

Organophosphate flame retardants (OPFRs), used as flame retardants and plasticizers, have been suggested to impair fetal growth and development in toxicological studies, but epidemiological data are extremely limited. This study was designed to explore whether prenatal exposure to OPFRs was associated with an increased risk of low birth weight (LBW) using a nested case-control design based on the ongoing prospective birth cohort in Wuhan, China. A total of 113 cases and 226 matched controls recruited from this cohort project in 2014-2016 were included. OPFR metabolite concentrations in maternal urine samples collected in the third trimester were determined, and birth outcomes were extracted from medical records. Compared with the lowest tertile of diphenyl phosphate (DPHP) concentrations, pregnant women with the highest tertile of DPHP had a 4.62-fold (95% confidence interval (CI): 1.72, 12.40) significantly increased risk for giving birth to LBW infants, with a significant dose-response relationship (p-trend < 0.01). After stratification by newborn sex, the significant positive association of DPHP levels with LBW risk was merely observed among female newborns. Our results suggest a positive association between maternal urinary DPHP concentrations and LBW risk for the first time, and the effect appears be sex-specific.

Multiple metal exposure and platelet counts during pregnancy: A repeated measure study

BACKGROUND

Evidence from animal and in vitro studies suggest that some metals interfere with normal platelet counts (PLT). However, limited human studies have investigated the association of metals and PLT, a marker of hematologic and hemostatic, particularly in susceptible populations such as pregnant women.

OBJECTIVES

Our purpose was to investigate the associations of repeated measures of 13 urinary metals with PLT during pregnancy.

METHODS

The present study involved 3911 pregnant women participating in a prospective cohort study in Wuhan, China, from 2013 to 2016. We measured 13 metals in urine and PLT in blood samples collected in the first, second, and third trimester (median = 13, 24, and 35 weeks of gestation, respectively). Mixed linear models and general linear models were applied to analyze the associations between multiple metals and PLT during pregnancy. The odds ratio (OR) for gestational thrombocytopenia was examined using generalized estimating equations.

RESULTS

After adjusting for other metals and covariates, the repeated measure analyses showed that decreased levels of PLT were associated with a 10-fold increase in urinary concentration of cadmium (Cd) [percent difference (%Δ) = -5.02, 95%CI = -9.53, -0.29], manganese (Mn) [percent difference (%Δ) = -4.63, 95%CI = -7.50, -1.67], and arsenic (As) [percent difference (%Δ) = -4.56, 95%CI = -8.11, -0.86]. Cross-sectional analyses by trimesters revealed that Cd was inversely associated with PLT through the three trimesters. In addition, Cd was associated with an increased OR of 1.80 (95%CI: 1.26, 2.56), 1.65 (95%CI: 1.05, 2.59), 1.54 (95%CI: 1.02, 2.33) for gestational thrombocytopenia in the first, second, and third trimester, respectively.

CONCLUSIONS

Our study suggested an association of Cd, Mn, and As with decreased PLT during pregnancy. Particularly, Cd may increase the risk of gestational thrombocytopenia.

Association of adverse birth outcomes with prenatal uranium exposure: A population-based cohort study

Uranium (U) is a well-recognized hazardous heavy metal with embryotoxicity and fetotoxicity. However, little is known about its association with adverse birth outcomes. We aimed to investigate the potential correlation between prenatal U exposure and birth outcomes. Urine samples of 8500 women were collected before delivery from a birth cohort in Wuhan, China. Concentrations of urinary U and other metals were measured by inductively coupled plasma mass spectrometry. We used multivariable logistic regressions to evaluate the associations between urinary U concentrations and adverse birth outcomes, such as preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA). Associations of urinary U concentrations with gestational age, birth weight, and birth length were investigated by linear regressions. The geometric mean of U concentration was 0.03 μg/L. After adjustment for potential confounders, we found each Log₂-unit increase in U concentration was associated with a significant decrease in gestational age [adjusted β = -0.32 day; 95% confidence interval (CI): -0.44, -0.20] and a significant increased likelihood of PTB (adjusted OR = 1.18, 95% CI: 1.07, 1.29). This birth cohort uncovered an association of maternal exposure to U during pregnancy with decreased gestational age and increased risk of PTB. Our findings reveal an association of maternal exposure to U during pregnancy with decreased gestational age and increased risk of PTB.

Association of circulating saturated fatty acids with the risk of pregnancy-induced hypertension: a nested case-control study

Circulating saturated fatty acids (SFAs) have been associated with cardiovascular disease. However, little is known about the relationship of SFAs with the risk of pregnancy-induced hypertension (PIH). We conducted a nested case-control study to examine the associations between circulating SFAs and the risk of PIH. A total of 92 PIH cases were matched to 184 controls by age (±2 years) and infant sex from a birth cohort study conducted in Wuhan, China. Levels of circulating fatty acids in plasma were measured using gas chromatography-mass spectrometry. Conditional logistic regressions were conducted to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs). Even-chain SFAs, including myristic acid (14:0) and palmitic acid (16:0), were positively associated with the risk of PIH [ORs (95% CIs): 2.92 (1.27, 6.74) for 14:0 and 2.85 (1.18, 6.89) for 16:0, % by wt]. In contrast, higher levels of very-long-chain SFAs, including arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0), were associated with a lower risk of PIH [ORs (95% CIs): 0.40 (0.17, 0.92) for 20:0, 0.30 (0.12, 0.71) for 22:0 and 0.26 (0.11, 0.64) for 24:0, μg/mL]. For odd-chain SFAs, including pentadecanoic acid (15:0) and heptadecanoic acid (17:0), no significant difference was observed. Our results provided convincing evidence that different subclasses of SFAs showed diverse effects on the risk of PIH. This suggests that dietary very-long-chain SFAs may be a novel means by which to prevent hypertension. Future studies are required to confirm these associations and elucidate the underlying mechanisms.

87 Analyzing metabolomic profile of bovine IVF and somatic cell nuclear transfer embryos through Raman spectroscopy

While knowledge of early embryo development and viability has continually increased, there is still a need for noninvasive methods to identify embryos with the highest chances of development to term when transferred. The most widely used technique, morphological assessment, is highly subjective and limited by personnel experience. Spent media from invitro culture could be used as a valuable noninvasive marker for embryo quality assessment. Raman spectroscopy has proven to be a powerful tool for identifying the molecular characteristics of spent culture media by measuring vibration of chemical bonds, allowing for metabolomic profiling of varying stages and quality of embryos. It is well documented that embryos produced through somatic cell nuclear transfer (SCNT) result in lower pregnancy rates and higher incidences of pregnancy loss when compared with embryos produced through IVF (Heyman et al. 2002 Biol. Reprod. 66, 1-13). This study was designed to examine differences in spent media between bovine embryos produced by IVF and SCNT. The SCNT embryos with a metabolomic profile more similar to IVF embryos may have a higher developmental competence. Bovine cumulus-oocyte complexes (COCs) were retrieved from abattoir-derived ovaries and matured for 21h in maturation medium. After IVM, COCs were either used for IVF or SCNT and cultured in 50μL droplets of synthetic oviductal fluid medium + fetal bovine serum in groups of 45 from Day 0-5. On Day 5, embryos that had reached morula stage were placed in individual droplets of 13μL of synthetic oviductal fluid + bovine serum albumin until Day 7. All embryos were cultured at 38.5°C and 5% CO2. On Day 7 embryos were assessed for developmental stage and quality and 10μL of medium from individual culture drops was collected for Raman spectroscopy. Samples were loaded on an MgF2 optical window, dried, and analysed using a 785nm near-infrared laser in the spectral range of 600 to 1800cm−1. Raw Raman data were first pre-processed by baseline correction (asymmetric least-squares smoothing) and normalization. Principal component analysis and partial least squares were then applied to reduce data dimensions. The score of the most significant principal components from principal component analysis and the optimum number of scores from partial least squares were used for linear discriminant analysis. Spent media samples from 4 SCNT embryos, 3 IVF embryos, and 3 empty media samples were analysed, with 50 spectra obtained from each sample. Preliminary data showed grouping of medium containing embryos developed to blastocyst from medium containing embryos arrested at morula or empty medium. We also saw grouping of medium containing SCNT embryos from medium containing IVF embryos within both the morula and blastocyst stage from empty medium. This shows evidence of metabolomic differences between embryos of different developmental potential and embryos produced by IVF and SCNT. Further investigation of the Raman profile of these groups can display specific differences in chemical components and help to identify candidate genes causing differing metabolism of these groups.

Prenatal exposure of rare earth elements cerium and ytterbium and neonatal thyroid stimulating hormone levels: Findings from a birth cohort study

BACKGROUND

Prior studies have suggested exposure to heavy metals and endocrine disrupting chemicals could disturb the homeostasis of thyroid stimulating hormone (TSH), but no epidemiology study concerning the influence of rare earth elements (REE) exposure during pregnancy on neonatal TSH levels. The present study aimed to investigate the relationships between prenatal REE exposure and neonatal TSH levels.

METHODS

A total of 7367 pregnant women were recruited from Wuhan Children's Hospital between September 2012 and October 2014 in Wuhan, China. Urinary concentrations of cerium (Ce), and ytterbium (Yb) were measured by inductively coupled plasma mass spectrometry (ICP-MS). Immunofluorescence assay was used to detect neonatal TSH levels. The associations between REE exposure and neonatal TSH levels were evaluated using multivariate linear regression models.

RESULTS

The geometric means of maternal urinary Ce and Yb concentrations were 0.060 μg/g creatinine and 0.025 μg/g creatinine, respectively. The results showed that per doubling of maternal urinary Ce and Yb were associated with 4.07% (95% CI: -5.80%, -2.31%), 5.13% (95% CI: -6.93%, -3.30%) decreased neonatal TSH levels respectively in the adjusted model. Sex stratified analysis demonstrated that the decreased neonatal TSH levels were observed both in male infants and female infants, and the decrease was greater in male infants in urinary Ce. There were no significant interactions between maternal urinary Ce, Yb and infant sex (Ce: P for interaction = 0.173, Yb: P for interaction = 0.967).

CONCLUSIONS

Our findings demonstrated that increased maternal urinary Ce and Yb were associated with decreased neonatal TSH levels. Further researches from different populations are warranted to verify the association and to explore the mechanisms.

Health effects associated with serum calcium concentrations: evidence from MR-PheWAS analysis in UK Biobank

We conducted a phenome-wide Mendelian randomization analysis (MR-PheWAS) to survey health effects associated with high normal serum calcium. We found causal evidence for conditions related to renal function, bone and joint health, and cardiovascular risk. These conditions collectively suggest that tissue calcification may be a key mechanism through which serum calcium influences health.

INTRODUCTION

Calcium is essential for the normal functioning of the cardiovascular system, muscles, and nerves. In this MR-PheWAS study, we sought to capture the totality of health effects associated with high normal serum calcium.

METHODS

We used data from up to 337,535 UK Biobank participants, and tested for associations between calcium genetic score (calcium-GS) and 925 disease outcomes, with follow-up analyses using complementary MR methods.

RESULTS

Calcium-GS was robustly associated with serum calcium concentration (F statistics = 349). After multiple testing correction (P < 1.62E-4), we saw genetic evidence for an association between high serum calcium and urinary calculus (OR per 1 mg/dl 3.5, 95%CI 1.3-9.2), renal colic (9.1, 95%CI 2.5-33.5), and allergy/adverse effect of penicillin (2.2, 95%CI 1.5-3.3). Secondary analyses with independent replication from consortia meta-analyses suggested further effects on myocardial infarction and osteoarthrosis.

CONCLUSION

We found causal evidence for effects of high normal serum calcium with conditions related to renal function, bone and joint health, and cardiovascular risk, which may collectively reflect influences on tissue calcification and immune function.

Associations of maternal glycemia and prepregnancy BMI with early childhood growth: a prospective cohort study

The prevalence of maternal and child overweight/obesity and gestational hyperglycemia has increased greatly in China in recent years. However, studies examining the relationship between maternal hyperglycemia, maternal prepregnancy body mass index (ppBMI), and offspring obesity in China are limited. Here, we conducted a prospective study of 6684 mother-child pairs in Wuhan, China in 2012-2015. Maternal glucose concentrations were measured at approximately 24-28 weeks of gestation; children's weight and length were measured at birth and at 6, 12, and 24 months of age; and BMI-for-age Z-scores (BMIZ) were calculated for different time points. We found that maternal fasting plasma glucose (FPG) concentrations were positively associated with offspring ponderal index and the risk of macrosomia at birth, but not with BMIZ or the risk of overweight/obesity at 6, 12, and 24 months of age. By contrast, maternal ppBMI was positively associated with both an increased risk of macrosomia at birth and overweight/obesity at 6, 12, and 24 months of age. Here, we observed an interaction effect of the association of FPG and ppBMI on offspring macrosomia and a mediating effect of gestational diabetes mellitus on the pathway between ppBMI and macrosomia. Our findings suggest that maternal ppBMI is a more pronounced predictor than gestational FPG concentrations in both the relation to BMIZ and the risk of overweight/obesity in early childhood.

Adaptive Evolution of Sphingobium hydrophobicum C1T in Electronic Waste Contaminated River Sediment

Electronic waste (e-waste) has caused a severe worldwide pollution problem. Despite increasing isolation of degradative microorganisms from e-waste contaminated environments, the mechanisms underlying their adaptive evolution in such habitats remain unclear. Sphingomonads generally have xenobiotic-degrading ability and may play important roles in bioremediation. Sphingobium hydrophobicum C1^T, characterized with superior cell surface hydrophobicity, was recently isolated from e-waste contaminated river sediment. To dissect the mechanisms driving its adaptive evolution, we evaluated its stress resistance, sequenced its genome and performed comparative genomic analysis with 19 other Sphingobium strains. Strain C1^T can feed on several kinds of e-waste-derived xenobiotics, exhibits a great resistance to heavy metals and possesses a high colonization ability. It harbors abundant genes involved in environmental adaptation, some of which are intrinsic prior to experiencing e-waste contamination. The extensive genomic variations between strain C1^T and other Sphingobium strains, numerous C1^T-unique genes, massive mobile elements and frequent genome rearrangements reflect a high genome plasticity. Positive selection, gene duplication, and especially horizontal gene transfer drive the adaptive evolution of strain C1^T. Moreover, presence of type IV secretion systems may allow strain C1^T to be a source of beneficial genes for surrounding microorganisms. This study provides new insights into the adaptive evolution of sphingomonads, and potentially guides bioremediation strategies.

Associations of Trimester-Specific Exposure to Bisphenols with Size at Birth: A Chinese Prenatal Cohort Study

BACKGROUND

Bisphenol A (BPA) is an endocrine disruptor that affects fetal growth in experimental studies. Bisphenol F (BPF) and bisphenol S (BPS), which have been substituted for BPA in some consumer products, have also shown endocrine-disrupting effects in experimental models. However, the effects of BPF and BPS on fetal growth in humans are unknown.

OBJECTIVES

Our goal was to investigate trimester-specific associations of urinary concentrations of BPA, BPF, and BPS with size at birth.

METHODS

The present study included 845 pregnant women from Wuhan, China (2013-2015), who provided one urine sample in each of the first, second, and third trimesters. Linear regressions with generalized estimating equations were applied to estimate trimester-specific associations of urinary bisphenol concentrations with birth weight, birth length, and ponderal index. Linear mixed-effects models were used to identify potential critical windows of susceptibility to bisphenols by comparing the exposure patterns of newborns in the 10th percentile of each birth anthropometric measurement to that of those in the 90th percentile.

RESULTS

Medians (25th-75th percentiles) of urinary concentrations of BPA, BPF, and BPS were 1.40 (0.19-3.85), 0.65 (0.34-1.39), and 0.38 (0.13-1.11) ng/mL, respectively. Urinary BPA concentrations in different trimesters were inversely, but not significantly, associated with birth weight and ponderal index. Urinary concentrations of BPF and BPS during some trimesters were associated with significantly lower birth weight, birth length, or ponderal index, with significant trend p-values (ptrend<0.05) across quartiles of BPF and BPS concentrations. The observed associations were unchanged after additionally adjusting for other bisphenols. In addition, newborns in the 10th percentile of each birth anthropometry measure had higher BPF and BPS exposures during pregnancy than newborns in the 90th percentile of each outcome.

CONCLUSIONS

Prenatal exposure to BPF and BPS was inversely associated with size at birth in this cohort. Replication in other populations is needed. https://doi.org/10.1289/EHP4664.

Impact of the 2017 ACC/AHA Guideline for High Blood Pressure on Evaluating Gestational Hypertension–Associated Risks for Newborns and Mothers

Rationale:

In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) released a new hypertension guideline for nonpregnant adults, using lower blood pressure values to identify hypertension. However, the impact of this new guideline on the diagnosis of gestational hypertension and the associated maternal and neonatal risks are unknown.

Objective:

To estimate the impact of adopting the 2017 ACC/AHA guideline on detecting gestational blood pressure elevations and the relationship with maternal and neonatal risk in the perinatal period using a retrospective cohort design.

Methods and Results:

This study included 16 345 women from China. Systolic and diastolic blood pressures of each woman were measured at up to 22 prenatal care visits across different stages of pregnancy. Logistic and linear regressions were used to estimate associations of blood pressure categories with the risk of preterm delivery, early-term delivery, and small for gestational age, and indicators of maternal liver, renal, and coagulation functions during pregnancy. We identified 4100 (25.1%) women with gestational hypertension using the 2017 ACC/AHA guideline, compared with 4.2% using the former definition. Gestational hypertension, but not elevated blood pressure (subclinical blood pressure elevation), was significantly associated with altered indicators of liver, renal, and coagulation functions during pregnancy for mothers and increased risk of adverse birth outcomes for newborns; adjusted odds ratios (95% CIs) for gestational hypertension stage 2 were 2.23 (1.18–4.24) for preterm delivery, 2.05 (1.67–2.53) for early-term delivery, and 1.43 (1.13–1.81) for small for gestational age.

Conclusions:

Adopting the 2017 ACC/AHA guideline would result in a substantial increase in the prevalence of gestational hypertension; subclinical blood pressure elevations during late pregnancy were not associated with increased maternal and neonatal risk in this cohort. Therefore, the 2017 ACC/AHA guideline may improve the detection of high blood pressure during pregnancy and the efforts to reduce maternal and neonatal risk. Replications in other populations are required.

Climate warming accelerates temporal scaling of grassland soil microbial biodiversity

Determining the temporal scaling of biodiversity, typically described as species-time relationships (STRs), in the face of global climate change is a central issue in ecology because it is fundamental to biodiversity preservation and ecosystem management. However, whether and how climate change affects microbial STRs remains unclear, mainly due to the scarcity of long-term experimental data. Here, we examine the STRs and phylogenetic-time relationships (PTRs) of soil bacteria and fungi in a long-term multifactorial global change experiment with warming (+3 °C), half precipitation (-50%), double precipitation (+100%) and clipping (annual plant biomass removal). Soil bacteria and fungi all exhibited strong STRs and PTRs across the 12 experimental conditions. Strikingly, warming accelerated the bacterial and fungal STR and PTR exponents (that is, the w values), yielding significantly (P < 0.001) higher temporal scaling rates. While the STRs and PTRs were significantly shifted by altered precipitation, clipping and their combinations, warming played the predominant role. In addition, comparison with the previous literature revealed that soil bacteria and fungi had considerably higher overall temporal scaling rates (w = 0.39-0.64) than those of plants and animals (w = 0.21-0.38). Our results on warming-enhanced temporal scaling of microbial biodiversity suggest that the strategies of soil biodiversity preservation and ecosystem management may need to be adjusted in a warmer world.

Association between urinary parabens and gestational diabetes mellitus across prepregnancy body mass index categories

Increasing evidence suggests a potential role of endocrine disrupting chemicals (EDCs) in inducing gestational diabetes mellitus (GDM). However, as far as we know, no study has examined the associations between GDM and exposure to parabens, a kind of EDCs. In this study, we explored the association between urinary parabens of pregnant women and GDM and studied the modification effect of prepregnancy body mass index (BMI). Urine samples were collected from 696 pregnant women and parabens were measured, including four alkyl side chain substituted para-hydroxybenzoic acid ester, substituents varying from methyl to butyl (abbreviates as MeP, EtP, PrP and BuP), and benzyl substituted para-hydroxybenzoic acid ester (BzP). Logistic regression models adjusting for potential confounders were used to study the association of parabens and GDM in the overall population, and further stratified analysis by prepregnancy BMI categories was also performed. The detection rates for the five parabens in the urine samples were 97.70% (MeP), 71.26% (EtP), 96.55% (PrP), 15.80% (BuP) and 2.73% (BzP). No significant association was found between parabens and GDM among the overall population. However, significant non-linear associations of PrP and the summed estrogenic activity of parabens with GDM were found in the stratified analysis by prepregnancy BMI in the overweight/obese population, with adjusted odds ratios (aORs) of 3.47 (95% CI: 1.28, 9.42) and 2.87 (95% CI: 1.07, 7.73) for GDM in the second tertile of urinary PrP and the summed estrogen activity, respectively, when compared to the first tertile. Although no statistically significant association between parabens and GDM was found in the overall population, we found that among the overweight/obese pregnant women, who represent a subgroup more prone to GDM, moderately higher levels of PrP and summed estrogenic activity of parabens were significantly associated with an increasing GDM prevalence.

Clinical diagnosis and genetic counseling of atypical ataxia‑telangiectasia in a Chinese family

Ataxia-telangiectasia (A-T) is an autosomal recessive chromosome breakage disorder caused by mutations in the ATM serine/threonine kinase (ATM) gene. Typically, it presents in early childhood with progressive cerebellar dysfunction, accompanied by immunodeficiency and oculocutaneous telangiectasia. In the present study, the clinical and genetic findings of a Chinese family affected with A-T in two live siblings, the proband (II-2) and his elder brother (II-1), as well as a fetus (II-3) were reported. General health, clinical neurological, electrophysiological (motor and sensory nerve conduction) and magnetic resonance imaging evaluations revealed that patients II-1 and II-2 had similar symptoms of ataxia, dysarthria, conjunctival hyperemia and elevated serum α-fetoprotein, whereas patient II-1 had earlier A-T onset at 2 years old and more serious problems with movement and intelligence. Targeted sequencing followed by Sanger sequencing revealed that these two patients carried the compound heterozygotes of a novel nonsense mutation c.5170G>T (p.Glu1724Ter) and a known nonsense mutation c.748C>T (p.Arg250Ter) in the ATM gene. Each mutation was inherited from an asymptomatic parent, which therefore confirmed the diagnosis of A-T. Given this, proband's mother performed prenatal diagnosis in her third pregnancy. Unfortunately, the fetus had the same causal mutations as its siblings and the pregnancy was terminated. The findings of the present study expanded the mutation spectrum of the ATM gene and may help in understanding the genetic basis of A-T, in order to guide genetic counseling and prenatal diagnosis.

Abstract P3-09-01: MYC dysregulates mitotic spindle function in triple-negative breast cancer creating a dependency on TPX2

Tumors that overexpress the MYC oncogene, including most receptor triple-negative breast cancers, frequently demonstrate aneuploidy, numerical chromosome alterations associated with highly aggressive cancers. Aneuploidy is also associated with rapid tumor evolution and poor patient outcome. We identify that MYC overexpression induces reversible defects in microtubule nucleation and mitotic spindle assembly, in TNBCs and other epithelial cells, promoting chromosome segregation defects, micronuclei and chromosomal instability (CIN). High TPX2 expression is permissive for mitotic spindle assembly and chromosome segregation in cells with MYC overexpression; whereas TPX2 depletion blocks mitotic progression, induces cell death and prevents tumor growth. Attenuating MYC expression reverses mitotic defects, even in established breast tumor cell lines, implicating an ongoing role for high MYC in the persistence of CIN in cancers. Our studies implicate the MYC oncogene as a regulator of spindle assembly and identify a new MYC-TPX2 synthetic-lethal interaction in TNBC that could represent a future therapeutic strategy in MYC-overexpressing cancers. Moreover, our studies suggest that blocking MYC activity can attenuate the emergence of CIN and tumor evolution.

Citation Format: Goga A, Rohrberg J, Corella A, Taileb M, Kilinc S, Jokisch M-L, Camarda R, Zhou A, Balakrishnan S, Chang AN, Klein-Connolly H. MYC dysregulates mitotic spindle function in triple-negative breast cancer creating a dependency on TPX2 [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-09-01.

Repeated Measurements of Paraben Exposure during Pregnancy in Relation to Fetal and Early Childhood Growth

Parabens are potential endocrine disruptors with short half-lives in the human body. To date, few epidemiological studies regarding repeated paraben measurements during pregnancy associated with fetal and childhood growth have been conducted. Within a Chinese prenatal cohort, 850 mother-infant pairs from whom a complete set of maternal urine samples were acquired during three trimesters were included, and the levels of five parabens were measured. We assessed the associations of both average and trimester-specific urinary paraben levels with weight and height z-scores at birth, 6 months, 1, and 2 years of age. In all infants, each doubling increase in average ethyl paraben (EtP) was associated with -2.82% (95% CI: -5.11%, -0.53%) decrease in weight z-score at birth, whereas no significant age-specific associations were identified. After stratifying by sex, we further observed age-specific association of average EtP with -3.96% (95% CI: -7.03%, -0.89%) and -3.38% (95% CI: 6.72%, -0.03%) reduction in weight z-scores at 1 and 2 years in males, respectively. Third-trimester EtP was negatively associated with weight z-scores at birth, 1 and 2 years in males. Our results suggested negative associations between prenatal paraben exposure and fetal and childhood growth, and the third trimester may be the window of susceptibility.

Critical Windows for Associations between Manganese Exposure during Pregnancy and Size at Birth: A Longitudinal Cohort Study in Wuhan, China

BACKGROUND

Prenatal overexposure to manganese (Mn), an essential micronutrient, is related to impaired fetal growth and development. Fetuses appear to be highly sensitive to Mn during short periods of gestation. However, little is known about the critical windows of susceptibility to Mn for humans.

OBJECTIVES

Our objective was to estimate trimester-specific associations of exposure to Mn with size at birth.

METHODS

Urine samples of 3,022 women were collected repeatedly in the first, second, and third trimesters in Wuhan, China. Urinary concentrations of Mn and other toxic metals were measured using an inductively coupled plasma mass spectrometry. Trimester-specific associations of specific gravity–adjusted urinary Mn concentrations with birth weight, birth length, and ponderal index were estimated using multivariable linear regressions with generalized estimating equations. Linear mixed models were applied to evaluate the windows of susceptibility to Mn exposure by comparing the pattern of Mn exposure among newborns with restricted size at birth to those without.

RESULTS

When compared with the third quintile of urinary Mn concentrations, both higher and lower quintiles of urinary Mn concentrations in the second and third trimesters were related to reduced birth weight, birth length, and ponderal index. But the observed associations for higher quintiles were stronger and more likely to be statistically significant [e.g., for women who were in the fifth quintile of Mn concentration in the third trimester, the reduction in birth weight was [Formula: see text] (95% CI: [Formula: see text], [Formula: see text]) g and in birth length was [Formula: see text] (95% CI: [Formula: see text], 0.00) cm]. Moreover, newborns with restricted size at birth, compared with those without, had higher levels of Mn exposure in the second and third trimesters.

CONCLUSIONS

This prospective prenatal cohort study revealed an association of exposure to Mn during pregnancy, especially late pregnancy, with restricted size at birth. Replications are needed. https://doi.org/10.1289/EHP3423.

Targeted next-generation sequencing identifies a novel mutation of LAMB3 in a Chinese neonatal patient presented with junctional epidermolysis bullosa

RATIONALE

Epidermolysis bullosa (EB) refers to a group of rare inherited mechanobullous disorders that present with great clinical and genetic heterogeneity. Its severity ranges from mild blistering to life-threatening. However, the clinical symptoms of different types of EB overlap significantly, especially at an early stage. Thus it is important to clarify the diagnosis for prognostic implications, patient management, and genetic counseling.

PATIENT CONCERNS

Here, we report a 10-day-old male neonate from a nonconsanguineous Chinese family. He showed a bulla on the left lower limb lasting for 3 days, erosions around fingertips and toe tips at birth (predominantly on fingers), with the progressive spread of generalized blisters over the body as well as the development of the illness.

DIAGNOSIS

The patient was diagnosed with suspected epidermolysis bullosa according to the blisters and erosions of the body as well as the pyogenic fingernails and toenails.

INTERVENTIONS

The patient was performed targeted next-generation sequencing (NGS) with 9 candidate known genes, subsequently, his parents were screened for the mutations identified in the patient by Sanger sequencing. Then, prenatal diagnosis with amniotic fluid was performed in the subsequent pregnancy by Sanger sequencing.

OUTCOMES

Targeted NGS revealed a previously unreported splice site variant c.822+1G>A (IVS 8) and a known recurrent nonsense variant c.124C>T (p.Arg42Ter, exon 3) in LAMB3 gene. The patient's father possessed a heterozygous c.822+1G>A mutation, his mother possessed a heterozygous c.124C>T mutation. For the subsequent pregnancy, the analyses of amniotic fluid sample indicated that the fetus carried neither of the mutations.

LESSONS

Our finding will further enlarge LAMB3 genotype-phenotype correlations spectrum. Targeted capture sequencing is a valuable method to illustrate precise molecular pathology in patients with EB disorders, especially at an early stage of the clinical evaluation of complex disorders to avoid unnecessary and economically wasteful tests.

The association of repeated measurements of prenatal exposure to triclosan with fetal and early-childhood growth

BACKGROUND

Triclosan (TCS) is known to possess endocrine disrupting properties and metabolize rapidly in the human body. Human data concerning repeated measurements of TCS throughout pregnancy in relation to fetal and childhood growth are sparse.

OBJECTIVES

We investigated the associations between multiple measurements of maternal urinary concentrations of TCS during pregnancy and fetal and early-childhood growth.

METHODS

The study population included 850 mother-infant pairs who participated in a prenatal cohort established between 2014 and 2015 in Wuhan. Prenatal TCS exposure was measured in a complete series of urine samples collected at the first, second and third trimesters. General linear models and generalized estimating equation models were applied to evaluate the associations of the averaged maternal urinary concentrations of TCS over trimesters and trimester-specific urinary TCS with the z-scores of estimated fetal weight, head circumference, abdominal circumference, and femur length at 16, 24, and 31 gestational weeks, weight and length at birth, and weight and height at 0.5, 1, and 2 years of age.

RESULTS

In overall infants, we did not observe any significant association of the averaged maternal urinary concentrations of TCS over trimesters with ultrasound parameters and size at birth. However, a positive association of borderline statistical significance was found between averaged prenatal TCS exposure and the third-trimester estimated fetal weight z-score in girls in sex-stratified analyses (β = 0.054, 95% CI: -0.005, 0.113, p = 0.07). Moreover, averaged prenatal TCS exposure was positively associated with 2 year-old weight z-score among total infants (β = 0.046, 95% CI: 0.005, 0.087). After stratifying by sex, the same association was observed in girls with more prominent estimation (β = 0.062, 95% CI: 0.000, 0.124), whereas the association weakened and became not significant in boys (β = 0.033, 95% CI: -0.024, 0.089). TCS exposure at 1st and 2nd-trimester were positively associated with weight z-score at 2 years, in both overall and female infants.

CONCLUSIONS

Prenatal exposure to triclosan was associated with elevated third-trimester estimated fetal weight and 2 year-old weight z-score in girls, and the early and middle stage of pregnancy may be the windows of vulnerability. Apart from these findings, we did not find strong evidence for prenatal triclosan exposure in relation to fetal and early-childhood growth.

Urinary concentrations of phthalate metabolites associated with changes in clinical hemostatic and hematologic parameters in pregnant women

BACKGROUND

Exposure to phthalates, one kind of widely used plasticizers, has been demonstrated to be associated with some clinical hematological changes in circulatory system from animal studies and in vitro experiments, but their relations to hemostatic and hematologic changes in human are unknown.

OBJECTIVES

We explored the relationships of urinary phthalate metabolites with clinical hemostatic and hematologic parameter changes in pregnant women.

METHODS

The present study population included 1482 pregnant women drawn from an ongoing prospective birth cohort study in Wuhan, China. Eight urinary phthalate metabolites and eight blood clinical parameters, including activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fg), total white blood cell counts (WBC), red blood cell counts (RBC), hemoglobin (Hb), and platelet counts (PLT) were measured in the late third trimester. The associations between phthalate metabolites and blood parameters were analyzed using general linear model. The odds ratios (ORs) for anemia during pregnancy associated with phthalates were also explored by using logistic regression models.

RESULTS

After adjustment for false discovery rate, a significantly negative association between ln-transformed urinary mono-ethyl phthalate (MEP) concentration and blood Fg, and a positive association between urinary mono-butyl phthalate (MBP) and APTT were found in this study. Higher concentrations of mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) and mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP) were associated with lower Hb concentrations. In addition, higher levels of MEHP, MEOHP and MECPP were also associated with increased likelihood of anemia. No significant associations were found between phthalates and other hematologic parameters.

CONCLUSIONS

Higher urinary phthalate metabolites in late third trimester were associated with prolonged blood clotting time, decreased Hb concentrations, and increased likelihood of anemia in pregnant women. Further research is needed to replicate the observed findings and clarify the potential biological mechanism.

Urinary vanadium concentration in relation to premature rupture of membranes: A birth cohort study

Heavy metal exposure has been indicated to be linked with reproductive and developmental toxicity. However, human studies on the association between heavy metal exposure and premature rupture of membranes (PROM) are limited. Thus, we aimed to evaluate the associations between urinary metal concentrations in pregnant women and the risk of PROM. The study was conducted among 7290 pregnant women from an ongoing cohort study in China. Levels of urinary metals were determined using an inductively coupled plasma-mass spectrometry and adjusted by creatinine concentration (μg/g creatinine). Adjusted odds ratios (OR) and 95% confidence intervals (CI) for PROM and preterm PROM were estimated using logistic regression models. Among 12 urinary metals detected, vanadium (V) have shown stable positive associations with PROM and preterm PROM. With one unit increase in natural logarithmically transformed urinary V concentration, adjusted OR of 1.57 (95% CI: 1.47, 1.66) for PROM was observed. Compared with the lowest tertile of urinary V, we also observed positive associations between V levels and PROM (for the medium tertile, adjusted OR = 1.66, 95% CI: 1.34, 2.05; for the highest tertile, adjusted OR = 3.75, 95% CI: 3.09, 4.54). In addition, higher adjusted ORs for preterm PROM were observed (for the highest tertile, adjusted OR = 8.14, 95% CI: 4.55, 14.55). Further stratified analysis suggested the associations were more pronounced among women delivering male infants than those with female infants. Our present epidemiological study indicated that pregnant women exposure to higher level of V might lead to an increased risk of PROM.

Effects of trimester-specific exposure to vanadium on ultrasound measures of fetal growth and birth size: a longitudinal prospective prenatal cohort study

BACKGROUND

Identification of windows of heightened vulnerability to environmental factors has substantial public health implications. Prenatal exposure to vanadium has been linked to adverse birth outcomes; however, critical windows for such exposure during fetal growth remain unknown. We aimed to assess trimester-specific associations of vanadium exposure with ultrasound measures of fetal growth and birth size in a Chinese longitudinal cohort.

METHODS

The present study was embedded in our ongoing prospective prenatal cohort study at the Wuhan Women and Children Medical Care Center (Wuhan, Hubei, China). Pregnant women were eligible for inclusion if they provided signed informed consent and were less than 16 weeks pregnant with a single gestation, and agreed to take in-person interviews, undergo ultrasound examinations, and provide blood and urine samples. We collected urine samples and measured urinary vanadium concentrations using inductively coupled plasma mass spectrometry. We calculated SD scores for ultrasound-measured biparietal diameter, head circumference, occipitofrontal diameter, abdominal circumference, femur length, and estimated fetal weight at 16, 24, and 31 weeks of gestation. We applied linear regressions with generalised estimating equations to estimate associations of urinary vanadium concentrations in each trimester with ultrasound-measured fetal growth parameters or neonatal size at birth.

FINDINGS

As of Oct 12, 2016, we recruited 3075 women who were non-smokers and non-drinkers during pregnancy, provided up to three urine samples during the first, second, and third trimesters, and gave birth to live singletons without birth defects. We excluded women who did not provide information on ultrasound measurements (n=20) or who only had one ultrasound measurement of fetal crown-rump length at the first trimester (n=14). We excluded another 16 women because they had missing values for confounding variables, leaving 3025 women retained in the study. Every doubling of urinary vanadium concentration in the first trimester was associated with a significant increase in femur length (adjusted percentage change 6·4%, 95% CI 0·7 to 12·1) at 16 weeks of gestation and reductions in biparietal diameter (-4·2%, -8·2 to -0·1), head circumference (-6·0%, -10·1 to -1·9), occipitofrontal diameter (-5·7%, -9·9 to -1·5), and abdominal circumference (-5·3%, -9·4 to -1·2) at 31 weeks of gestation. Every doubling of urinary vanadium concentration in the second trimester was significantly associated with reductions in SD scores for head circumference (-7·2%, -14·1 to -0·3) and abdominal circumference (-6·9%, -13·8 to -0·1) at 31 weeks of gestation. The highest quartile of urinary vanadium concentration (>1·18 μg/L) in the first trimester, when compared with the lowest quartile (≤0·60 μg/L), was associated with a mean decrease in birthweight of 12·6 g (95% CI 2·5-22·8; p_trend=0·0055) and a mean decrease in ponderal index of 0·07 kg/m³ (0·01-0·12; p_trend=0·0053). Moreover, newborns with restricted birth size had higher vanadium exposure in the first and third trimesters.

INTERPRETATION

Vanadium might be toxic to humans and impair fetal growth. The first, early second, and late third trimesters could be critical windows for heightened vulnerability to vanadium for fetal growth. Our findings require further investigation in other populations.

FUNDING

National Key R&D Plan of China, National Natural Science Foundation of China, and Fundamental Research Funds for the Central Universities, Huazhong University of Science and Technology.