1
|
Islam MZ, Chowdhury MRK, Billah B, Rashid M, Kabir R, Hasan M, Kader M. Prevalence and determinants of fetal macrosomia in Bangladesh. Front Pediatr 2024; 12:1405442. [PMID: 39156021 PMCID: PMC11327860 DOI: 10.3389/fped.2024.1405442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 07/11/2024] [Indexed: 08/20/2024] Open
Abstract
Background Fetal macrosomia, marked by excessive birth weight, is a significant public health issue in developing countries, yet it has received less attention compared to low birth weight. This study aims to determine the prevalence of fetal macrosomia in Bangladesh and its associated factors. Methods The study utilized data from 4,754 women with complete birth weight information of their children from the Bangladesh Multiple Indicator Cluster Survey (MICS) -2019, defining fetal macrosomia as newborns with a birth weight ≥4,000 g regardless of gestational age. Bivariate logistic regression assessed associations between independent variables and fetal macrosomia, presenting adjusted odds ratios (AOR) and a 95% confidence interval (CI), while controlling for potential confounders such as women's age, wealth index, education, healthcare utilization, comorbidities, newborn sex, and place of residence. Results The prevalence of fetal macrosomia was 11.6%. Significant associations with fetal macrosomia included higher maternal age group (30-34 years) (AOR = 1.36, 95% CI = 1.07-1.74), secondary level of mother's education (AOR = 1.95, 95% CI = 1.43-2.66), experienced physical attacks (AOR = 1.41, 95% CI = 1.06-1.88), hypertension during pregnancy (AOR = 1.54, 95% CI = 1.15-2.07), and rural residence (AOR = 1.25, 95% CI = 1.15-1.49). Female infants had 18% lower odds of being macrosomic compared to male infants (AOR = 0.82, 95% CI = 0.72-0.93). Conclusion One in ten infants in Bangladesh are born with macrosomia, necessitating a multi-faceted approach involving improving maternal nutrition, promoting healthy lifestyles, enhancing access to quality prenatal care, and addressing socioeconomic, residential, and healthcare system challenges, underlining the importance of further community-based research to expand the study's scope.
Collapse
Affiliation(s)
- Md. Zahidul Islam
- Department of Public Health, First Capital University of Bangladesh, Chuadanga, Bangladesh
- Faculty of Biological Sciences, University of Rajshahi, Rajshahi, Bangladesh
| | - Mohammad Rocky Khan Chowdhury
- Department of Public Health, First Capital University of Bangladesh, Chuadanga, Bangladesh
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Baki Billah
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Mamunur Rashid
- Department of Public Health and Sports Science, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Russell Kabir
- School of Allied Health, Faculty of Health, Medicine and Social Care, Anglia Ruskin University, Chelmsford, Essex, United Kingdom
| | - Mehedi Hasan
- School of Science and Technology (SST), Bangladesh Open University (BOU), Dhaka, Bangladesh
| | - Manzur Kader
- Department of Medical Science, School of Health and Welfare, Dalarna University, Falun, Sweden
| |
Collapse
|
2
|
Lin L, Lin J. Interactive effects and relative contribution of prepregnancy overweight and obesity, excessive gestational weight gain and gestational diabetes mellitus to macrosomia: A retrospective cohort in Fujian, China. Eur J Obstet Gynecol Reprod Biol 2024; 296:354-359. [PMID: 38547611 DOI: 10.1016/j.ejogrb.2024.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 01/27/2024] [Accepted: 03/21/2024] [Indexed: 04/19/2024]
Abstract
AIM To conduct a retrospective cohort study to investigate the association between prepregnancy overweight and obesity, excessive gestational weight gain (GWG), gestational diabetes mellitus (GDM) and macrosomia, both individually and in combination. METHODS Binary logistic regression was used to analyse the effects of overweight and obesity, excessive GWG and GDM on macrosomia, both separately and in combination. The interaction effects between prepregnancy overweight and obesity, excessive GWG and GDM were tested. The population attributable fraction (PAF) was calculated separately when interaction terms were significant. RESULTS When analysed separately, prepregnancy overweight and obesity, excessive GWG and GDM increased the risk of macrosomia significantly. The pairwise interactions of each pair of risk factors or all three risk factors on macrosomia appear to be greater than any of them individually. Prepregnancy overweight and obesity contributed the least (5.69%) to macrosomia, while GDM contributed the most (8.5%). The PAF values for prepregnancy overweight and obesity/GDM, excessive GWG/GDM, and prepregnancy overweight and obesity/excessive GWG were 13.6%, 16.25% and 14.45%, respectively, and the total PAF for all three risk factors was 22.63%. CONCLUSIONS Prepregnancy overweight and obesity, excessive GWG and GDM were associated with newborn macrosomia.
Collapse
Affiliation(s)
- Lihua Lin
- Department of Healthcare, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynaecology and Paediatrics, Fujian Medical University, Fuzhou, Fujian Province, PR China
| | - Juan Lin
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynaecology and Paediatrics, Fujian Medical University, Fuzhou, Fujian Province, PR China.
| |
Collapse
|
3
|
Zheng S, Cao Y, Strasser S, Wei H. Prevalence and risk factors of low birth weight in the United States: An analysis of 2016-2021 data. Am J Hum Biol 2024; 36:e24016. [PMID: 37974547 DOI: 10.1002/ajhb.24016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/24/2023] [Accepted: 11/04/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Low birthweight (LBW), infants weighing less than 2,500 g, is a global health concern associated with high infant morbidity and mortality rates. This study investigates LBW prevalence and its relation to maternal sociodemographic characteristics and lifestyle behaviors factors in the United States (US). METHODS This analysis used the National Survey of Children's Health (NSCH) data from 2016 to 2021, including n = 225,443 children aged 0-17 years. 18,131 had LBW (<2,500 g), and 2810 had very LBW (VLBW) (<1,500 g). Logistic regression calculated odds ratios (OR) using LBW as the dependent variable, adjusting for various factors. RESULTS Between 2016 and 2021 in the United States, LBW prevalence averaged 9.31%, with VLBW at 1.50%. Mothers aged 18-35, White, had the lowest LBW (7.63%) and VLBW (1.17%) rates. Mothers aged ≤18 years, black, had the highest LBW (15.45%) and VLBW infants (4.70%). Maternal age emerged as a significant LBW factor, with an OR of 1.27 for ≤18 and 1.19 for >35. Children in poor health had the highest OR (2.87). Race/ethnicity and other disparities were observed. CONCLUSION Our study highlights LBW risk among non-White mothers with specific criteria, emphasizing the need for continued exploration of intersectional targets for change that are exacerbating LBW disparities among marginalized populations which may be artificially attributed to biologic determinants and individual-level risk factors. In-depth analysis of repressive structures at the root of inequalities demand continued research on macro levels of influence. Customized healthcare reform holds the greatest potential to disrupt the patterns contributing to poor health outcomes among LBW children, and will ultimately maximize the reach and effectiveness of health promotion strategies and clinical practices aimed to improve universal maternal and infant health.
Collapse
Affiliation(s)
- Shimin Zheng
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
| | - Yan Cao
- Center for Nursing Research, College of Nursing, East Tennessee State University, Johnson City, Tennessee, USA
| | - Sheryl Strasser
- Department of Health Promotion & Behavior, Georgia State University School of Public Health, Atlanta, Georgia, USA
| | - Holly Wei
- Center for Nursing Research, College of Nursing, East Tennessee State University, Johnson City, Tennessee, USA
| |
Collapse
|
4
|
Geng S, Wang J, Geng Z, Wen J. Association of Parity with the Risks of Gestational Diabetes and Macrosomia: A Retrospective Cohort Study in Nanjing, China. Curr Pharm Des 2024; 30:1194-1199. [PMID: 38584550 DOI: 10.2174/0113816128294311240322041144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/06/2024] [Accepted: 03/11/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND After implementing the two-child policy, more Chinese women who had a previous delivery had their second child. Nevertheless, the impacts of parity on Gestational Diabetes (GDM) and macrosomia have not been fully confirmed. Therefore, we aimed to analyse the characteristics of pregnancy by parity and evaluate the association of parity with risks of GDM/macrosomia in a Chinese population. METHODS A total of 193,410 pregnant women (including 148,293 primiparae and 45,117 multiparae) with complete information were included. Univariate and multivariate logistic regression analyses were used to examine the association between parity and risks of GDM/macrosomia. RESULTS With the gradual implementation of the two-child policy, the proportion of multiparae increased rapidly and then decreased slightly. Multiparae were more likely to be older and have higher intrapartum BMI, as compared to primiparae (P < 0.001). Univariate regression analyses suggested that parity could increase the risks of GDM and macrosomia; while after adjustment, the association between parity and GDM risk disappeared, and the effects of parity on macrosomia risk and birth weight of babies were also weakened. Further, stratified analysis showed that parity only increased the risk of GDM in women over 30 years, and the effects of parity on macrosomia risk and birth weight were more pronounced among women over 30 years compared to women under 30 years. CONCLUSION Parity was not associated with GDM risk, but mildly associated with macrosomia risk. Particular attention should be paid to multiparae with advanced age to reduce the risks of GDM and macrosomia.
Collapse
Affiliation(s)
- Shijie Geng
- Nanjing Maternity and Child Health Care Institute, Nanjing Women and Children's Healthcare Hospital, Women's Hospital of Nanjing Medical University, Nanjing, China
| | - Junya Wang
- Nanjing Maternity and Child Health Care Institute, Nanjing Women and Children's Healthcare Hospital, Women's Hospital of Nanjing Medical University, Nanjing, China
| | - Zhi Geng
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Juan Wen
- Nanjing Maternity and Child Health Care Institute, Nanjing Women and Children's Healthcare Hospital, Women's Hospital of Nanjing Medical University, Nanjing, China
| |
Collapse
|
5
|
Zhong G, Zhuang C, Hu X, Chen Q, Bi Z, Jia X, Peng S, Li Y, Huang Y, Zhang Q, Hong Y, Qiao Y, Su Y, Pan H, Wu T, Wei L, Huang S, Zhang J, Xia N. Safety of hepatitis E vaccination for pregnancy: a post-hoc analysis of a randomized, double-blind, controlled phase 3 clinical trial. Emerg Microbes Infect 2023; 12:2185456. [PMID: 36877135 PMCID: PMC10026809 DOI: 10.1080/22221751.2023.2185456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Special attention has been paid to Hepatitis E (HE) prophylaxis for pregnant women due to poor prognosis of HE in this population. We conducted a post-hoc analysis based on the randomized, double-blind, HE vaccine (Hecolin)-controlled phase 3 clinical trial of human papillomavirus (HPV) vaccine (Cecolin) conducted in China. Eligible healthy women aged 18-45 years were randomly assigned to receive three doses of Cecolin or Hecolin and were followed up for 66 months. All the pregnancy-related events throughout the study period were closely followed up. The incidences of adverse events, pregnancy complications, and adverse pregnancy outcomes were analysed based on the vaccine group, maternal age, and interval between vaccination and pregnancy onset. During the study period, 1263 Hecolin receivers and 1260 Cecolin receivers reported 1684 and 1660 pregnancies, respectively. The participants in the two vaccine groups showed similar maternal and neonatal safety profiles, regardless of maternal age. Among the 140 women who were inadvertently vaccinated during pregnancy, the incidences of adverse reactions had no statistical difference between the two groups (31.8% vs 35.1%, p = 0.6782). The proximal exposure to HE vaccination was not associated with a significantly higher risk of abnormal foetal loss (OR 0.80, 95% CI 0.38-1.70) or neonatal abnormality (OR 2.46, 95% CI 0.74-8.18) than that to HPV vaccination, as did distal exposure. Significant difference was not noted between pregnancies with proximal and distal exposure to HE vaccination. Conclusively, HE vaccination during or shortly before pregnancy is not associated with increased risks for both the pregnant women and pregnancy outcomes.
Collapse
Affiliation(s)
- Guohua Zhong
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, People's Republic of China
| | - Chunlan Zhuang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, People's Republic of China
| | - Xiaowen Hu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, People's Republic of China
| | - Qi Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, People's Republic of China
| | - Zhaofeng Bi
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, People's Republic of China
| | - Xinhua Jia
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, People's Republic of China
| | - Siying Peng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, People's Republic of China
| | - Yufei Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, People's Republic of China
| | - Yue Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, People's Republic of China
- Xiang'an Biomedicine Laboratory, Xiamen, People's Republic of China
| | - Qiufen Zhang
- Xiamen Innovax Biotech Company, Xiamen, People's Republic of China
| | - Ying Hong
- The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, People's Republic of China
| | - Youlin Qiao
- National Cancer Center, National Center for Cancer Clinical Research, the Cancer Institute, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, People's Republic of China
| | - Yingying Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, People's Republic of China
- Xiang'an Biomedicine Laboratory, Xiamen, People's Republic of China
| | - Huirong Pan
- Xiamen Innovax Biotech Company, Xiamen, People's Republic of China
| | - Ting Wu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, People's Republic of China
- Xiang'an Biomedicine Laboratory, Xiamen, People's Republic of China
| | - Lihui Wei
- Peking University People's Hospital, Beijing, People's Republic of China
| | - Shoujie Huang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, People's Republic of China
- Xiang'an Biomedicine Laboratory, Xiamen, People's Republic of China
| | - Jun Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, People's Republic of China
- Xiang'an Biomedicine Laboratory, Xiamen, People's Republic of China
| | - Ningshao Xia
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, People's Republic of China
- Xiang'an Biomedicine Laboratory, Xiamen, People's Republic of China
- The Research Unit of Frontier Technology of Structural Vaccinology of Chinese Academy of Medical Sciences, Xiamen University, Xiamen, People's Republic of China
| |
Collapse
|
6
|
He Y, Huang C, Luo B, Liao S. Association between Maternal Body Composition in Second Trimester and Risk of Fetal Macrosomia: A Population-Based Retrospective Study in China. Nutrients 2023; 15:3879. [PMID: 37764664 PMCID: PMC10536007 DOI: 10.3390/nu15183879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: Female body composition undergoes significant changes to support fetal growth and development during pregnancy. This study investigated the association of maternal body composition in the second trimester and macrosomia and explored whether body-composition-related indicators could be used to predict macrosomia. (2) Methods: This study was conducted in China from December 2016 to December 2021. Women with singleton pregnancies, gestational ages between 37 and 42 weeks, and an absence of pregnancy complications were included. In the second trimester, bioelectric impedance analysis (BIA) was used to measure body-composition-related indicators. Logistic regression analysis was performed to explore the risk factors for macrosomia. The predictive performance of maternal body composition and clinical indicators for macrosomia were assessed using the area under the receiver-operating-characteristics curve (AUC). (3) Results: This retrospective study involved 43,020 pregnant women; we collected 2008 cases of macrosomia. Gravidity, gestational age, body mass index (BMI), gestational weight gain (GWG), total body water, fat mass, fat-free mass (FFM), skeletal muscle mass, and visceral fat level were risk factors for macrosomia (p < 0.05 for all). In the prediction model, the AUC of FFM for predicting macrosomia was the largest (0.742). (4) Conclusions: Body-composition-related indicators associated with macrosomia and body composition measurements in the second trimester can predict the risk of macrosomia, enabling clinicians to implement interventions earlier to reduce adverse perinatal outcomes.
Collapse
Affiliation(s)
- Yirong He
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu 610041, China; (Y.H.); (C.H.)
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, China
| | - Chuanya Huang
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu 610041, China; (Y.H.); (C.H.)
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, China
| | - Biru Luo
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu 610041, China; (Y.H.); (C.H.)
| | - Shujuan Liao
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, China
| |
Collapse
|
7
|
Adjei-Gyamfi S, Musah B, Asirifi A, Hammond J, Aryee PA, Miho S, Aiga H. Maternal risk factors for low birthweight and macrosomia: a cross-sectional study in Northern Region, Ghana. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:87. [PMID: 37644518 PMCID: PMC10464333 DOI: 10.1186/s41043-023-00431-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Abnormal birthweights are critical public health challenges accountable for most non-communicable diseases and perinatal mortalities. Regardless of the myriad of mixed evidence on maternal factors responsible for abnormal birthweight globally, most of these findings are attained from urban and rural settings. This study serves as one of the key pieces of evidence in view of the increasing prevalence of abnormal birthweight particularly in some parts of semi-rural Ghana. The study, therefore, aims to estimate the prevalence of abnormal birthweight and identify some possible maternal risk factors for abnormal birthweight in Northern Ghana. METHODS A retrospective cross-sectional study was conducted in Savelugu municipality from February-March 2022. A total of 356 mothers aged 16-46 years, having a neonate and attending postnatal care service, were recruited as study participants. Data were collected from maternal and child health record books and through structured interviews. To identify the maternal risk factors for abnormal birthweight, chi-square/Fischer's exact test and multinomial logistic regression were employed as bivariate and multivariate analyses, respectively, at 95% confidence level. RESULTS Prevalence rates of low birthweight and macrosomia were 22.2% and 8.7%, respectively. Maternal anaemia in first trimester (AOR 3.226; 95% CI 1.372-7.784) and third trimester (AOR 23.94; 95% CI 7.442-70.01) of gestation was strong predictors for low birthweight. Mothers belonging to minority ethnic groups (AOR 0.104; 95% CI 0.011-0.995); mothers who had ≥ 8 antenatal care visits (AOR 0.249; 95% CI 0.103-0.602); and mothers having neonates whose birth length > 47.5 cm (AOR 0.271; 95% CI 0.113-0.651) had reduced odds for low birthweight. Alternatively, mothers with gestational weeks ≥ 42 (AOR 23.21; 95% CI 4.603-56.19) and mothers from the richest households (highest socioeconomic homes) (AOR 14.25; 95% CI 1.638-23.91) were more likely to birth to macrosomic infants. CONCLUSION The prevalence rates of low birthweight and macrosomia were relatively high. Anaemia in the first and third trimesters was strong determinants of low birthweight. Being minority ethnic group, frequency of antenatal visits, and childbirth length reduced the risk of low-weight births. Advanced gestational age and socioeconomic status of mothers were also predictors of macrosomia. Hence, nutrition counselling, community health education, and promotion of lifestyle improvement coupled with strengthening of health service delivery are recommended interventions.
Collapse
Affiliation(s)
- Silas Adjei-Gyamfi
- School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4, Sakamoto, Nagasaki City, 852-8523, Japan.
- Savelugu Municipal Hospital, Ghana Health Service, P.O. Box 45, Savelugu, Northern Region, Ghana.
| | - Bashiru Musah
- Savelugu Municipal Hospital, Ghana Health Service, P.O. Box 45, Savelugu, Northern Region, Ghana
| | - Abigail Asirifi
- Seventh Day Adventist Hospital, Christian Health Association of Ghana, P.O. Box 24, Wiamoase, Ashanti Region, Ghana
| | - John Hammond
- Central Regional Health Directorate, Ghana Health Service, P.O. Box 63, Cape Coast, Central Region, Ghana
| | - Paul Armah Aryee
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P.O. Box TL 1883, Tamale, Northern Region, Ghana
| | - Sato Miho
- School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4, Sakamoto, Nagasaki City, 852-8523, Japan
| | - Hirotsugu Aiga
- School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4, Sakamoto, Nagasaki City, 852-8523, Japan
| |
Collapse
|
8
|
Okui T. Analysis of the Incidence of Macrosomia in Japan by Parental Nationalities at 5-year Intervals From 1995 to 2020. J Prev Med Public Health 2023; 56:348-356. [PMID: 37551073 PMCID: PMC10415649 DOI: 10.3961/jpmph.23.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/26/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVES We investigated trends in the incidence rate of macrosomia and its association with parental nationalities using Vital Statistics data in Japan. METHODS We used singleton birth data every 5 years from 1995 to 2020. The incidence rate of macrosomia was calculated according to specific attributes (maternal age, infant's sex, parental nationalities, parity, and household occupation) over time (years). In addition, a log-binomial model was used to investigate the relationship between the incidence of macrosomia and the attributes. This study compared Korea, China, the Philippines, Brazil, and other countries with Japan in terms of parental nationalities. "Other countries" indicates countries except for Japan, Korea, China, the Philippines, and Brazil. RESULTS The study included 6 180 787 births. The rate of macrosomia in Japan decreased from 1.43% in 1995 to 0.88% in 2020, and the decrease was observed across all parental nationalities. The rates for Japanese parents were the lowest values among parental nationalities during the timespan investigated. Multivariate regression analysis showed that mothers from Korea, China, the Philippines, Brazil, and other countries had a significantly higher risk of macrosomia than those from Japan (risk ratio, 1.91, 2.82, 1.59, 1.74, and 1.64, respectively). Furthermore, fathers from China, the Philippines, Brazil, and other countries had a significantly higher risk of macrosomia than those from Japan (risk ratio, 1.66, 1.38, 1.88, and 3.02, respectively). CONCLUSIONS The rate of macrosomia decreased from 1995 to 2020 in Japan for parents of all nationalities, and the risk of macrosomia incidence was associated with parental nationality.
Collapse
Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| |
Collapse
|
9
|
Xu HB, Li MH, Tang XF, Lu J. The relationship between poor glycaemic control at different time points of gestational diabetes mellitus and pregnancy outcomes. J OBSTET GYNAECOL 2022; 42:2979-2986. [PMID: 36149633 DOI: 10.1080/01443615.2022.2124852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We aimed to identify the complications of gestational diabetes mellitus (GDM) associated with poor control of fasting plasma glucose (FPG) and postload plasma glucose (PPG) on the 75-g oral glucose tolerance test (OGTT). This retrospective study included 997 singleton pregnancy GDM patients who were assigned to poor or good glycaemic control groups. Multivariate analysis indicated that poor FPG control and poor PPG control were both independent predictors of hypertensive disorder complicating pregnancy (HDCP) (odd ratio (OR) of 2.551 (95% CI [1.146-5.682], p = .022) and OR of 2.084 (95% [1.115-3.894], p = .021) compared with good glycaemic control groups, respectively). Poor PPG control promoted the rate of caesarean delivery (1.534 (95% CI [1.063-2.214]), p = .022), whereas good PPG control increased the risk of premature rupture of membranes (PROM) (0.373 (95% CI [0.228-0.611]), p < .001). Conclusively, poor control FPG and PPG dissimilarly affect pregnancy complications in GDM; these findings may help clinicians in the effective implementation of measures to prevent pregnancy complications in GDM.IMPACT STATEMENTWhat is already known on this subject? Previous studies displayed that GDM patients with 2-h PPG elevated at 24-28 week of gestation had a 2.254-fold increased risk of postpartum dysglycaemia. Abnormal plasma glucose in GDM mother increased the probability of childhood obesity in the offspring. With the implementation of China's second-child policy, the incidence of GDM is rising.What do the results of this study add? Our results indicated that the older patients with GDM, the greater the risk of abnormal plasma glucose control. In addition, maternal age and prenatal BMI were notably correlated with poor plasma glucose control of FPG and PPG, respectively. We also found that both poor FPG and PPG control notably increased the incidence of HDCP in pregnant women. The incidence of PROM was higher in the good PPG control group compared with the poor PPG control group.What are the implications of these findings for clinical practice and/or further research? This study displayed that the effects of poor FPG and PPG control on pregnancy complications and newborn outcomes were heterogeneous, which might be related to the specificity of plasma glucose metabolism at different time points. Good glycaemic control, especially PPG control, was of great significance for improving pregnancy complications and perinatal conditions.
Collapse
Affiliation(s)
- Hong-Bin Xu
- Department of Obstetrics and Gynecology, Changzhou Second People's Hospital affiliated to Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Min-Hui Li
- Department of Obstetrics and Gynecology, Changzhou Second People's Hospital affiliated to Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Xiao-Fang Tang
- Department of Obstetrics and Gynecology, Changzhou Second People's Hospital affiliated to Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Jing Lu
- Department of Obstetrics and Gynecology, Changzhou Second People's Hospital affiliated to Nanjing Medical University, Changzhou, Jiangsu Province, China
| |
Collapse
|
10
|
Risk Factors for Macrosomia in Multipara: A Multi-Center Retrospective Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9070935. [PMID: 35883919 PMCID: PMC9323661 DOI: 10.3390/children9070935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/20/2022] [Accepted: 06/14/2022] [Indexed: 12/04/2022]
Abstract
The increased incidence of macrosomia has caused an enormous burden after the transition from the almost 40-year one-child policy to the universal two-child policy in 2015 and further to the three-child policy in 2021 in China. However, studies on risk factors of macrosomia in multipara under the new fertility policy in China are limited. We aim to explore the incidence and risk factors for macrosomia in multipara to provide the scientific basis for preventing macrosomia in multipara. A multi-center retrospective study was conducted among 6200 women who had two consecutive deliveries in the same hospital and their second newborn was delivered from January to October 2018 at one of 18 hospitals in 12 provinces in China. Macrosomia was defined as birth weight ≥ 4000 g. Logistic regression models were performed to analyze risk factors for macrosomia in multipara. The incidence of macrosomia in multipara was 7.6% (470/6200) and the recurrence rate of macrosomia in multipara was 27.2% (121/445). After adjusting for potential confounders, a higher prepregnancy BMI, higher gestational weight gain, history of macrosomia, a longer gestation in the subsequent pregnancy were independent risk factors of macrosomia in multipara (p < 0.05). Healthcare education and preconception consultation should be conducted for multipara patients with a history of macrosomia to promote maintaining optimal prepregnancy BMI and avoid excessive gestational weight gain to prevent macrosomia.
Collapse
|
11
|
Shen Y, Wang C, Yu G, Meng X, Wang W, Kan H, Zhang J, Cai J. Associations of Ambient Fine Particulate Matter and Its Chemical Constituents with Birth Weight for Gestational Age in China: A Nationwide Survey. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:8406-8415. [PMID: 35609000 DOI: 10.1021/acs.est.1c08393] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study examined the associations of fine particulate matter (PM2.5) and its chemical constituents with risks of small for gestational age (SGA) and large for gestational age (LGA). Based on the China Labor and Delivery Survey, we included 70,206 birth records from 24 provinces in China. Concentrations of PM2.5 mass and six main constituents were estimated using satellite-based models. Logistic regression analysis was used to examine the associations, adjusted for sociodemographic characteristics and time trends. We found that an interquartile range increase in PM2.5 exposure during pregnancy was associated with 16% (95% confidence interval [CI]: 3-30%) and 11% (95% CI: 1-22%) higher risk of SGA and LGA, respectively. Elevated risk of SGA was associated with exposure to black carbon [odds ratio (OR) = 1.15, 95% CI: 1.00-1.32], ammonium (OR = 1.12, 95% CI: 1.01-1.25), and sulfate (OR = 1.12, 95% CI: 1.04-1.21); while increased risk of LGA was associated with exposure to black carbon (OR = 1.13, 95% CI: 1.02-1.26), ammonium (OR = 1.13, 95% CI: 1.03-1.24), sulfate (OR = 1.08, 95% CI: 1.01-1.15), and nitrate (OR = 1.14, 95% CI: 1.03-1.27). Our findings provide evidence that PM2.5 exposure was associated with increased risks of SGA and LGA, and constituents related to emissions from anthropogenic sources may play important roles in these associations.
Collapse
Affiliation(s)
- Yang Shen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Cuiping Wang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200092, China
| | - Guoqi Yu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200092, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Weidong Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200092, China
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
| |
Collapse
|
12
|
Peng Y, Chen Z, Zhu W, Shi F, Wang M, Zhou Y, Xiang D, Chen X, Chen F. Automatic zoning for retinopathy of prematurity with semi-supervised feature calibration adversarial learning. BIOMEDICAL OPTICS EXPRESS 2022; 13:1968-1984. [PMID: 35519283 PMCID: PMC9045915 DOI: 10.1364/boe.447224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/05/2022] [Accepted: 02/09/2022] [Indexed: 06/14/2023]
Abstract
Retinopathy of prematurity (ROP) is an eye disease, which affects prematurely born infants with low birth weight and is one of the main causes of children's blindness globally. In recent years, there are many studies on automatic ROP diagnosis, mainly focusing on ROP screening such as "Yes/No ROP" or "Mild/Severe ROP" and presence/absence detection of "plus disease". Due to the lack of corresponding high-quality annotations, there are few studies on ROP zoning, which is one of the important indicators to evaluate the severity of ROP. Moreover, how to effectively utilize the unlabeled data to train model is also worth studying. Therefore, we propose a novel semi-supervised feature calibration adversarial learning network (SSFC-ALN) for 3-level ROP zoning, which consists of two subnetworks: a generative network and a compound network. The generative network is a U-shape network for producing the reconstructed images and its output is taken as one of the inputs of the compound network. The compound network is obtained by extending a common classification network with a discriminator, introducing adversarial mechanism into the whole training process. Because the definition of ROP tells us where and what to focus on in the fundus images, which is similar to the attention mechanism. Therefore, to further improve classification performance, a new attention mechanism based feature calibration module (FCM) is designed and embedded in the compound network. The proposed method was evaluated on 1013 fundus images of 108 patients with 3-fold cross validation strategy. Compared with other state-of-the-art classification methods, the proposed method achieves high classification performance.
Collapse
Affiliation(s)
- Yuanyuan Peng
- MIPAV Lab, School of Electronics and Information Engineering, Soochow University, Suzhou, Jiangsu 215006, China
| | - Zhongyue Chen
- MIPAV Lab, School of Electronics and Information Engineering, Soochow University, Suzhou, Jiangsu 215006, China
| | - Weifang Zhu
- MIPAV Lab, School of Electronics and Information Engineering, Soochow University, Suzhou, Jiangsu 215006, China
| | - Fei Shi
- MIPAV Lab, School of Electronics and Information Engineering, Soochow University, Suzhou, Jiangsu 215006, China
| | - Meng Wang
- MIPAV Lab, School of Electronics and Information Engineering, Soochow University, Suzhou, Jiangsu 215006, China
| | - Yi Zhou
- MIPAV Lab, School of Electronics and Information Engineering, Soochow University, Suzhou, Jiangsu 215006, China
| | - Daoman Xiang
- Guangzhou Women and Children's Medical Center, Guangzhou 510623, China
| | - Xinjian Chen
- MIPAV Lab, School of Electronics and Information Engineering, Soochow University, Suzhou, Jiangsu 215006, China
- State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, China
| | - Feng Chen
- Guangzhou Women and Children's Medical Center, Guangzhou 510623, China
| |
Collapse
|
13
|
Zhang P, Chen H, Shang J, Ge J, Zhang H, Xu M, Bian C, Zhao Y, Chen M, Hirst JE. Mobile Phone App Use Among Pregnant Women in China and Associations Between App Use and Perinatal Outcomes: Retrospective Study. JMIR Form Res 2022; 6:e29644. [PMID: 35076402 PMCID: PMC8826146 DOI: 10.2196/29644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/26/2021] [Accepted: 11/15/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Maternal and child health (MCH)-related mobile apps are becoming increasingly popular among pregnant women; however, few apps have demonstrated that they lead to improvements in pregnancy outcomes. OBJECTIVE This study aims to investigate the use of MCH apps among pregnant women in China and explore associations with pregnancy outcomes. METHODS A retrospective study was conducted at 6 MCH hospitals in northern China. Women who delivered a singleton baby at >28 weeks' gestation at the study hospitals were sequentially recruited from postnatal wards from October 2017 to January 2018. Information was collected on the women's self-reported MCH app use during their pregnancy, along with clinical outcomes. Women were categorized as nonusers of MCH apps and users (further divided into intermittent users and continuous users). The primary outcome was a composite adverse pregnancy outcome (CAPO) comprising preterm birth, birth weight <2500 g, birth defects, stillbirth, and neonatal asphyxia. The association between app use and CAPO was explored using multivariable logistic analysis. RESULTS The 1850 participants reported using 127 different MCH apps during pregnancy. App use frequency was reported as never, 24.7% (457/1850); intermittent, 47.4% (876/1850); and continuous, 27.9% (517/1850). Among app users, the most common reasons for app use were health education (1393/1393, 100%), self-monitoring (755/1393, 54.2%), and antenatal appointment reminders (602/1393, 43.2%). Nonusers were older, with fewer years of education, lower incomes, and higher parity (P<.01). No association was found between any app use and CAPO (6.8% in nonusers compared with 6.3% in any app users; odds ratio 0.77, 95% CI 0.48-1.25). CONCLUSIONS Women in China access a large number of different MCH apps, with social disparities in access and frequency of use. Any app use was not found to be associated with improved pregnancy outcomes, highlighting the need for rigorous development and testing of apps before recommendation for use in clinical settings.
Collapse
Affiliation(s)
- Puhong Zhang
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
- Faculty of Medicine, University of New South Wale, Sydney, Australia
| | - Huan Chen
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jie Shang
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Jun Ge
- Shijiazhuang Obstetrics and Gynaecology Hospital, Shijiazhuang, China
| | - Huichen Zhang
- Shijiazhuang Luquan People's Hospital, Shijiazhuang, China
| | - Mingjun Xu
- Department of Anesthesiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Cui Bian
- Gaoyang Maternal and Child Health Hospital, Baoding, China
| | - Yang Zhao
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Minyuan Chen
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Jane Elizabeth Hirst
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom
- The George Institute for Global Health, Central Working - Fourth Floor Translation and Innovation Hub Imperial College London, London, United Kingdom
| |
Collapse
|
14
|
Sun Y, Zhang M, Liu R, Wang J, Yang K, Wu Q, Yue W, Yin C. Protective Effect of Maternal First-Trimester Low Body Mass Index Against Macrosomia: A 10-Year Cross-Sectional Study. Front Endocrinol (Lausanne) 2022; 13:805636. [PMID: 35222271 PMCID: PMC8866317 DOI: 10.3389/fendo.2022.805636] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 01/05/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE We aimed to assess whether maternal first-trimester low body mass index (BMI) has a protective effect against macrosomia. METHODS This was a cross-sectional study from January 1, 2011, to June 30, 2021, and 84,900 participants were included. The predictive performance of maternal first-trimester and parental pre-pregnancy BMI for macrosomia was assessed using the area under the receiver-operating characteristics curve (AUC). Multivariate logistic regression analyses were performed to evaluate the independent effect of maternal first-trimester low BMI on macrosomia. Interactions were investigated to evaluate the potential variation of the effect of first-trimester low BMI across different groups. Furthermore, interactions were also examined across groups determined by multiple factors jointly: a) gestational diabetes mellitus (GDM)/GDM history status, parity, and maternal age; and b) GDM/GDM history status, fetal sex, and season of delivery. RESULTS The proportion of macrosomia was 6.14% (5,215 of 84,900). Maternal first-trimester BMI showed the best discrimination of macrosomia (all Delong tests: P < 0.001). The protective effect of maternal first-trimester low BMI against macrosomia remained significant after adjusting for all confounders of this study [adjusted odds ratios (aOR) = 0.37, 95% CI: 0.32-0.43]. Maternal first-trimester low BMI was inversely associated with macrosomia, irrespective of parity, fetal sex, season of delivery, maternal age, and GDM/GDM history status. The protective effect was most pronounced among pregnant women without GDM/GDM history aged 25 to 29 years old, irrespective of parity (multipara: aOR = 0.32, 95% CI: 0.22-0.47; nullipara: aOR = 0.32, 95% CI: 0.24-0.43). In multipara with GDM/GDM history, the protective effect of low BMI was only observed in the 30- to 34-year-old group (aOR = 0.12, 95% CI: 0.02-0.86). For pregnant women without GDM/GDM history, the protective effect of maternal first-trimester low BMI against macrosomia was the weakest in infants born in winter, irrespective of fetal sex (female: aOR = 0.45, 95% CI: 0.29-0.69; male: aOR = 0.39, 95% CI: 0.28-0.55). CONCLUSION Maternal first-trimester low BMI was inversely associated with macrosomia, and the protective effect was most pronounced among 25- to 29-year-old pregnant women without GDM/GDM history and was only found among 30- to 34-year-old multipara with GDM/GDM history. The protective effect of maternal first-trimester low BMI against macrosomia was the weakest in winter among mothers without GDM/GDM history.
Collapse
Affiliation(s)
- Yongqing Sun
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Man Zhang
- Beijing Maternal and Child Health Care Hospital, Beijing, China
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Ruixia Liu
- Beijing Maternal and Child Health Care Hospital, Beijing, China
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Jingjing Wang
- Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Kai Yang
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Qingqing Wu
- Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- *Correspondence: Chenghong Yin, ; Wentao Yue, ; Qingqing Wu,
| | - Wentao Yue
- Beijing Maternal and Child Health Care Hospital, Beijing, China
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- *Correspondence: Chenghong Yin, ; Wentao Yue, ; Qingqing Wu,
| | - Chenghong Yin
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
- *Correspondence: Chenghong Yin, ; Wentao Yue, ; Qingqing Wu,
| |
Collapse
|
15
|
Weng X, Lou Y, Tao R, Li Y, Cao D, Yu M, Ying B, Wang H. The association between low birth weight and dental caries among 11-to-13-year-old school age children in Ningbo, China. BMC Pediatr 2021; 21:491. [PMID: 34736440 PMCID: PMC8567616 DOI: 10.1186/s12887-021-02968-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 10/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background The association between low birth weight (LBW) and dental caries is currently unclear. The aim of this study was to investigate the association of LBW with dental caries in permanent teeth in children of Ningbo city. Methods A total of 1975 children aged 11-to-13 years in Ningbo, China were enrolled in this cross-sectional study. LBW was defined as a birthweight< 2500 g. Ten dentists assessed the status of dental caries in permanent teeth in line with the World Health Organization (WHO) criteria and guidelines. Decayed, missing or filled teeth were considered to have dental caries. Parental questionnaires were used to collect child information. Non-conditional logistic regression analysis was used to estimate odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Results Dental caries in permanent teeth was found in 610 children (30.9%), with a mean DMFS of 2.09 (SD = 1.2). The adjusted ORs for dental caries in permanent teeth was 1.46 (95% CI 1.00, 2.13) for LBW. Conclusions LBW was not associated with dental caries in permanent teeth in the study population.
Collapse
Affiliation(s)
- Xiaoyan Weng
- The Department of Stomatology, The Affiliated Ningbo Hospital of Zhejiang University, Ningbo, 315000, China.,The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, 310006, Hangzhou, China
| | - Yiting Lou
- The Department of Stomatology, The Affiliated Ningbo Hospital of Zhejiang University, Ningbo, 315000, China.,The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, 310006, Hangzhou, China
| | - Ran Tao
- The Department of Human Anatomy, Laboratory of Clinical Applied Anatomy, School of Basic Medical Science, Fujian Medical University, Fuzhou, 350000, China
| | - Yongzheng Li
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, 310006, Hangzhou, China
| | - Danna Cao
- The Department of Stomatology, The Affiliated Ningbo Hospital of Zhejiang University, Ningbo, 315000, China. .,The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, 310006, Hangzhou, China.
| | - Mengfei Yu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, 310006, Hangzhou, China.
| | - Binbin Ying
- The Department of Stomatology, The Affiliated Ningbo Hospital of Zhejiang University, Ningbo, 315000, China. .,The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, 310006, Hangzhou, China.
| | - Huiming Wang
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang, 310006, Hangzhou, China
| |
Collapse
|
16
|
Lin S, Chai J, Li J, Shang X, Pei L, Jiang L, Zhang J, Sun P, Dong W, Wang Y, Zhou D. Incidence of Macrosomia in Rural Areas - Henan Province, China, 2013-2017. China CDC Wkly 2021; 3:788-792. [PMID: 34594991 PMCID: PMC8441182 DOI: 10.46234/ccdcw2021.196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 09/07/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Macrosomia has short-term and long-term adverse health effects and is thus an important public health concern. Recent decades have witnessed increasing incidence of macrosomia in many countries. METHODS The present study used a large population-based birth cohort study to depict incidence of macrosomia among live births in rural areas of Henan Province of China from 2013 to 2017. RESULTS Among the 1,262,916 births, 82,353 were cases of macrosomia. The overall incidence of all types of macrosomia, of macrosomia with birth weight <4,500 g, and of macrosomia with birth weight ≥4,500 g were 6.52%, 5.30%, and 1.22%, respectively. From 2013 to 2017, the incidence of macrosomia decreased by 31.3% from 7.96% in 2013 to 5.47% in 2017 ( [Formula: see text]=946.96, [Formula: see text]<0.001). Male infants and infants ≥42 gestational weeks had significantly higher incidence of macrosomia than that of female infants and infants <42 gestational weeks (P<0.001). CONCLUSION Gestational weight control through nutrition management and physical activities during pregnancy are needed to reduce incidence of macrosomia.
Collapse
Affiliation(s)
- Shiqi Lin
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
| | - Jian Chai
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, Henan, China
| | - Jiajia Li
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
| | - Xuejun Shang
- Department of Andrology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Lijun Pei
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China
| | - Lifang Jiang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, Henan, China
| | - Junxi Zhang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, Henan, China
| | - Panpan Sun
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, Henan, China
| | - Wei Dong
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, Henan, China
| | - Yuhong Wang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, Henan, China
| | - Dezhuan Zhou
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, Henan, China
| |
Collapse
|
17
|
Zhou H, Sun X, Wang Y, Ye Y, Chen H, Chen Q, He G, Wang J, Liu X, Dong M, Chen D, Chen G, Yuan L, Xiao J, Hu J, Zeng W, Rong Z, Zhang Q, Zhou M, Guo L, Lv Y, Fan J, Pu Y, Ma W, Zhang B, Liu T. The Mediating Role of Placental Weight Change in the Association Between Prenatal Exposure to Thallium and Birth Weight: A Prospective Birth Cohort Study. Front Public Health 2021; 9:679406. [PMID: 34277546 PMCID: PMC8283527 DOI: 10.3389/fpubh.2021.679406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/08/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Previous studies have demonstrated the embryotoxicity and fetotoxicity of thallium (Tl). However, the effects of prenatal exposure to Tl on birth weight and placental weight and the mediating role of placental weight in the association of Tl with birth weight remain unclear. Methods: We recruited 2,748 participants from the ongoing Prenatal Environment and Offspring Health Cohort (PEOH Cohort) study, which was initiated in 2016 in Guangzhou, China. The Tl concentrations in maternal urine samples collected during the first and third trimester were determined by inductively coupled plasma mass spectrometry. Birth weight and placental weight were extracted from maternal medical records. Results: Pregnant women exposed to the highest tertile of Tl in the first trimester (β = −42.7 g, 95% CI: −82.3, −3.1 g) and third trimester (β = −50.6 g, 95% CI: −99.0, −2.3 g) had babies with lower birth weights than those exposed to the lowest tertile. We also found significant negative associations of exposure to Tl concentrations in the first and third trimester with placental weight. Mediation analyses showed that 50.3% (95% CI: 15.9, 79.2%) and 33.5% (95% CI: 1.3, 80.3%) of the effects of Tl exposure in the first and third trimester on birth weight were mediated by decreased placental weight. Conclusion: Our results suggest that prenatal exposure to Tl is negatively associated with birth weight and that this association may be mediated by decreased placental weight.
Collapse
Affiliation(s)
- He Zhou
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.,Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xiaoli Sun
- Gynecology Department, Guangdong Women and Children Hospital, Guangzhou, China
| | - Yiding Wang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yufeng Ye
- Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Hanwei Chen
- Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Qingsong Chen
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Guanhao He
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jiaqi Wang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.,Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Xin Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Moran Dong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.,School of Public Health, Southern Medical University, Guangzhou, China
| | - Dengzhou Chen
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.,Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Guimin Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.,School of Public Health, Southern Medical University, Guangzhou, China
| | - Lixia Yuan
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.,School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Zuhua Rong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Qianqian Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China
| | - Mengya Zhou
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China
| | - Lingchuan Guo
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Yanyun Lv
- Affiliated Jiangmen Hospital of Sun Yat-sen University, Jiangmen, China
| | - Jingjie Fan
- Department of Prevention and Health Care, Shenzhen Maternity & Child Health Care Hospital, Southern Medical University, Shenzhen, China
| | - Yudong Pu
- Songshan Lake Central Hospital of Dongguan City, Dongguan, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Bo Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China.,School of Public Health, Southern Medical University, Guangzhou, China
| | - Tao Liu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.,Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.,School of Medicine, Jinan University, Guangzhou, China
| |
Collapse
|
18
|
Peng Y, Zhu W, Chen Z, Wang M, Geng L, Yu K, Zhou Y, Wang T, Xiang D, Chen F, Chen X. Automatic Staging for Retinopathy of Prematurity With Deep Feature Fusion and Ordinal Classification Strategy. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:1750-1762. [PMID: 33710954 DOI: 10.1109/tmi.2021.3065753] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Retinopathy of prematurity (ROP) is a retinal disease which frequently occurs in premature babies with low birth weight and is considered as one of the major preventable causes of childhood blindness. Although automatic and semi-automatic diagnoses of ROP based on fundus image have been researched, most of the previous studies focused on plus disease detection and ROP screening. There are few studies focusing on ROP staging, which is important for the severity evaluation of the disease. To be consistent with clinical 5-level ROP staging, a novel and effective deep neural network based 5-level ROP staging network is proposed, which consists of multi-stream based parallel feature extractor, concatenation based deep feature fuser and clinical practice based ordinal classifier. First, the three-stream parallel framework including ResNet18, DenseNet121 and EfficientNetB2 is proposed as the feature extractor, which can extract rich and diverse high-level features. Second, the features from three streams are deeply fused by concatenation and convolution to generate a more effective and comprehensive feature. Finally, in the classification stage, an ordinal classification strategy is adopted, which can effectively improve the ROP staging performance. The proposed ROP staging network was evaluated with per-image and per-examination strategies. For per-image ROP staging, the proposed method was evaluated on 635 retinal fundus images from 196 examinations, including 303 Normal, 26 Stage 1, 127 Stage 2, 106 Stage 3, 61 Stage 4 and 12 Stage 5, which achieves 0.9055 for weighted recall, 0.9092 for weighted precision, 0.9043 for weighted F1 score, 0.9827 for accuracy with 1 (ACC1) and 0.9786 for Kappa, respectively. While for per-examination ROP staging, 1173 examinations with a 4-fold cross validation strategy were used to evaluate the effectiveness of the proposed method, which prove the validity and advantage of the proposed method.
Collapse
|
19
|
Harvey L, van Elburg R, van der Beek EM. Macrosomia and large for gestational age in Asia: One size does not fit all. J Obstet Gynaecol Res 2021; 47:1929-1945. [PMID: 34111907 DOI: 10.1111/jog.14787] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 02/05/2021] [Accepted: 03/22/2021] [Indexed: 12/17/2022]
Abstract
Macrosomia, usually defined as infant birth weight of ≥4000 g, does not consider gestational age, sex, or country/region-specific differences in mean birth weight and maternal body weight. This issue is particularly relevant for Asia, where 60% of the world's population lives, due to variations in maternal size and birth weights across populations. Large for gestational age (LGA), defined as birth weight > 90th centile, is a more sensitive measure as it considers gestational age and sex, though it is dependent on the choice of growth charts. We aimed to review reporting of macrosomia and LGA in Asia. We reviewed the literature on prevalence and risk of macrosomia and LGA in Asia over the last 29 years. Prevalence of macrosomia ranged from 0.5% (India) to 13.9% (China) while prevalence of LGA ranged from 4.3% (Korea) to 22.1% (China), indicating substantial variation in prevalence within and between Asian countries. High pre-pregnancy body mass index, excessive gestational weight gain, and impaired glucose tolerance conferred risk of macrosomia/LGA. Incidence of macrosomia and LGA varies substantially within and between Asian countries, as do the growth charts and definitions. The latter makes it impossible to make comparisons but suggests differences in intrauterine growth between populations. Reporting LGA, using standardized country/regional growth charts, would better capture the incidence of high birth weight and allow for comparison and identification of contributing factors. Better understanding of local drivers of excessive intrauterine growth could enable development of improved strategies for prevention and management of LGA.
Collapse
Affiliation(s)
- Louise Harvey
- Nutricia Research, Danone Nutricia Research, Utrecht, The Netherlands
| | - Ruurd van Elburg
- Department of Pediatrics, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Eline M van der Beek
- Department of Pediatrics, University Medical Centre Groningen, Groningen, The Netherlands
| |
Collapse
|
20
|
Peng Y, Fang Z, Zhang M, Li S, Li A, Zhang L, Wang X. Predicting the risk of fetal macrosomia at pregnancy in Shandong province: a case-control study. J Matern Fetal Neonatal Med 2021; 35:6260-6266. [PMID: 33866935 DOI: 10.1080/14767058.2021.1910662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIM Macrosomia is used to describe an infant born with excessively high weight, and it brings lots of unexpected risks in clinical work. Macrosomia causes considerable challenges for both physicians and pregnant women. Our objectives were to identify factors in gravida to be associated with the risk of macrosomia, to guide clinical prevention and treatment. METHODS The study assessed risk factors of macrosomia by comparison with normal birth weight neonates, and a case-control study was conducted at Shandong Provincial Maternity and Child Healthcare Hospital. We followed and selected the relevant indicators of gravida who gave birth to macrosomia or normal infants, and applied statistical analysis to identify clinical indicators related to macrosomia. RESULTS Maternal blood glucose (OR 3.88 (1.07, 14.15)), history of abnormal conception (OR 18.44 (1.05, 322.89)), situation of menarche (OR 13.53 (1.28, 142.66)), and menstrual cycle of gravida (OR 13.24 (1.17, 150.24)) were significant influencing factors of macrosomia, but did not appear in the univariate analysis. Adding gestational age at delivery (OR 4.00 (1.45, 11.09)), triglyceride (OR 0.01 (<0.01, 0.40)), and MBI (OR 46.35 (2.08, >99.99)) of pregnant women, the area under the curve (AUC) curve was drawn for forecasting the risk of macrosomia, and the value of AUC was 0.9174. The triglyceride blood index of pregnant women was the only one that was inversely proportional to the probability of giving birth to macrosomic infants. The low-density lipoprotein (LDL) (OR 0.29 (0.12, 0.72)) and total cholesterol (OR 0.39 (0.20, 0.75)) were important factors in univariate analysis, and both of them were negative correlation factors of macrosomia. All influencing factors in multivariate analysis were selected for drawing a receiver operating characteristic (ROC) curve, and the value of the AUC was 0.9174. CONCLUSIONS This analysis could therefore accurately predict the risk of pregnant women who would deliver macrosomic infants.
Collapse
Affiliation(s)
- Yanjie Peng
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Shandong University, Jinan, China
| | - Zhenya Fang
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Shandong University, Jinan, China
| | - Meihua Zhang
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Shandong University, Jinan, China
| | - Shuxian Li
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Shandong University, Jinan, China
| | - Anna Li
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Shandong University, Jinan, China
| | - Lin Zhang
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Shandong University, Jinan, China
| | - Xietong Wang
- Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Shandong University, Jinan, China
| |
Collapse
|
21
|
Luo L, Zeng H, Zeng M, Liu X, Xu X, Wang L, Zhao Y. The second pregnancy has no effect in the incidence of macrosomia: a cross-sectional survey in two western Chinese regions. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:19. [PMID: 33849665 PMCID: PMC8045374 DOI: 10.1186/s41043-021-00244-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 03/31/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND After the implementation of the universal two-child policy in China, the increase in parity has led to an increase in adverse pregnancy outcomes. The impact of one and two fetuses on the incidence of fetal macrosomia has not been fully confirmed in China. This study aimed to explore the differences in the incidence of fetal macrosomia in first and second pregnancies in Western China after the implementation of the universal two-child policy. METHODS A total of 1598 pregnant women from three hospitals were investigated by means of a cross-sectional study from August 2017 to January 2018. Participants were recruited by convenience and divided into first and second pregnancy groups. These groups included 1094 primiparas and 504 women giving birth to their second child. Univariate and multivariate logistic regression analyses were performed to discuss the differences in the incidence of fetal macrosomia in first and second pregnancies. RESULTS No significant difference was found in the incidence of macrosomia in the first pregnancy group (7.2%) and the second pregnancy group (7.1%). In the second-time pregnant mothers, no significant association was found between the macrosomia of the second child (5.5%) and that of the first child (4.7%). The multivariate logistic regression model showed that mothers older than 30 years are not likely to give birth to children with macrosomia (odds ratio (OR) 0.6, 95% confidence interval (CI) 0.4,0.9). CONCLUSIONS The incidence of macrosomia in Western China is might not be affected by the birth of the second child and is not increased by low parity.
Collapse
Affiliation(s)
- Li Luo
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016 China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, 400016 China
- Chengdu Center for Disease Control and Prevention, 610041 Chengdu, China
| | - Huan Zeng
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016 China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, 400016 China
| | - Mao Zeng
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016 China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, 400016 China
| | - Xueqing Liu
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016 China
| | - Xianglong Xu
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016 China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, 400016 China
- Chengdu Center for Disease Control and Prevention, 610041 Chengdu, China
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, 3800 Melbourne, Australia
| | - Lianlian Wang
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, 3800 Melbourne, Australia
- The Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, China
- Department of Reproduction Health and Infertility, The First Affiliated Hospital of Chongqing Medical University, 400016 Chongqing, China
- Canada-China-New Zealand Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, 400016 Chongqing, China
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing, 400016 China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, 400016 China
| |
Collapse
|
22
|
Wang S, Yang L, Shang L, Yang W, Qi C, Huang L, Xie G, Wang R, Chung MC. Changing trends of birth weight with maternal age: a cross-sectional study in Xi'an city of Northwestern China. BMC Pregnancy Childbirth 2020; 20:744. [PMID: 33256654 PMCID: PMC7708914 DOI: 10.1186/s12884-020-03445-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 11/19/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Most studies have shown that maternal age is associated with birth weight. However, the specific relationship between each additional year of maternal age and birth weight remains unclear. The study aimed to analyze the specific association between maternal age and birth weight. METHODS Raw data for all live births from 2015 to 2018 were obtained from the Medical Birth Registry of Xi'an, China. A total of 490,143 mother-child pairs with full-term singleton live births and the maternal age ranging from 20 to 40 years old were included in our study. Birth weight, gestational age, neonatal birth date, maternal birth date, residence and ethnicity were collected. Generalized additive model and two-piece wise linear regression model were used to analyze the specific relationships between maternal age and birth weight, risk of low birth weight, and risk of macrosomia. RESULTS The relationships between maternal age and birth weight, risk of low birth weight, and risk of macrosomia were nonlinear. Birth weight increased 16.204 g per year when maternal age was less than 24 years old (95%CI: 14.323, 18.086), and increased 12.051 g per year when maternal age ranged from 24 to 34 years old (95%CI: 11.609, 12.493), then decreased 0.824 g per year (95% CI: -3.112, 1.464). The risk of low birth weight decreased with the increase of maternal age until 36 years old (OR = 0.917, 95%CI: 0.903, 0.932 when maternal age was younger than 27 years old; OR = 0.965, 95%CI: 0.955, 0.976 when maternal age ranged from 27 to 36 years old), then increased when maternal age was older than 36 years old (OR = 1.133, 95%CI: 1.026, 1.250). The risk of macrosomia increased with the increase of maternal age (OR = 1.102, 95%CI: 1.075, 1.129 when maternal age was younger than 24 years old; OR = 1.065, 95%CI: 1.060, 1.071 when maternal age ranged from 24 to 33 years old; OR = 1.029, 95%CI: 1.012, 1.046 when maternal age was older than 33 years old). CONCLUSIONS For women of childbearing age (20-40 years old), the threshold of maternal age on low birth weight was 36 years old, and the risk of macrosomia increased with the increase of maternal age.
Collapse
Affiliation(s)
- Shanshan Wang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, 710061, Xi'an, Shaanxi, People's Republic of China.,Department of Obstetrics and Gynecology, Xijing Hospital, the Fourth Military Medical University, Shaanxi, Xi'an, PR China
| | - Liren Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, 710061, Xi'an, Shaanxi, People's Republic of China
| | - Li Shang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, 710061, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi, Xi'an, PR China
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, 710061, Xi'an, Shaanxi, People's Republic of China.
| | - Cuifang Qi
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, 710061, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi, Xi'an, PR China
| | - Liyan Huang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, 710061, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi, Xi'an, PR China
| | - Guilan Xie
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, 710061, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi, Xi'an, PR China
| | - Ruiqi Wang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, 710061, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi, Xi'an, PR China
| | - Mei Chun Chung
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Massachusetts, Boston, USA
| |
Collapse
|
23
|
Khan MMA, Mustagir MG, Islam MR, Kaikobad MS, Khan HT. Exploring the association between adverse maternal circumstances and low birth weight in neonates: a nationwide population-based study in Bangladesh. BMJ Open 2020; 10:e036162. [PMID: 33109640 PMCID: PMC7592295 DOI: 10.1136/bmjopen-2019-036162] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This study is concerned with helping to improve the health and care of newborn babies in Bangladesh by exploring adverse maternal circumstances and assessing whether these are contributing towards low birth weight (LBW) in neonates. STUDY DESIGNS AND SETTINGS Data were drawn and analysed from the Bangladesh Demographic and Health Survey, 2014. Any association between LBW and adverse maternal circumstances were assessed using a Chi-square test with determinants of LBW identified by multivariate logistic regression analysis. PARTICIPANTS The study is based on 4728 children aged below 5 years and born to women from selected households. RESULTS The rate of LBW was around 19.9% (199 per 1000 live births) with the highest level found in the Sylhet region (26.2%). The rate was even higher in rural areas (20.8%) and among illiterate mothers (26.6%). Several adverse maternal circumstances of the women included in the survey were found to be significant for increasing the likelihood of giving birth to LBW babies. These circumstances included the women being underweight (adjusted odds ratio (AOR) 1.26, 95% CI 1.06 to 1.49); having unwanted births (AOR 1.22, 95% CI 1.03 to 1.44); had previous pregnancies terminated (AOR 1.28, 95% CI 1.05 to 1.57); were victims of intimate partner violence (AOR 1.23, 95% CI 1.05 to 1.45) and taking antenatal care <4 times (AOR 1.23, 95% CI 1.03 to 1.48). Other important risk factors that were revealed included age at birth <18 years (AOR 1.42, 95% CI 1.11 to 1.83) and intervals between the number of births <24 months (AOR 1.25, 95% CI 1.01 to 1.55). When taking multiple fertility behaviours together such as, the ages of the women at birth (<18 years with interval <24 months (AOR 1.26, 95% CI 1.02 to 1.57) and birth order (>3 with interval <24 months (AOR 1.68, 95% CI 1.18 to 2.37), then the risk of having LBW babies significantly increased. CONCLUSION This study finds that adverse maternal circumstances combined with high-risk fertility behaviours are significantly associated with LBW in neonates. This situation could severely impede progress in Bangladesh towards achieving the sustainable development goal concerned with the healthcare of newborns.
Collapse
Affiliation(s)
- Md Mostaured Ali Khan
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi 6205, Bangladesh
- MEL and Research, Practical Action, Dhaka 1205, Bangladesh
| | - Md Golam Mustagir
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Md Rafiqul Islam
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Md Sharif Kaikobad
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Hafiz Ta Khan
- Professor of Public Health & Statistics, College of Nursing, Midwifery and Healthcare, University of West London, Brentford TW8 9GB, UK
| |
Collapse
|
24
|
Kamiya M, Suzuki K, Yamagata Z. Effect of maternal active smoking during pregnancy on the trajectory of childhood body mass index: A multilevel analysis using quartiles of birthweight. Tob Induc Dis 2020; 18:34. [PMID: 32382256 PMCID: PMC7199658 DOI: 10.18332/tid/119117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/28/2020] [Accepted: 03/16/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Maternal active smoking during pregnancy is associated with childhood obesity; however, whether maternal active smoking affects childhood body mass index (BMI) according to birthweight has not been examined. METHODS The study participants were 1955 women and their single-born infants, born between 1 April 1991 and 31 March 2003, in Koshu City, Japan, for whom complete data for birthweight, pre-pregnancy maternal BMI and pregnancy smoking status were available. Maternal smoking status during pregnancy was recorded using a questionnaire at the time of pregnancy registration. Childhood BMI was estimated by the BMI z-score, established by the World Health Organisation. Birthweight quartiles were grouped by sex and parity (first vs second or higher). Multilevel analysis, including both the individual and time as different level variables by each birthweight quartile, was used to describe the trajectories of BMI z-scores for statistical analyses. RESULTS In every quartile group, although children born to smoking mothers were leaner at birth, their BMI z-score increased around the age of 3 years. These children were larger than children born to non-smoking mothers. Significant interactions between maternal active smoking during pregnancy and child’s age were seen in those in the first and second quartiles of birthweight. Moreover, rapid growth in infancy was observed in the second quartile of birthweight. CONCLUSIONS The effect of maternal active smoking during pregnancy on childhood growth was more apparent among children in the second quartile of birthweight.
Collapse
Affiliation(s)
- Miho Kamiya
- Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.,Department of Child and Family Health Nursing, Faculty of Nursing, Japanese Red Cross College of Nursing, Shibuya, Japan
| | - Kohta Suzuki
- Department of Health and Psychosocial Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Zentaro Yamagata
- Department of Health Sciences, Graduate School of Medicine, University of Yamanashi, Chuo, Japan
| |
Collapse
|
25
|
Lu C, Zhang W, Zheng X, Sun J, Chen L, Deng Q. Combined effects of ambient air pollution and home environmental factors on low birth weight. CHEMOSPHERE 2020; 240:124836. [PMID: 31561165 DOI: 10.1016/j.chemosphere.2019.124836] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/29/2019] [Accepted: 09/10/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Low birth weight (LBW) remains a major public health problem worldwide, yet its crucial environmental risk factors are still unclear. OBJECTIVE To examine the association between LBW (term and preterm LBW) and prenatal exposure to ambient air pollution and home environmental factors as well as their combination, in order to identify critical time window for exposure and key outdoor and indoor factors in LBW development. METHODS A cohort study of 3509 preschool children was performed in Changsha, China during the period 2011-2012. A questionnaire was conducted to survey each child's birth outcome and each mother's exposure to home environmental factors including parental smoking, new furniture, redecoration, mold/damp stains, window pane condensation, and household pets during pregnancy. Maternal exposure to inhalable particulate matter (PM10), industrial air pollutant (SO2), and traffic air pollutant (NO2) was estimated during different time windows of gestation, including conception month, three trimesters, birth month, and whole gestation. Associations of term and preterm LBW with ambient air pollutants and home environmental factors were assessed by multiple logistic regression models in terms of odds ratio (OR) with 95% confidence interval (CI). RESULTS Term LBW (TLBW) was significantly associated with exposure to ambient PM10 during pregnancy, with OR (95% CI) = 1.47 (1.00-2.14) for per IQR increase after adjustment for the covariates and home environmental factors. Specifically, we identified the significant association in early phase of pregnancy including conception month (1.90, 1.09-3.30) and the first trimester (1.72, 1.10-2.69). We further found that TLBW was significantly related with parental smoking at home, OR (95% CI) = 2.17 (1.09-4.33). However, no association was observed for preterm LBW (PLBW). The TLBW risk of ambient air pollution and home environmental factors was independent each other and hence the combined exposure to ambient PM10 and indoor parental smoking caused the highest risk. Sensitivity analysis suggested that foetus with younger mothers were significantly more susceptible to risk of indoor parental smoking, while those with smaller house and cockroaches were more sensitive to risk of outdoor PM10 exposure. CONCLUSION Prenatal exposure to combined outdoor and indoor air pollution, particularly in critical window(s) during early pregnancy, significantly increases the risk of term LBW.
Collapse
Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, China; Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University, Changsha, China.
| | - Weishe Zhang
- Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University, Changsha, China; Department of Obstetrics, XiangYa Hospital, Central South University, Changsha, China
| | - Xiangrong Zheng
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, China
| | - Jingchi Sun
- Department of Obstetrics, XiangYa Hospital, Central South University, Changsha, China
| | - Lv Chen
- XiangYa School of Public Health, Central South University, Changsha, China
| | - Qihong Deng
- XiangYa School of Public Health, Central South University, Changsha, China; Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University, Changsha, China; School of Architecture and Art, Central South University, Changsha, China.
| |
Collapse
|
26
|
Tu S, Wang AL, Tan MZ, Lu JH, He JR, Shen SY, Wei DM, Lu MS, Au Yeung SL, Xia HM, Qiu X. Family socioeconomic position and abnormal birth weight: evidence from a Chinese birth cohort. World J Pediatr 2019; 15:483-491. [PMID: 31286424 DOI: 10.1007/s12519-019-00279-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 06/17/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Birth weight is a strong determinant of infant short- and long-term health outcomes. Family socioeconomic position (SEP) is usually positively associated with birth weight. Whether this association extends to abnormal birth weight or there exists potential mediator is unclear. METHODS We analyzed data from 14,984 mother-infant dyads from the Born in Guangzhou Cohort Study. We used multivariable logistic regression to assess the associations of a composite family SEP score quartile with macrosomia and low birth weight (LBW), and examined the potential mediation effect of maternal pre-pregnancy body mass index (BMI) using causal mediation analysis. RESULTS The prevalence of macrosomia and LBW was 2.62% (n = 392) and 4.26% (n = 638). Higher family SEP was associated with a higher risk of macrosomia (OR 1.30, 95% CI 0.93-1.82; OR 1.53, 95% CI 1.11-2.11; and OR 1.59, 95% CI 1.15-2.20 for the 2nd, 3rd, and 4th SEP quartile respectively) and a lower risk of LBW (OR 0.69, 95% CI 0.55-0.86; OR 0.76, 95% CI 0.61-0.94; and OR 0.61, 95% CI 0.48-0.77 for the 2nd, 3rd, and 4th SEP quartile respectively), compared to the 1st SEP quartile. We found that pre-pregnancy BMI did not mediate the associations of SEP with macrosomia and LBW. CONCLUSIONS Socioeconomic disparities in fetal macrosomia and LBW exist in Southern China. Whether the results can be applied to other populations should be further investigated.
Collapse
Affiliation(s)
- Si Tu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou 510623, China.,Department of Women and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Department of Neonatal Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Ao-Lin Wang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou 510623, China.,Program on Reproductive Health and the Environment and Bakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA
| | - Mei-Zhen Tan
- Department of Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jin-Hua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou 510623, China.,Department of Women and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Jian-Rong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou 510623, China.,Department of Women and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Song-Ying Shen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou 510623, China
| | - Dong-Mei Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou 510623, China.,Department of Women and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Min-Shan Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou 510623, China.,Department of Women and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Shiu Lun Au Yeung
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou 510623, China.,School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Hui-Min Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou 510623, China.,Department of Neonatal Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Road, Zhujiang Newtown, Tianhe District, Guangzhou 510623, China. .,Department of Women and Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China. .,Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
| |
Collapse
|
27
|
Foussard N, Cougnard-Grégoire A, Rajaobelina K, Delcourt C, Helmer C, Lamireau T, Gonzalez C, Grouthier V, Haissaguerre M, Blanco L, Alexandre L, Mohammedi K, Rigalleau V. Skin Autofluorescence of Pregnant Women With Diabetes Predicts the Macrosomia of Their Children. Diabetes 2019; 68:1663-1669. [PMID: 31127055 DOI: 10.2337/db18-0906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 05/18/2019] [Indexed: 11/13/2022]
Abstract
Advanced glycation end products (AGEs) accumulated during long-term hyperglycemia are involved in diabetes complications and can be estimated by skin autofluorescence (sAF). During pregnancy, hyperglycemia exposes women to the risk of having a macrosomic newborn. The aim of this study was to determine whether sAF of women with diabetes during a singleton pregnancy could predict macrosomia in their newborns. Using an AGE Reader, we measured the sAF at the first visit of 343 women who were referred to our diabetology department during years 2011-2015. Thirty-nine women had pregestational diabetes, 95 early gestational diabetes mellitus (GDM), and 209 late GDM. Macrosomia was defined as birth weight ≥4,000 g and/or large for gestational age ≥90th percentile. Forty-six newborns were macrosomic. Their mothers had 11% higher sAF compared with other mothers: 2.03 ± 0.30 arbitrary units (AUs) vs. 1.80 ± 0.34 (P < 0.0001). Using multivariate logistic regression, the relation between sAF and macrosomia was significant (odds ratio 4.13 for 1-AU increase of sAF [95% CI 1.46-11.71]) after adjusting for several potential confounders. This relation remained significant after further adjustment for HbA1c (among 263 women with available HbA1c) and for women with GDM only. sAF of pregnant women with diabetes, a marker of long-term hyperglycemic exposure, predicts macrosomia in their newborns.
Collapse
Affiliation(s)
- Ninon Foussard
- Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Audrey Cougnard-Grégoire
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Team Lifelong Exposures Health and Aging, UMR 1219, Bordeaux, France
| | - Kalina Rajaobelina
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Team Lifelong Exposures Health and Aging, UMR 1219, Bordeaux, France
| | - Cécile Delcourt
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Team Lifelong Exposures Health and Aging, UMR 1219, Bordeaux, France
| | - Catherine Helmer
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Team Lifelong Exposures Health and Aging, UMR 1219, Bordeaux, France
| | - Thierry Lamireau
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Team Lifelong Exposures Health and Aging, UMR 1219, Bordeaux, France
| | - Concepcion Gonzalez
- Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Virginie Grouthier
- Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | | | - Laurence Blanco
- Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Laure Alexandre
- Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Kamel Mohammedi
- Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Vincent Rigalleau
- Nutrition-Diabetology, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, Team Lifelong Exposures Health and Aging, UMR 1219, Bordeaux, France
| |
Collapse
|
28
|
Li H, Zheng J, Wang H, Huang G, Huang Q, Feng N, Xiao J. Maternal cosmetics use during pregnancy and risks of adverse outcomes: a prospective cohort study. Sci Rep 2019; 9:8030. [PMID: 31142815 PMCID: PMC6541712 DOI: 10.1038/s41598-019-44546-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 05/20/2019] [Indexed: 11/09/2022] Open
Abstract
To probe into the associations between maternal personal cosmetics use during pregnancy and risk of adverse outcomes, and explore the potential dose-response relationships, we carried out a prospective cohort study involving 9710 pregnant women in Zhuzhou City and Xiangtan City in Hunan province during 2016-2017. A structured questionnaire was used to collection information for the pregnant women and their pregnancy outcomes. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by binary or multinomial logistic regressions. The study population included 4652 (47.9%) cosmetics non-users and 5058 (52.1%) cosmetics users. Cosmetics use was associated with an increased risk of small for gestational age (SGA) (aOR = 1.23, 95%CI 1.04 to 1.44), compared with cosmetics non-users. A positive dose-response relationship between frequency of cosmetics use and SGA was observed, although a borderline association was found at low use frequency (1-2 times per week; aOR = 1.18, 95%CI 0.99 to 1.40) and moderate use frequency (3-4 times per week; aOR = 1.23, 95%CI 0.92 to 1.64). High-frequency of cosmetics use (≥5 times per week) was significantly correlated with a higher risk of SGA (aOR = 1.83, 95%CI 1.25 to 2.69). No significant association between personal cosmetics use and the risk of preterm birth, low birth weight, macrosomia, or large for gestational age was observed. The present study suggests that personal cosmetics use will increase the risk of SGA, but further research is required to determine which cosmetic products may account for the higher risk of SGA.
Collapse
Affiliation(s)
- Huixia Li
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China
- NHC Key Laboratory of Birth Defects Research, Prevention and Treatment, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China
| | - Jianfei Zheng
- Department of Emergency and Intensive Care Medicine, Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan Province, China
| | - Hua Wang
- NHC Key Laboratory of Birth Defects Research, Prevention and Treatment, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China.
- Department of Maternal Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China.
| | - Guangwen Huang
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China.
| | - Qun Huang
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China
| | - Na Feng
- Department of Health Care, Shenzhen Nanshan Maternal and Child Health Care Hospital, Shenzhen, 518067, Guangdong Province, China
| | - Juan Xiao
- Department of Child Health Care, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan Province, China
| |
Collapse
|
29
|
Quality antenatal care protects against low birth weight in 42 poor counties of Western China. PLoS One 2019; 14:e0210393. [PMID: 30650127 PMCID: PMC6335019 DOI: 10.1371/journal.pone.0210393] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 12/21/2018] [Indexed: 11/03/2022] Open
Abstract
Limited data exist related to low birth weight (LBW) incidence and risk factors in Western China. This paper aims to assess LBW and its relationship with antenatal care (ANC) in the poor counties of Western China. A community-based study in rural Western China was conducted in 2011. A kernel distribution was used to estimate the adjusted LBW incidence, and associations between LBW and socio-demographic or maternal factors were examined using multilevel logistic regression. Among 8,964 participants, 65.7% were weighed at birth. Crude LBW incidence was 6.6% and the adjusted rate was 9.3%. The study revealed that risk factors of LBW are being female, raised within a minority group, and with a family income below the national poverty line. For maternal risk factors, LBW was positively associated with not attending at least five or eight ANC visits, not receiving any ANC during the first trimester, and not having access to assess certain ANC content (weight, blood pressure, blood test, urine test, B-scan ultrasound, and folic acid supplement). There is urgent need to promote quality ANC in poor and rural areas of Western China and to prioritize vulnerable women and children who will benefit from quality ANC.
Collapse
|
30
|
Bao H, Yu P, Song X, Zhou Y, Zhu Y, Xu X. The influence of home-based exercise on gestational diabetes: a meta-analysis of randomized controlled trials. J Matern Fetal Neonatal Med 2019; 33:2300-2305. [PMID: 30626247 DOI: 10.1080/14767058.2018.1548595] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction: The impact of home-based exercise for gestational diabetes remains controversial. We conduct a systematic review and meta-analysis to explore the influence of home-based exercise on glycemic control for gestational diabetes.Methods: We search PubMed, Embase, Web of Science, EBSCO, and Cochrane Library databases through April 2018 for randomized controlled trials (RCTs) assessing the effect of home-based exercise on glycemic control for gestational diabetes.Results: Five RCTs involving 266 patients are included in the meta-analysis. Overall, compared with control group for gestational diabetes, home-based exercise shows no important impact on fasting glucose (std. MD =0.18; 95% CI = -0.11-0.46; p = .22), HbA1c (std. MD = -0.05; 95% CI = -0.32-0.22; p = .70), insulin requirement (risk ratios (RR) = 1.63; 95% CI =0.51-5.17; p = .41), insulin sensitivity index (std. MD = -0.18; 95% CI = -1.02-0.66; p = .67), gestational age at delivery (std. MD =0.01; 95% CI = -0.26-0.28; p = .95), preterm birth (RR =1.01; 95% CI =0.34-2.99; p = .99), birth weight (std. MD =0.06; 95% CI = -0.45-0.58; p = .81) and head circumference (std. MD =0.11; 95% CI = -0.16-0.38; p = .44).Conclusions: Home-based exercise demonstrates no substantial benefits to fasting glucose, HbA1c, insulin requirement, insulin sensitivity index, gestational age at delivery, preterm birth, birth weight and head circumference for gestational diabetes women.
Collapse
Affiliation(s)
- Hongdan Bao
- Department of Endocrinology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Department of Endocrinology, Fourth hospital of Ningbo City, Ningbo, China
| | - Pingxiang Yu
- Department of Endocrinology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoxiao Song
- Department of Endocrinology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yafen Zhou
- Department of Endocrinology, Fourth hospital of Ningbo City, Ningbo, China
| | - Yuyu Zhu
- Department of Endocrinology, Fourth hospital of Ningbo City, Ningbo, China
| | - Xiaohong Xu
- Department of Endocrinology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
31
|
Both maternal and paternal risk factors for term singleton low birthweight infants in rural Chinese population: a population-based, retrospective cohort study. Sci Rep 2018; 8:12539. [PMID: 30135564 PMCID: PMC6105589 DOI: 10.1038/s41598-018-30036-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 07/18/2018] [Indexed: 11/28/2022] Open
Abstract
No large population-based study has focused on both maternal paternal risk factors for low birthweight (LBW) in China. We aimed to identify parental risk factors associated with LBW.A population-based, retrospective cohort study was conducted on 202,725 singleton infants at 37–42 weeks. These term singleton newborns were classified as LBW with birthweight ≤2500 g(TLBW) and normal birthweight between 50th to 97th percentile (TNBW 50th–97th) according to Chinese singleton norms. Multiple logistic regression analyses were used to find those parental risk factors of LBW by comparing two groups. TLBW and TNBW(50th–97th) occupied 4.8% and 70.8% of the study population, respectively. Logistic regression showed a significant association with positive maternal hepatitis B surface antigen (RR = 1.979, P = 0.047), irregular folic acid intake (RR = 1.152, P = 0.003), paternal history of varicocele (RR = 2.404, P = 0.003) and female babies (RR = 1.072, P = 0.046). Maternal smoking, hypertension and history of stillbirth were found related to LBW but no statistically significant. Positive maternal hepatitis B surface antigen, irregular folic acid intake, paternal history of varicocele had a negative effect on birth weight. Measures are necessarily taken to avoid them to improve pregnancy outcomes. Further studies should be done to investigate each detailed risk factors on LBW.
Collapse
|