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Idriss HT, Werler MM. Investigating the association between vitamin D dietary intake during pregnancy and incidence of clubfoot in neonates. Birth Defects Res 2024; 116:e2261. [PMID: 37853656 DOI: 10.1002/bdr2.2261] [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: 05/15/2023] [Revised: 09/08/2023] [Accepted: 09/26/2023] [Indexed: 10/20/2023]
Abstract
AIMS Talipes equinovarus (clubfoot) is a congenital lower foot deformity that results from a neuromuscular deficiency, but the precise etiology remains elusive. Vitamin D is important for fetal neuromuscular development. In this study, we investigated the association between dietary vitamin D intake during pregnancy and incidence of clubfoot in neonates, since such a question has thus far been overlooked. METHODS We conducted a secondary analysis of data collected in the United States, between 2007 and 2011 for a case-control study of children born with clubfoot. Participating mothers were interviewed by telephone about dietary and other health and life-style indicators. Exposure to vitamin D was recorded as the average daily intake of dietary vitamin D over a period of 6 months before pregnancy began. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression. RESULTS The dataset included 2667 study participants, of which 663 were cases. Logistic regression showed no significant association between dietary vitamin D or log10 (Vitamin D) intake during pregnancy and incidence of clubfoot in neonates (OR = 1.00, CI = 1.00-1.00, OR = 1.51, CI = 0.83-2.82, respectively). No interaction in the regression model was found between vitamin D and other predictor variables. Results were not confounded by supplement intake of vitamin D during pregnancy. CONCLUSIONS Results show no evidence of an association between dietary vitamin D intake and incidence of clubfoot in neonates. The lack of association is not confounded by consumption of vitamin D supplements during pregnancy.
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Affiliation(s)
- Haitham T Idriss
- School of Public Health, Imperial College of Science, Technology and Medicine, London, UK
| | - Martha M Werler
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
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Luo Y, Qu C, Zhang R, Zhang J, Han D, Na L. Geographic location and ethnicity comprehensively influenced vitamin D status in college students: a cross-section study from China. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:145. [PMID: 38124154 PMCID: PMC10734112 DOI: 10.1186/s41043-023-00488-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Vitamin D plays an important role in the health of adolescents, whereas vitamin D status of Chinese college students was seldom studied in China. To explore the vitamin D status and its relationship with ethnicity and geographic location in Chinese college students. METHODS The freshmen were taken a physical examination by trained medical personnel after they reported to university. Demographic information including age, gender, ethnicity, region of original residence was collected using a questionnaire survey. Serum 25(OH)D3 concentrations were measured using a liquid chromatograph mass spectrometer. Multiple regression analyses were used to explore the factors that influence serum 25(OH)D3 levels. RESULTS Totally 3220 freshmen who came from 26 provinces, autonomous districts or municipalities were recruited, with a mean age of 18.75 ± 1.18 years and 70.2% of them were female. The mean serum 25(OH)D3 levels were 18.51 ± 6.54 ng/mL, and the proportion of vitamin D deficiency (< 20 ng/mL) and insufficiency (20 ~ < 30 ng/mL) was 64.4% and 30.2%, respectively. The combined proportion of vitamin D deficiency and insufficiency was increased with the latitude increased. Miao had the highest serum 25(OH)D3 levels, whereas Kazak ethnic had the lowest (22.51 ng/mL vs. 13.94 ng/mL) among different ethnic groups. Female students, students from city, Uighur and Kazak ethnic, residing in high latitude was significantly associated with lower serum 25(OH)D3 levels (P < 0.05). CONCLUSIONS Vitamin D deficiency is an important health problem in Chinese college students. Sunlight activities, dietary and life-style intervention for college students according to geographic location and ethnicities should be considered.
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Affiliation(s)
- Yingyi Luo
- Medical Technology College, Shanghai University of Medicine & Health Sciences, 279 Zhouzhu Road, Pudong New Area, Shanghai, 201318, China
| | - Chunbo Qu
- Public Health College, Shanghai University of Medicine & Health Sciences, 279 Zhouzhu Road, Pudong New Area, Shanghai, 201318, China
| | - Rui Zhang
- Public Health College, Shanghai University of Medicine & Health Sciences, 279 Zhouzhu Road, Pudong New Area, Shanghai, 201318, China
| | - Jingyi Zhang
- Public Health College, Shanghai University of Medicine & Health Sciences, 279 Zhouzhu Road, Pudong New Area, Shanghai, 201318, China
| | - Dan Han
- Medical Technology College, Shanghai University of Medicine & Health Sciences, 279 Zhouzhu Road, Pudong New Area, Shanghai, 201318, China
| | - Lixin Na
- Public Health College, Shanghai University of Medicine & Health Sciences, 279 Zhouzhu Road, Pudong New Area, Shanghai, 201318, China.
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Yu H, Fu J, Feng Y. Utility of umbilical cord blood 25-hydroxyvitamin D levels for predicting bronchopulmonary dysplasia in preterm infants with very low and extremely low birth weight. Front Pediatr 2022; 10:956952. [PMID: 35989993 PMCID: PMC9386287 DOI: 10.3389/fped.2022.956952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/11/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE There remains controversy regarding vitamin D deficiency and bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW) and extremely low birth weight (ELBW) preterm infants. This study aimed to determine the prevalence of vitamin D deficiency assessed by umbilical cord blood 25-hydroxyvitamin D [25(OH)D] in preterm infants in northeast China and to evaluate the ability and optimal threshold of 25(OH)D for predicting BPD. METHODS The clinical data of VLBW and ELBW preterm infants with known cord-blood 25(OH)D levels were analyzed retrospectively. Infants were divided into groups based on their cord-blood 25(OH)D levels and BPD diagnosis. Logistic regression was performed to assess the risk factors for BPD and a nomogram was established. Receiver operating characteristic (ROC) curve analysis was used to evaluate the optimal threshold of cord-blood 25(OH)D concentration for predicting BPD. RESULTS A total of 267 preterm infants were included, of which 225 (84.3%) exhibited vitamin D deficiency and 134 (50.2%) were diagnosed with BPD. The incidence of BPD was lower in the group with a 25(OH)D level of >20 ng/ml than in the other groups (P = 0.024). Infants with BPD had lower cord-blood 25(OH)D levels than those without BPD (11.6 vs. 13.6 ng/ml, P = 0.016). The multivariate logistic regression model revealed that 25(OH)D levels (odds ratio [OR] = 0.933, 95% confidence interval [95% CI]: 0.891-0.977), gestational age (OR = 0.561, 95% CI: 0.425-0.740), respiratory distress syndrome (OR = 2.989, 95% CI: 1.455-6.142), and pneumonia (OR = 2.546, 95% CI: 1.398-4.639) were independent risk factors for BPD. A predictive nomogram containing these four risk factors was established, which had a C-index of 0.814. ROC curve analysis revealed that the optimal cutoff value of 25(OH)D for predicting BPD was 15.7 ng/ml (area under the curve = 0.585, 95% CI: 0.523-0.645, P = 0.016), with a sensitivity of 75.4% and a specificity of 42.9%. CONCLUSIONS A cord-blood 25(OH)D level of <15.7 ng/ml was predictively valuable for the development of BPD. The nomogram established in this study can help pediatricians predict the risk of BPD more effectively and easily.
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Affiliation(s)
- Haoting Yu
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jianhua Fu
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yong Feng
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
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Jeyakumar A, Shinde V, Ravindran R. Pooled estimate of vitamin D deficiency among pregnant women in India: a systematic review and meta-analysis. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:28. [PMID: 34187594 PMCID: PMC8243731 DOI: 10.1186/s41043-021-00253-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 06/02/2021] [Indexed: 04/12/2023]
Abstract
BACKGROUND Vitamin D deficiency among pregnant women is a public health concern globally. In India, individual studies report high prevalence. However, lack of national data masks the true burden. This work determined the pooled prevalence of vitamin D deficiency among pregnant women in India through a systematic review of literature and meta-analysis. METHODS Three different search engines yielded 15 eligible articles. Study quality was assessed by 10 different criteria and summary of study quality was categorized as per Cochrane standards. Meta-analysis was performed to estimate pooled prevalence of vitamin D deficiency among healthy pregnant women and heterogeneity among selected studies. A sample of n = 4088 was used to study the pooled prevalence among pregnant women. RESULTS The random effects combined estimate was 32.35% (95% CI, (12.58-117.48). High heterogeneity (tau2 = 0.39, I2 = 100%) and high risk of bias was observed among the selected studies. The test for overall effect was observed to be z = 2.54(P = 0.01). CONCLUSION Pooled estimate > 30% emphasizes the need for screening through antenatal care services and initiate preventive measures to address the deficiency.
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Affiliation(s)
- Angeline Jeyakumar
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Maharashtra, India
- School of Hospitality Management, University of Johannesburg, Johannesburg, South Africa
| | - Vidhya Shinde
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Maharashtra, India
| | - Reshma Ravindran
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Maharashtra, India
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Prevalence and risk factors of hypovitaminosis D in pregnant Spanish women. Sci Rep 2020; 10:15757. [PMID: 32978425 PMCID: PMC7519135 DOI: 10.1038/s41598-020-71980-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/18/2020] [Indexed: 02/08/2023] Open
Abstract
The hypovitaminosis D epidemic is a global health problem. Our aim was to assess the prevalence and potential risk factors of hypovitaminosis D among pregnant women on the eastern Mediterranean coast. Cross-sectional analysis involved 793 healthy pregnant women (35.3 ± 5.0 years) participating in ECLIPSES, a multicenter randomized trial. Socio-demographic, obstetric, anthropometric, lifestyle, dietary variables and blood draw was collected in the first trimester. Vitamin D deficiency was identified in 50.2% and insufficiency in 30.3% of pregnant women. The mean vitamin D level in the overall sample was 33.9 nmol/L (SD, 17.0). Multivariable logistic regression analysis applying AIC-based backward selection identified excess weight during the 1st trimester (BMI ≥ 25 kg/m2) (OR = 1.950, 95% CI = 1.409, 2.699), Arab ethnic group/dark skin colour (OR = 4.005, 95% CI = 2.488, 6.447), winter/spring (OR = 4.319, 95% CI = 3.112, 5.994), and consumption of milk (OR = 0.754, 95% CI = 0.572, 0.993) and yogurt (OR = 0.635, 95% CI = 0.436, 0.922) as independent risk factors for vitamin D deficiency. All of these factors (except yogurt consumption) and physical activity were independently associated with vitamin D deficiency/insufficiency risk in the final multivariable model (all p < 0.05). All these factors and social class were the most important determinants of circulating 25(OH)D concentrations. Our results confirm a high prevalence of vitamin D deficiency and insufficiency among pregnant women from the eastern Mediterranean coast.
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A systematic review and meta-analysis of the response of serum 25-hydroxyvitamin D concentration to vitamin D supplementation from RCTs from around the globe. Eur J Clin Nutr 2019; 73:816-834. [PMID: 30872787 DOI: 10.1038/s41430-019-0417-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/10/2019] [Accepted: 02/18/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES Optimal doses of vitamin D (VitD) supplement in different populations are unclear. We aim to evaluate the relationship between VitD supplementation and post-intervention serum 25-hydroxyvitamin D [25(OH)D] concentration, to provide a recommended dosage of VitD for achieving an optimal 25(OH)D concentration for different populations. SUBJECTS/METHODS Literature search was conducted in Embase, etc. Randomized controlled trials about VitD supplemental intakes and their effect on 25(OH)D concentration were enrolled. The effect on 25(OH)D concentration between different supplementation doses in each population group was compared by meta-analysis. Multivariate meta-regression model is utilized to establish reference intake dosage of VitD. RESULTS A total of 136 articles were included about children (3-17 years), adults (18-64 years), postmenopausal women, the elderly ( >64 years), pregnant, or lactating women. Overall, intervention groups obtained higher 25(OH)D concentration than controls and there was obvious dose-response effect between intake dose and 25(OH)D concentration. Baseline 25(OH)D concentration and age were significant indicators for 25(OH)D concentration. To reach sufficient 25(OH)D concentration (75 nmol/L), the recommended VitD supplemental intakes was 1340 and 2250 IU/day for children and pregnant women, 2519 and 797 IU/day for European adults aged 18-64 and 65-85 years, 729, 2026, and 1229 IU/day for adults in North America, Asia and Middle East and Africa, respectively. CONCLUSIONS Regional- and age-specific recommended dosages of VitD supplements for population to achieve optimal 25(OH)D concentrations have been suggested.
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Husain NE, Badie Suliman AA, Abdelrahman I, Bedri SA, Musa RM, Osman HE, Mustafa AH, Gafer N, Farah E, Satir AA, Ahmed MH, Osman M, Khalil AA, Agaimy A. Vitamin D level and its determinants among Sudanese Women: Does it matter in a sunshine African Country? J Family Med Prim Care 2019; 8:2389-2394. [PMID: 31463263 PMCID: PMC6691462 DOI: 10.4103/jfmpc.jfmpc_247_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Vitamin D deficiency is a worldwide concern. The aim of the current study was to determine the vitamin D level and its contributing factors in Sudanese women. Methods: In this cross-sectional study, 251 Sudanese women attending Family Health Centers in Khartoum, Sudan were interviewed. Following the exclusion of confounding factors, samples from 190 women were analzsed. Serum 25 hydroxyvitamin D “25(OH) D” was quantified using competitive electrochemiluminescence immunoassay. Results: Participants’ age ranged from 18 to 85 years with a mean age (±SD) of 40.2 (±14.06) years. The mean (±SD) vitamin D level was 13.4 (±6.72) ng/ml, ranged 3.00–36.5 ng/ml and the median was 12.7 ng/mL. In total, 157 out of 190 (82.6%) had vitamin D serum levels below 20 ng/ml (deficient); of whom, 52 (27.4%) were in the age group 21–30 years (P value = 0.228). The correlation between vitamin D level and residence outside Khartoum, sun-exposed face and hands, and face and limbs in comparison with being completely covered were found to be statistically significant (p values 0.008, 0.023, and 0.036). Conclusion: This study displayed a high percentage (82.6%.) of vitamin D deficiency among women in Sudan, and this in part may indicate that sunshine alone cannot guarantee vitamin D sufficiency in the tropics. Family physicians in tropical countries should screen those with clinical presentations related to vitamin D deficiency.
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Affiliation(s)
| | | | | | - Shahinaz A Bedri
- Department of Pathology, Faculty of Medicine, Ahfad University for Women, Omdurman, Sudan
| | - Rasha M Musa
- Department of Medical Laboratories and Blood Bank, National Ribat University Hospital, Sudan
| | - Hind E Osman
- Department of Pathology, Faculty of Veterinary Medicine, Sudan University for Science and Technology, Sudan
| | - Ayda H Mustafa
- Combined Clinic, Radiation and Isotope Center, Khartoum (RICK) and Department of Surgery, Alneelain University, Sudan
| | - Nahla Gafer
- Radiation and Isotope Center, Khartoum (RICK), Sudan
| | - Ehab Farah
- Department of Statistics, Faculty of Sciences, University of Tabouk, Saudi Arabia
| | | | - Mohamed H Ahmed
- Department of Medicine and HIV Metabolic Clinic, Milton Keynes University, Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK
| | - Mugtaba Osman
- Armed Forces Centre for Psychiatric Care, Taif, Saudi Arabia
| | - Atif A Khalil
- Nephrology Department, Noble's Hospital, Isle of Man IM44RJ, UK
| | - Abbas Agaimy
- Institute of Pathology, University of Erlangen, Germany
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Low vitamin D status in nursing Pakistani mothers in an environment of ample sunshine: a cross-sectional study. BMC Pregnancy Childbirth 2018; 18:426. [PMID: 30373543 PMCID: PMC6206706 DOI: 10.1186/s12884-018-2062-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 10/16/2018] [Indexed: 11/10/2022] Open
Abstract
Background The maternal 25-hydroxy vitamin D (25OHD) insufficiency is related to adverse maternal and neonatal outcome. The 25OHD content of breast milk is dependent on 25OHD status of the mothers. We undertook this study to ascertain the 25OHD status and its determinants in the nursing mothers of the south Punjab, Pakistan. Methods We recruited 67 mothers for this cross-sectional study by convenience sampling from August 2010 to June 2011 to ascertain their serum 25OHD level & its determinants. We used SPSS 23.0 for analyses. Results The mean age of the mothers was 25.75 ± 4.4 years. The median age (and mode) was 25 years (range 18-37 years). The majority of mothers were less than 25 years of age (62.7%), uneducated (68.7%), from rural area (70.1%), lived in open houses with ample sun exposure (85.1%) and belonged to low socioeconomic strata (71.6%). Serum 25OHD ranged from 7.2 to 43.8 nmol/L with a mean of 20.87 ± 7.69 nmol/L. The median and mode were 21.8 nmol/L & 24.0 nmol/L, respectively. The proportion of mothers with 25OHD < 20 nmol/L (severe deficiency) was 44.8%, < 30 nmol/L (deficiency) 49.3% and < 50 nmol/L (insufficiency) 5.9%. All had 25OHD below 50 nmol/L. The oral supplementation with vitamin D (vD) was the only significant determinant of vitamin D sufficiency. Conclusions The majority of Pakistani mothers in south Punjab are vD deficient & universal vD supplementation is the need of the hour to improve health outcomes in mothers & infants.
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Zhang Q, Chen H, Wang Y, Zhang C, Tang Z, Li H, Huang X, Ouyang F, Huang H, Liu Z. Severe vitamin D deficiency in the first trimester is associated with placental inflammation in high-risk singleton pregnancy. Clin Nutr 2018; 38:1921-1926. [PMID: 30031659 DOI: 10.1016/j.clnu.2018.06.978] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 05/17/2018] [Accepted: 06/23/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND & AIMS Vitamin D deficiency during pregnancy is a worldwide epidemic. This study aimed to identify whether vitamin D deficiency in early pregnancy is associated with placental inflammation in high-risk pregnancy. METHODS This study comprised 23,396 women who provided serum samples in the first trimester for vitamin D analysis from January 2015 to December 2016. Among them, 2648 women with high-risk pregnancy underwent placental pathologic examination. Women were divided into placental inflammation positive (PIP) and placental inflammation negative (PIN) groups based on placental pathology. Multivariate logistic regression was used to evaluate the relationship between vitamin D levels and placental inflammation. RESULTS We found that severe vitamin D deficiency in early pregnancy was associated with placental inflammation. Maternal vitamin D levels were significantly lower in the PIP group than those in the PIN group (P = 0.025). Compared with the highest quartile of vitamin D levels, risk for placental inflammation was significantly higher in women with extremely low vitamin D levels (<5th percentile; P = 0.012). The effect estimate was slightly decreased but still significant (P = 0.027) after adjusting for maternal age, gestational age at birth, birth weight, infant sex, and sample collection season. In addition, compared with the PIN group, the incidences of adverse neonatal outcomes, including sepsis (0.5% vs 2.4%) and fetal intrauterine infection (5.7% vs 15.6%), were significantly higher in the PIP group than that in the PIN group (P < 0.001). CONCLUSIONS Severe vitamin D deficiency in the first trimester is a risk factor for placental inflammation in high-risk pregnancy.
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Affiliation(s)
- Qianqian Zhang
- International Peace Maternity and Child Health Hospital of China Welfare Institution, School of Medicine, Shanghai Jiao Tong University, Shanghai 20030, China
| | - Hao Chen
- Departments of Neonatology, Children's Hospital of Shanghai, School of Medicine, Shanghai Jiao Tong University, Shanghai 20040, China
| | - Yi Wang
- International Peace Maternity and Child Health Hospital of China Welfare Institution, School of Medicine, Shanghai Jiao Tong University, Shanghai 20030, China
| | - Chen Zhang
- International Peace Maternity and Child Health Hospital of China Welfare Institution, School of Medicine, Shanghai Jiao Tong University, Shanghai 20030, China
| | - Zhen Tang
- International Peace Maternity and Child Health Hospital of China Welfare Institution, School of Medicine, Shanghai Jiao Tong University, Shanghai 20030, China
| | - Hong Li
- International Peace Maternity and Child Health Hospital of China Welfare Institution, School of Medicine, Shanghai Jiao Tong University, Shanghai 20030, China
| | - Xiaoyi Huang
- International Peace Maternity and Child Health Hospital of China Welfare Institution, School of Medicine, Shanghai Jiao Tong University, Shanghai 20030, China
| | - Fengxiu Ouyang
- Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Hefeng Huang
- International Peace Maternity and Child Health Hospital of China Welfare Institution, School of Medicine, Shanghai Jiao Tong University, Shanghai 20030, China.
| | - Zhiwei Liu
- International Peace Maternity and Child Health Hospital of China Welfare Institution, School of Medicine, Shanghai Jiao Tong University, Shanghai 20030, China.
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