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Okui T, Nakashima N. Effects of ambient air pollution on the risk of small- and large-for-gestational-age births: an analysis using national birth data in Japan. Int Arch Occup Environ Health 2024; 97:545-555. [PMID: 38602525 DOI: 10.1007/s00420-024-02063-1] [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: 12/27/2023] [Accepted: 03/28/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES Small-for-gestational-age (SGA) and large-for-gestational-age (LGA) births are major adverse birth outcomes related to newborn health. In contrast, the association between ambient air pollution levels and SGA or LGA births has not been investigated in Japan; hence, the purpose of our study is to investigate this association. METHODS We used birth data from Vital Statistics in Japan from 2017 to 2021 and municipality-level data on air pollutants, including nitrogen dioxide (NO2), sulfur dioxide (SO2), photochemical oxidants, and particulate matter 2.5 (PM2.5). Ambient air pollution levels throughout the first, second, and third trimesters, as well as the whole pregnancy, were calculated for each birth. The association between SGA/LGA and ambient levels of the air pollutants was investigated using crude and adjusted log-binomial regression models. In addition, a regression model with spline functions was also used to detect the non-linear association. RESULTS We analyzed data from 2,434,217 births. Adjusted regression analyses revealed statistically significant and positive associations between SGA birth and SO2 level, regardless of the exposure period. Specifically, the risk ratio for average SO2 values throughout the whole pregnancy was 1.014 (95% confidence interval [CI] 1.009, 1.019) per 1 ppb increase. In addition, regression analysis with spline functions indicated that an increase in risk ratio for SGA birth depending on SO2 level was linear. Furthermore, statistically significant and negative associations were observed between LGA birth and SO2 except for the third trimester. CONCLUSIONS It was suggested that ambient level of SO2 during the pregnancy term is a risk factor for SGA birth in Japan.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Maidashi 3-1-1 Higashi-ku, Fukuoka City , Fukuoka prefecture, 812-8582, Japan.
| | - Naoki Nakashima
- Medical Information Center, Kyushu University Hospital, Maidashi 3-1-1 Higashi-ku, Fukuoka City , Fukuoka prefecture, 812-8582, Japan
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Sonaglioni A, Pusca I, Casieri F, Dell'Anna R, Luigi Nicolosi G, Bianchi S, Lombardo M. Echocardiographic assessment of left atrial mechanics in women with hypertensive disorders of pregnancy: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2024; 299:62-70. [PMID: 38838388 DOI: 10.1016/j.ejogrb.2024.05.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 04/27/2024] [Accepted: 05/31/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE The influence of hypertensive disorders of pregnancy (HDP) on left atrial (LA) mechanics assessed by speckle tracking echocardiography (STE) has been poorly investigated. Accordingly, we performed a meta-analysis to summarize the main findings of STE studies who measured LA reservoir (LASr), conduit (LAScd) and contractile (LASct) strain in HDP women. STUDY DESIGN All echocardiographic studies assessing LA strain parameters in HDP women vs. healthy controls, selected from PubMed and EMBASE databases, were included. The risk of bias was assessed by using the National Institutes of Health (NIH) Quality Assessment of Case-Control Studies. Continuous data (LASr, LAScd and LASct) were pooled as standardized mean difference (SMD) comparing HDP group with healthy controls. The overall SMDs of LASr, LAScd and LASct were calculated using the random-effect model. RESULTS The full-texts of 8 studies with 566 HDP women and 420 healthy pregnant women were analyzed. Average LASr (34.3 ± 6.4 vs 42.7 ± 5.3 %, P = 0.01) and LAScd (23.4 ± 6.3 vs 32.5 ± 6.0 %, P < 0.001) were significantly lower in HDP women than controls, whereas LASct (-13.0 ± 5.4 vs -13.7 ± 4.5 %, P = 0.18) was similar in the two groups of women. Substantial heterogeneity was detected among the studies evaluating LASr (I2 = 94.3 %), LAScd (I2 = 64.9 %) and LASct (I2 = 86.4 %). SMDs were large and statistically significant for LASr (-1.70, 95 %CI -2.34,-1.06, P < 0.001) and LAScd (-1.35, 95 %CI -1.69,-1.00, P < 0.001), small and not statistically significant for LASct (-0.11, 95 %CI -0.60,0.39, P = 0.678) assessment. Egger's test gave P-values of 0.10, 0.34 and 0.75 for LASr, LAScd and LASct measurement respectively, indicating no publication bias. On meta-regression analysis, none of the moderators was significantly associated with effect modification for LASr and its components (all P < 0.05). CONCLUSIONS HDPs are independently associated with LASr impairment in pregnancy. STE allows to identify, among HDP women, those who might benefit from a more aggressive antihypertensive treatment and/or a closer clinical follow-up, aimed at reducing the risk of adverse maternal outcome and cardiovascular complications later in life.
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Affiliation(s)
| | - Irene Pusca
- Division of Gynecology and Obstetrics, IRCCS MultiMedica, Milan, Italy
| | - Federica Casieri
- Division of Gynecology and Obstetrics, IRCCS MultiMedica, Milan, Italy
| | - Rebecca Dell'Anna
- Division of Gynecology and Obstetrics, IRCCS MultiMedica, Milan, Italy
| | | | - Stefano Bianchi
- Division of Gynecology and Obstetrics, IRCCS MultiMedica, Milan, Italy
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Damasceno AADA, Matijasevich A, Mosquera PS, Malta MB, Cardoso MA. Hypertensive disorders of pregnancy in Western Brazilian Amazon: Associated factors and neonatal outcomes. Am J Hum Biol 2024; 36:e24026. [PMID: 38041520 DOI: 10.1002/ajhb.24026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 09/27/2023] [Accepted: 11/18/2023] [Indexed: 12/03/2023] Open
Abstract
OBJECTIVE Hypertensive disorders of pregnancy (HDP) are responsible for several maternal and fetal complications. This study investigated the occurrence of HDP, associated factors, and neonatal complications in women living in the Western Brazilian Amazon. METHODS This is a population-based cross-sectional study with 1521 mother-child pairs enrolled in the Maternal and Child Health and Nutrition in Acre birth cohort (MINA-Brazil study). All parturients with HDP (registered in the medical records) were identified. Crude and adjusted prevalence ratios were calculated in Poisson regression models with robust variance. RESULTS The prevalence of HDP was 11.0% (95% CI: 9.5-12.7). Factors associated with the prevalence of HDP were maternal age ≥ 35 years (PR: 1.9; 95% CI: 1.3-3.0), primigravida status (PR: 2.0; 95% CI: 1.5-2.7), pre-pregnancy obesity (PR: 2.7; 95% CI: 1.9-4.0), higher gestational weight gain (highest quartile RP: 2.5; 95% CI: 1.6-3.8), chronic hypertension (RP: 3.6; 95% CI: 2.7-4.9), and diabetes in pregnancy (RP: 1.9; 95% CI: 1.1-3.2). HDP was associated with risk for caesarean delivery (PR: 1.8; 95% CI: 1.6-2.0) and prematurity (PR: 2.0; 95% CI: 1.3-3.2). Gestational malaria was not associated with HDP in Amazonian pregnant women. CONCLUSIONS Evaluating risk factors before pregnancy and during the prenatal period is essential for reducing adverse maternal and neonatal outcomes.
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Affiliation(s)
- Ana Alice de Araújo Damasceno
- Programa de pós-graduação em Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
- Campus Floresta, Universidade Federal do Acre, Cruzeiro do Su, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Paola Soledad Mosquera
- Programa de pós-graduação em Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
| | - Maíra Barreto Malta
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
| | - Marly Augusto Cardoso
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
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Wainwright E, Sheikh I, Qureshi R, Yousuf S, Khan R, Elmes M. Evaluating the effect of maternal non-communicable disease on adverse pregnancy outcomes and birthweight in Pakistan, a facility based retrospective cohort study. Sci Rep 2024; 14:571. [PMID: 38177278 PMCID: PMC10766973 DOI: 10.1038/s41598-023-51122-z] [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: 05/26/2023] [Accepted: 12/31/2023] [Indexed: 01/06/2024] Open
Abstract
Non-communicable diseases (NCDs) claim 74% of global lives, disproportionately affecting lower and middle-income countries like Pakistan. NCDs may increase the risk of preterm birth (PTB), caesarean section (CS), and low birthweight. This study aims to determine whether the high prevalence of NCDs in Pakistan play a role in the high rates of preterm births, and CS. This retrospective cohort study from Aga Khan University Hospital, Pakistan, investigated effects of pre-existing NCDs on pregnancy outcomes of 817 pregnant women. Medical records were used to generate odds ratios for the risk of PTB, labour outcome and birthweight in women with type 1 and type 2 diabetes, hypertension, asthma and thyroid disorders. Multinomial logistic regression and general linear models were used to adjust for confounding variables using IBM SPSS Statistics (v27). Type 2 diabetes significantly increased the risk of PTB and elective CS (both P < 0.05). Elective CS was significantly increased by hypertension and asthma (both, P < 0.05). Surprisingly, asthma halved the risk of PTB (P < 0.05), while type 1 diabetes significantly increased birthweight from 2832 to 3253g (P < 0.001). In conclusion, pre-existing NCDs increase the risk of negative pregnancy outcomes, including PTB, elective CS and birthweight. Asthma, however reduced PTB and justifies further investigation.
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Affiliation(s)
- Esther Wainwright
- Division of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough, LE12 5RD, UK
| | - Irfan Sheikh
- Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
| | - Rahat Qureshi
- Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
| | - Sana Yousuf
- Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan
| | - Raheela Khan
- School of Medicine, Royal Derby Hospital Centre, University of Nottingham, Translational Medical Sciences Unit, Derby, DE22 3DT, UK
| | - Matthew Elmes
- Division of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Loughborough, LE12 5RD, UK.
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5
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Pan HY, Wang TD. The association of a panel of circulating markers with hypertensive disorders of pregnancy: the jury is still out. Hypertens Res 2023; 46:2759-2761. [PMID: 37821567 DOI: 10.1038/s41440-023-01445-1] [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: 07/08/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 10/13/2023]
Abstract
Comparison between using either sFlt-1/PlGF ratio or proposed panel of biomarkers. The latter is proposed by using statistical and machine learning methods. The levels of both sFlt-1 and PlGF are measured in pg/mL. sFlt-1 soluble fms-like tyrosine kinase-1, PlGF placental growth factor, PPV positive predictive value, NPV negative predictive value.
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Affiliation(s)
- Heng-Yu Pan
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu City, Taiwan
| | - Tzung-Dau Wang
- Divisions of Cardiology and Hospital Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
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Pi Z, Chen Y, Nie Z, Peng J, Jiang Z. Association between pre-pregnancy body mass index and the risk of preterm birth: a mediating effect of hypertensive disorders of pregnancy. J Matern Fetal Neonatal Med 2023; 36:2224489. [PMID: 37365012 DOI: 10.1080/14767058.2023.2224489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/29/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE We aim to explore the mediating effect of hypertensive disorders of pregnancy (HDP) on the relationship between pre-pregnancy body mass index (BMI) and the risk of preterm birth (PTB) in women with singleton live births. METHODS Demographic and clinical data of 3,249,159 women with singleton live births were extracted from the National Vital Statistics System (NVSS) database in this retrospective cohort study. The associations between pre-pregnancy BMI and HDP, HDP, and PTB, and pre-pregnancy BMI and PTB were evaluated using univariate and multivariate logistic regression analyses, with odds ratios (ORs) and 95% confidence intervals (CIs). Structural equation modeling (SEM) was used to explore the mediating effect of HDP on the relationship between pre-pregnancy BMI and PTB. RESULTS In total, 324,627 women (9.99%) had PTB. After adjustment for covariables, there were significant associations between pre-pregnancy BMI and HDP [OR = 2.07, 95% CI: 2.05-2.09)], HDP and PTB [OR = 2.54, 95% CI: (2.52-2.57)], and pre-pregnancy BMI and PTB [OR = 1.03, 95% CI: 1.02-1.03)]. The effect of pre-pregnancy BMI on PTB was significantly mediated by HDP with a mediation proportion of 63.62%, especially in women of different ages and having gestational diabetes mellitus (GDM) or not. CONCLUSION HDP may play a mediating role in the effect of pre-pregnancy BMI on PTB risk. Women preparing for pregnancy should pay close attention to BMI, and pregnant women should monitor and develop interventions for HDP to reduce the risk of PTB.
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Affiliation(s)
- Zixin Pi
- Department of Obstetrics and Gynecology, The First People's Hospital of Jiangxia District, Wuhan City. Union Jiangnan Hospital Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Yinghui Chen
- Department of Obstetrics and Gynecology, Central People's Hospital of Zhanjiang, Zhanjiang, Guangdong, P.R. China
| | - Zhimin Nie
- Department of Science and Education, The First People's Hospital of Jiangxia District, Wuhan City. Union Jiangnan Hospital Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Jing Peng
- Department of Obstetrics and Gynecology, The First People's Hospital of Jiangxia District, Wuhan City. Union Jiangnan Hospital Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Zhaoyang Jiang
- Department of Obstetrics and Gynecology, Shenzhen Maternity &Child Healthcare Hospital, Shenzhen, Guangdong, P.R. China
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Morisaki N, Obara T, Piedvache A, Kobayashi S, Miyashita C, Nishimura T, Ishikuro M, Sata F, Horikawa R, Mori C, Metoki H, Tsuchiya KJ, Kuriyama S, Kishi R. Association Between Smoking and Hypertension in Pregnancy Among Japanese Women: A Meta-analysis of Birth Cohort Studies in the Japan Birth Cohort Consortium (JBiCC) and JECS. J Epidemiol 2023; 33:498-507. [PMID: 35934789 PMCID: PMC10483100 DOI: 10.2188/jea.je20220076] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/25/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Recent literature suggest the effect of maternal smoking on risk of hypertensive disorders in pregnancy (HDP) and preeclampsia may differ by ethnicity; however, studies on Asians are limited. METHODS We investigated the association of maternal smoking with HDP and preeclampsia using a common analysis protocol to analyze the association in six birth cohorts participating in a Japanese consortium of birth cohorts (JBiCC). Results were compared with-published results from cohorts not included in this consortium, and, where possible, we produced a meta-analysis including these studies. RESULTS Meta-analysis of four cohort studies including 28,219 participants produced an odds ratio (OR) of 1.24 (95% confidence interval [CI], 0.88-1.87) for the effect of smoking beyond early pregnancy compared to women who did not smoke during pregnancy. These results combined with those from the Japan Environment and Children's Study (JECS) yielded an OR of 1.19 (95% CI, 1.00-1.43, P = 0.056). Meta-analysis results for categories of smoking volume were insignificant, but when combined with JECS yielded an OR of 0.86 (95% CI, 0.65-1.12) for smoking 1-4 cigarettes, 1.25 (95% CI, 0.98-1.60) for smoking 5-9 cigarettes, and 1.27 (95% CI, 1.04-1.54) for smoking 10 or more cigarettes per day. All effects were insignificant for preeclampsia. CONCLUSION Our results suggest that the protective effects of smoking longer and smoking more on HDP and preeclampsia repeatedly observed among Europeans and North Americans likely do not hold for the Japanese.
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Affiliation(s)
- Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Aurelie Piedvache
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Sumitaka Kobayashi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Tomoko Nishimura
- Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | | | - Reiko Horikawa
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
| | - Chisato Mori
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Japan
| | - Kenji J Tsuchiya
- Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
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Huang B, Wang Y, Jiang Y, Lv H, Jiang T, Qiu Y, Lu Q, Du J, Lin Y, Ma H. Association of maternal hypertensive disorders in pregnancy with infant neurodevelopment. J Biomed Res 2023; 37:479-491. [PMID: 37767602 PMCID: PMC10687531 DOI: 10.7555/jbr.37.20230074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/14/2023] [Accepted: 05/19/2023] [Indexed: 09/29/2023] Open
Abstract
Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, we re-visited such associations in one-year-old infants from 2576 singleton pregnancies and 261 twin pregnancies. We first assessed infant neurodevelopment by the Bayley Scales of Infant and Toddler Development Screening Test (the Third Edition), and then estimated its association with maternal HDP using general linear regression models and Poisson regression models. In singleton pregnancies, compared with mothers unexposed to HDP, infants born to mothers with chronic hypertension exhibited a lower score ( β, -0.67; 95% confidence interval [CI], -1.19--0.15) and a higher risk of "non-optimal" gross motor development (risk ratio [RR], 2.21; 95% CI, 1.02-4.79); in twin pregnancies, infants born to mothers with HDP exhibited lower scores in cognition ( β, -0.49; 95% CI, -0.96--0.01), receptive communication ( β, -0.55; 95% CI, -1.03--0.06), and gross motor ( β, -0.44; 95% CI, -0.86--0.03), and at a higher risk of "non-optimal" gross motor development (RR, 2.12; 95% CI, 1.16-3.88). These findings indicate that infants born to mothers with HDP may have inferior neurodevelopment outcomes at the age of one year.
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Affiliation(s)
- Bo Huang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Yifan Wang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Yangqian Jiang
- Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Hong Lv
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- State Key Laboratory of Reproductive Medicine (Suzhou Centre), the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu 215002, China
| | - Tao Jiang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Yun Qiu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- State Key Laboratory of Reproductive Medicine (Suzhou Centre), the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu 215002, China
| | - Qun Lu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Jiangbo Du
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- State Key Laboratory of Reproductive Medicine (Suzhou Centre), the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu 215002, China
| | - Yuan Lin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- State Key Laboratory of Reproductive Medicine (Suzhou Centre), the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu 215002, China
| | - Hongxia Ma
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
- State Key Laboratory of Reproductive Medicine (Suzhou Centre), the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu 215002, China
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9
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Aizawa M, Murakami K, Takahashi I, Onuma T, Noda A, Ueno F, Matsuzaki F, Ishikuro M, Obara T, Hamada H, Iwama N, Saito M, Sugawara J, Yaegashi N, Kuriyama S. Association between frequency of breakfast intake before and during pregnancy and infant birth weight: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. BMC Pregnancy Childbirth 2023; 23:268. [PMID: 37076802 PMCID: PMC10114420 DOI: 10.1186/s12884-023-05603-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 04/12/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Low birth weight is associated with an increased risk of developing chronic diseases in adulthood, with a particularly high incidence in Japan among developed countries. Maternal undernutrition is a risk factor for low birth weight, but the association between the timing of food intake and infant birth weight has not been investigated. This study aimed to examine the association between breakfast intake frequency among Japanese pregnant women and infant birth weight. METHODS Of all pregnant women who participated in the Tohoku Medical Megabank Project Three Generation Cohort Study, 16,820 who answered the required questions were included in the analysis. The frequency of breakfast intake from pre- to early pregnancy and from early to mid-pregnancy was classified into four groups: every day and 5-6, 3-4, and 0-2 times/week. Multivariate linear regression models were constructed to examine the association between breakfast intake frequency among pregnant women and infant birth weight. RESULTS The percentage of pregnant women who consumed breakfast daily was 74% in the pre- to early pregnancy period and 79% in the early to mid-pregnancy period. The average infant birth weight was 3,071 g. Compared to women who had breakfast daily from pre- to early pregnancy, those who had breakfast 0-2 times/week had lower infant birth weight (β = -38.2, 95% confidence interval [CI]: -56.5, -20.0). Similarly, compared to women who had breakfast daily from early to mid-pregnancy, those who had breakfast 0-2 times/week had lower infant birth weight (β = -41.5, 95% CI: -63.3, -19.6). CONCLUSIONS Less frequent breakfast intake before and mid-pregnancy was associated with lower infant birth weight.
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Affiliation(s)
- Misato Aizawa
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Keiko Murakami
- Graduate School of Medicine, Tohoku University, Sendai, Japan.
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573, Japan.
| | - Ippei Takahashi
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Tomomi Onuma
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573, Japan
| | - Aoi Noda
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Fumihiko Ueno
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573, Japan
| | - Fumiko Matsuzaki
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573, Japan
| | - Mami Ishikuro
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573, Japan
| | - Taku Obara
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Hirotaka Hamada
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan
| | - Noriyuki Iwama
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573, Japan
- Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan
| | - Masatoshi Saito
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan
| | - Junichi Sugawara
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573, Japan
- Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan
- Suzuki Memorial Hospital, Iwanuma, Japan
| | - Nobuo Yaegashi
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573, Japan
- Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan
| | - Shinichi Kuriyama
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8573, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
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10
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Yang Y, Xie Y, Li M, Mu Y, Chen P, Liu Z, Wang Y, Li Q, Li X, Dai L, Liang J, Zhu J. Characteristics and fetal outcomes of pregnant women with hypertensive disorders in China: a 9-year national hospital-based cohort study. BMC Pregnancy Childbirth 2022; 22:924. [PMID: 36482386 PMCID: PMC9733350 DOI: 10.1186/s12884-022-05260-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hypertensive disorders of pregnancy (HDP) are a growing concern and a challenge for maternity care providers as the prevalence of hypertension continues to increase. However, optimal management of HDP is unclear. Therefore, we aimed to explore the differences in adverse fetal outcomes among women with different subtypes of HDP and different blood pressure (BP) levels, to provide evidence-based management of HDP. METHODS We obtained data from China's National Maternal Near-Miss Surveillance System from 2012 to 2020. Associations between BP management and adverse fetal outcomes, stratified by the four subtypes of HDP, were assessed using logistic regression analysis with a robust variance estimator. RESULTS For the period, a total of 393,353 pregnant women with HDP were included in the study; 8.51% had chronic hypertension, 2.27% had superimposed preeclampsia, 50.17% had preeclampsia or eclampsia, and 39.04% had gestational hypertension. The BP levels at delivery admission were mostly (61.14%) of non-severe stage 2 (systolic BP 140-159 mm Hg and/or diastolic BP 90-109 mm Hg) hypertension by American Heart Association classification. A high rate of adverse fetal outcomes was observed among women with HDP, especially among those aged < 20 or > 35 y or those diagnosed with superimposed preeclampsia. Compared with those with normal BP levels at delivery admission, we found an upward curve with increased risk among pregnant women with more severe BP levels, including the risk of preterm birth and small for gestational age (SGA) fetus. The odds ratios (ORs) of stillbirth, neonatal death, and low Apgar scores associated with severe stage 2 hypertension increased significantly. In addition, the association between BP at admission and fetal outcomes differed among women with varying HDP subtypes. Pregnant women with preeclampsia or eclampsia had an increased risk for preterm birth (adjusted OR [aOR], 1.33 [95% confidence interval {CI}, 1.07 ~ 1.65]) and SGA (aOR, 1.37 [95% CI, 1.10 ~ 1.71]) even when the admission BP was at stage 1 level. CONCLUSION Greater attention should be paid to cases involving preeclampsia superimposed on chronic hypertension and pregnant women aged < 20 or > 35 y to mitigate the burden of adverse fetal outcomes caused by HDP.
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Affiliation(s)
- Yi Yang
- grid.13291.380000 0001 0807 1581Department of obstetrics and gynecology intensive care unit Nursing, West China Second University Hospital, West China School of Nursing, Sichuan University, Ren Min South Road Section 3 No.17, Sichuan Chengdu, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Ren Min South Road Section 3 No.17, Sichuan Chengdu, China
| | - Yanxia Xie
- grid.461863.e0000 0004 1757 9397National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu Sichuan, China
| | - Mingrong Li
- grid.461863.e0000 0004 1757 9397National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu Sichuan, China
| | - Yi Mu
- grid.461863.e0000 0004 1757 9397National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu Sichuan, China
| | - Peiran Chen
- grid.461863.e0000 0004 1757 9397National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu Sichuan, China
| | - Zheng Liu
- grid.461863.e0000 0004 1757 9397National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu Sichuan, China
| | - Yanping Wang
- grid.461863.e0000 0004 1757 9397National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu Sichuan, China ,grid.461863.e0000 0004 1757 9397Department of Pediatric, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China, Sichuan Chengdu, China
| | - Qi Li
- grid.461863.e0000 0004 1757 9397National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu Sichuan, China
| | - Xiaohong Li
- grid.461863.e0000 0004 1757 9397National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu Sichuan, China
| | - Li Dai
- grid.461863.e0000 0004 1757 9397National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu Sichuan, China ,grid.13291.380000 0001 0807 1581Medical Big Data Center, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China, Sichuan Chengdu, China
| | - Juan Liang
- grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Ren Min South Road Section 3 No.17, Sichuan Chengdu, China ,grid.461863.e0000 0004 1757 9397National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu Sichuan, China
| | - Jun Zhu
- grid.461863.e0000 0004 1757 9397National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu Sichuan, China ,grid.461863.e0000 0004 1757 9397Department of Obstetrics, West China Second University Hospital, Sichuan University, Ren Min South Road Section 3 No.17, Chengdu, Sichuan, China, Sichuan Chengdu, China
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11
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Trends in antihypertensive prescription for pregnant women with hypertension and their peripartum outcomes before and after label and guideline revisions in Japan. Hypertens Res 2022; 45:1823-1831. [DOI: 10.1038/s41440-022-01018-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 07/20/2022] [Accepted: 08/13/2022] [Indexed: 11/08/2022]
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12
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Hypertensive disorders of pregnancy: definition, management, and out-of-office blood pressure measurement. Hypertens Res 2022; 45:1298-1309. [PMID: 35726086 PMCID: PMC9207424 DOI: 10.1038/s41440-022-00965-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/11/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022]
Abstract
Hypertensive disorders of pregnancy increase the risk of adverse maternal and fetal outcomes. In 2018, the Japanese classification of hypertensive disorders of pregnancy was standardized with those of other countries, and a hypertensive disorder of pregnancy was considered to be present if hypertension existed during pregnancy and up to 12 weeks after delivery. Strategies for the prevention of hypertensive disorders of pregnancy have become much clearer, but further research is needed on appropriate subjects and methods of administration, and these have not been clarified in Japan. Although guidelines for the use of antihypertensive drugs are also being studied and standardized with those of other countries, the use of calcium antagonists before 20 weeks of gestation is still contraindicated in Japan because of the safety concerns that were raised regarding possible fetal anomalies associated with their use at the time of their market launch. Chronic hypertension is now included in the definition of hypertensive disorders of pregnancy, and blood pressure measurement is a fundamental component of the diagnosis of hypertensive disorders of pregnancy. Out-of-office blood pressure measurements, including ambulatory and home blood pressure measurements, are important for pregnant and nonpregnant women. Although conditions such as white-coat hypertension and masked hypertension have been reported, determining their occurrence in pregnancy is complicated by the gestational week. This narrative review focused on recent reports on hypertensive disorders of pregnancy, including those related to blood pressure measurement and classification. ![]()
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13
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Liau ZQG, Wang Y, Lin HY, Cheong CK, Gupta S, Hui JHP. Orthopedic concerns of a child with short stature. Curr Opin Pediatr 2022; 34:82-91. [PMID: 34840250 DOI: 10.1097/mop.0000000000001081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW Pediatric short stature poses severe concerns to the patient, parents, and physicians. Management for pediatric short stature is still widely debated due to heterogenous etiological factors and treatment options. This review will address the approach to pediatric short stature, commonly within the subset of skeletal dysplasia resulting in disproportionate short stature. The following will be discussed: the etiology, clinical, and radiological evaluations, and management for pediatric short stature. RECENT FINDINGS Early recognition of short stature and appropriate referrals is shown to benefit the patient and reduce parental concern. A multidisciplinary team, comprising an orthopedic surgeon, is fundamental to provide holistic care and ensure overall good quality of life. Advancements in clinical diagnostic tools and diversified treatment modalities today provides optimism in managing pediatric short stature. SUMMARY Skeletal dysplasia can be treated with good prognosis if diagnosed and managed early. Thorough clinical, radiological, laboratory, and even genetic investigations are important to differentiate and manage various types of skeletal dysplasia. Our review will provide a comprehensive and up-to-date approach to skeletal dysplasia for pediatric orthopedic surgeons, and indications for physicians to refer patients with suspected short stature to pediatric orthopedic surgeons.
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Affiliation(s)
- Zi Qiang Glen Liau
- University Orthopaedic, Hand and Reconstructive Microsurgery Cluster
- Department of Orthopaedic Surgery, National University Health System
| | - Yuhang Wang
- National University of Singapore, Yong Loo Lin School of Medicine, Singapore
| | - Hong-Yi Lin
- National University of Singapore, Yong Loo Lin School of Medicine, Singapore
| | - Chin Kai Cheong
- National University of Singapore, Yong Loo Lin School of Medicine, Singapore
| | - Shobhit Gupta
- University Orthopaedic, Hand and Reconstructive Microsurgery Cluster
- Department of Orthopaedic Surgery, National University Health System
| | - James Hoi Po Hui
- University Orthopaedic, Hand and Reconstructive Microsurgery Cluster
- Department of Orthopaedic Surgery, National University Health System
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14
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Hypertensive Disorders during Pregnancy and Anthropometric Measurement of Children up to 7 Years of Age: The Hokkaido Birth Cohort Study in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010951. [PMID: 34682697 PMCID: PMC8536157 DOI: 10.3390/ijerph182010951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/22/2021] [Accepted: 10/15/2021] [Indexed: 12/17/2022]
Abstract
Hypertensive disorders during pregnancy (HDP) increase the risk of offspring with a low birth weight, preterm birth and small-for-gestational age; however, evidence of the anthropometric measurements during early childhood remains limited. We aimed to understand the associations between maternal HDP and anthropometric measurements of children aged up to seven years in a Japanese cohort. In total, 20,926 mother–infant pairs participated in the Hokkaido Study on Environment and Children’s Health, Japan, from 2002 to 2013. Medical reports were used to confirm HDP exposure, while weight, height, height z score, and weight z score were the outcomes. The prevalence of HDP in the study population was 1.7%. The birth height of male children born to HDP mothers was smaller as compared to those born to non-HDP mothers. When adjusted with covariates, the linear regressions showed significant changes in birth weight (β: −79.3; 95% confidence interval [CI]: −154.8, −3.8), birth height (−0.67; 95% CI: −1.07, −0.26), weight at seven years (1.21; 95% CI: 0.13, 2.29), and weight gain between four and seven years (1.12; 95% CI: 0.28, 1.96) of male children exposed to HDP. Differences were more significant in male children than female. Our study showed that despite low birth weight, male children exposed to HDP caught up with their growth and gained more weight by seven years of age compared with male children not exposed to HDP, whereas no such differences were observed in female children; however, this finding requires replication.
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15
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Kishi R, Ikeda-Araki A, Miyashita C, Itoh S, Kobayashi S, Ait Bamai Y, Yamazaki K, Tamura N, Minatoya M, Ketema RM, Poudel K, Miura R, Masuda H, Itoh M, Yamaguchi T, Fukunaga H, Ito K, Goudarzi H. Hokkaido birth cohort study on environment and children's health: cohort profile 2021. Environ Health Prev Med 2021; 26:59. [PMID: 34022817 PMCID: PMC8141139 DOI: 10.1186/s12199-021-00980-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 05/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The Hokkaido Study on Environment and Children's Health is an ongoing study consisting of two birth cohorts of different population sizes: the Sapporo cohort and the Hokkaido cohort. Our primary objectives are to (1) examine the effects that low-level environmental chemical exposures have on birth outcomes, including birth defects and growth retardation; (2) follow the development of allergies, infectious diseases, and neurobehavioral developmental disorders, as well as perform a longitudinal observation of child development; (3) identify high-risk groups based on genetic susceptibility to environmental chemicals; and (4) identify the additive effects of various chemicals, including tobacco. METHODS The purpose of this report is to provide an update on the progress of the Hokkaido Study, summarize recent results, and suggest future directions. In particular, this report provides the latest details from questionnaire surveys, face-to-face examinations, and a collection of biological specimens from children and measurements of their chemical exposures. RESULTS The latest findings indicate different risk factors of parental characteristics on birth outcomes and the mediating effect between socioeconomic status and children that are small for the gestational age. Maternal serum folate was not associated with birth defects. Prenatal chemical exposure and smoking were associated with birth size and growth, as well as cord blood biomarkers, such as adiponectin, leptin, thyroid, and reproductive hormones. We also found significant associations between the chemical levels and neuro development, asthma, and allergies. CONCLUSIONS Chemical exposure to children can occur both before and after birth. Longer follow-up for children is crucial in birth cohort studies to reinforce the Developmental Origins of Health and Disease hypothesis. In contrast, considering shifts in the exposure levels due to regulation is also essential, which may also change the association to health outcomes. This study found that individual susceptibility to adverse health effects depends on the genotype. Epigenome modification of DNA methylation was also discovered, indicating the necessity of examining molecular biology perspectives. International collaborations can add a new dimension to the current knowledge and provide novel discoveries in the future.
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Affiliation(s)
- Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan. .,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan.
| | - Atsuko Ikeda-Araki
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan.,Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan
| | - Sumitaka Kobayashi
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan
| | - Yu Ait Bamai
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan
| | - Keiko Yamazaki
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan
| | - Naomi Tamura
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan
| | - Machiko Minatoya
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan
| | - Rahel Mesfin Ketema
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Kritika Poudel
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan.,Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Ryu Miura
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan
| | - Hideyuki Masuda
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan
| | - Mariko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan
| | - Takeshi Yamaguchi
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan
| | - Hisanori Fukunaga
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan.,WHO Collaborating Centre for Environmental Health and Prevention of Chemical Hazards, Sapporo, Japan
| | - Kumiko Ito
- Center for Environmental and Health Sciences, Hokkaido University, Kita 12, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-0812, Japan
| | - Houman Goudarzi
- Faculty of Medicine and Graduate School of Medicine, Center for Medical Education and International Relations, Hokkaido University, Sapporo, Japan
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