Fetal growth at different gestational periods and risk of impaired childhood growth, low childhood weight and obesity: a prospective birth cohort study

OBJECTIVE

To examine the longitudinal associations of fetal growth with adverse child growth outcomes and to assess whether maternal metabolic factors modify the associations.

DESIGN

Prospective cohort study.

SETTING

Born in Guangzhou Cohort Study, China.

POPULATION

A total of 4818 mother-child pairs.

METHODS

Fetal growth was assessed according to estimated fetal weight (EFW) from 22 weeks of gestation until birth and the measurement of the birthweight. Fetal growth Z-scores were computed from random effects in the multilevel linear spline models to represent fetal size in early pregnancy (22 weeks of gestation) and growth in mid-pregnancy (22-27 weeks of gestation), early third trimester (28-36 weeks of gestation) and late third trimester (≥37 weeks of gestation).

MAIN OUTCOME MEASURES

Z-scores for childhood stunting, low weight, overweight or obesity, length/height for age (LAZ/HAZ), weight for age (WAZ) and body mass index for age (BMIZ) at the age of 3 years. Adjusted associations were examined using multiple Poisson or linear regression models.

RESULTS

Increased Z-scores of fetal size in early pregnancy and growth in mid-pregnancy and early third trimester were associated with a higher risk of childhood overweight or obesity (risk ratios 1.25-1.45). Fetal growth in each period was negatively associated with stunting and low weight, with the strongest associations observed for fetal size in early pregnancy and growth in mid-pregnancy. The results for continuous outcomes (LAZ/HAZ, WAZ and BMIZ) were similar. The associations of fetal growth with overweight or obesity in childhood were stronger among mothers who were underweight and who were overweight or obese than among mothers of normal weight.

CONCLUSIONS

Accelerated fetal growth before 37 weeks of gestation is associated with children who are overweight or obese, whereas the critical period for stunting and low weight occurs before 28 weeks of gestation.

TWEETABLE ABSTRACT

Fetal growth during different periods is differentially associated with childhood stunting, underweight and overweight or obesity.

[The efficacy and safety of transbronchial lung cryobiopsy in interstitial lung disease: a prospective study]

Objective: To evaluate the efficacy and safety of transbronchial lung cryobiopsy (TBCB) and conventional transbronchial lung biopsy (TBLB) in the diagnosis of interstitial lung diseases(ILD). Methods: A prospective, self-control study was conducted during January 2017 and April 2017 in First Affiliated Hospital of Guangzhou Medical University. A total of 25 patients [male 16, female 9; mean age (51±13) years, range 24 to 70 years] with inconclusive diagnosis of interstitial lung diseases were sequentially enrolled. In the study, TBCB (TBCB group) and TBLB (TBLB group) were performed successively under general anesthesia in all patients. The size of biopsy specimens, the duration of procedures, complications and pathological results were recorded. Gaussian distribution data were compared between 2 groups by using Student's t test, while abnormal distribution data were compared by using Wilcoxon rank sum test. The incidences of bleeding and pathologic diagnostic yield between the 2 groups were compared by using Pearson chi-square test. A P-value< 0.05 was assumed to be statistically significant. Results: The specimen sizes of TBCB group and TBLB group were (12.3+ 4.9) and (3.1+ 1.9) mm(2) respectively (t=-18.268, P=0.000). The duration of procedures was (7.8±3.2) and (5.4±2.1)min respectively (Z=-3.001, P=0.003). In TBCB group, the diagnostic yield was 72% (18/25), with valuable pathological results in 2 cases (8%), but in 5 cases (20%) it failed to provide valuable pathological results. In TBLB group, the diagnostic yield was 12% (3/25). There were no useful pathological results in other 22 cases. The difference in the rate of useful pathological results between TBCB group and TBLB group was significant (χ(2)=20.779, P=0.000). There was no pneumothorax or severe bleeding. The rate of mild to moderate bleeding in TBCB group and TBLB group was 47.2%(50/106) and 18.9%(20/106) (χ(2)=19.195, P=0.000) respectively. Conclusion: TBCB is superior to TBLB for lung biopsy as indicated by larger sample size, higher diagnostic yield and less complication. TBCB is valuable for the diagnosis of ILD.

Controllable release of salmon-calcitonin in injectable calcium phosphate cement modified by chitosan oligosaccharide and collagen polypeptide

The aim of this research is to study the effect of the controlled releasing character of the salmon calcitonin (S-CT) loaded injectable calcium phosphate cement (CPC) modified by adding organic phase, chitosan oligosaccharide (CO) and collagen polypeptide (CP). The uniform design was used to determine the basic formulation with suitable injectable time for clinical application, and then the changes of the physical characters, the controlled releasing character of the modified CPC along with the ratio of the organic phase were also evaluated in vitro. The surface morphous of the modified CPC been implanted in the abdominal cavity or soaked into the serum of rat was also observed by scanning electron microscope (SEM). The result shows that a suitable formulation of modified CPC could be got, and the injectable time is 12 min, the compressive strength is 12 MPa, and the final setting time is 40 min. Comparing with the CPC without organic phase, the releasing rate of S-CT would increase along with the increase of the organic phase after 7th day. Therefore, a novel S-CT loaded bioactive injectable CPC for treating osteoporosis induced bone defect was obtained, and the release of the containing S-CT was controlled easily through adjusting the ratio of CO and CP.

[No promoting effects of sodium tanshinone II-A sulfonate on growth and metastasis of Lewis carcinoma]

From d 3 after transplantation of Lewis pulmonary carcinoma in C57BL mouse leg muscles, the mice were injected ip sodium tanshinone II-A sulfonate (DS-201) 0.2, 0.4, 6.3, 12.5, 25.0, and 50.0 mg.kg-1 qd x 12 d. At the dose of 12.5 mg.kg-1 or below, the mice appeared to be as vivid as those of the control. In the group of 25 mg.kg-1, declining brisk and unkept appearances were seen. At 50 mg.kg-1, the mice were more emaciated and half of them died. On d 2 of cessation of the medication, all remaining mice were dissected. The weights of muscle tumors and the metastatic foci on lungs in the medicated mice showed no significant differences from their controls. These results demonstrate that DS-201 has no promoting effect both on growth of Lewis carcinoma transplanted in C57BL mouse leg muscles and on lung metastasis of the neoplasm.

[Effects of 10-hydroxycamptothecin on induced chromosome aberrations in Chinese hamster ovary cells and micronuclei in mouse bone marrow and fetal liver]

10-Hydroxycamptothecin (HC) is a new antitumor principle isolated from Camptotheca acuminata indigenous to China. The genetic toxicity of HC was assessed by mouse bone marrow and transplacental micronucleus test as well as Chinese hamster ovary cell chromosomal aberrations. All of these tests showed positive results. The highest rate of chromosomal aberrations was 83% at 0.125 microgram/ml for 48 h. The number of micronucleated polychromatic erythrocytes in bone marrow of mice was remarkably increased in 19.8% cells at 12.5 mg/kg for 24 h. The micronucleus formation was most often seen at 16 h after im HC in fetal liver and 24 h in maternal bone marrow. The peaks were 36 +/- 19 and 31 +/- 10%, respectively. The results from in vivo and in vitro suggest HC is a mutagen, furthermore, a transplacental mutagen in mouse.