Association of periconceptional folate supplements and FOLR1 and FOLR2 gene polymorphisms with risk of congenital heart disease in offspring: A hospital-based case-control study / 中南大学学报(医学版)

OBJECTIVES@#Maternal periconceptional folic acid supplement is by far the most effective primary prevention strategy to reduce the incidence of congenital heart disease (CHD) in offspring. It was revealed that the underlying mechanisms are complex, including a combination of genetic and environmental factors. The purpose of this study is to investigate the association between periconceptional folic acid supplement, the genetic polymorphisms of maternal folic acid receptor 1 gene (FOLR1) and folic acid receptor 2 gene (FOLR2) and the impact of their interaction on the risk of CHD in offspring, and to provide epidemiological evidence for individualized folic acid dosing in hygienic counseling.@*METHODS@#A case-control study on 569 mothers of CHD infants and 652 mothers of health controls was performed. The interesting points were periconceptional folate supplements, single nucleotide polymorphisms (SNPs) of maternal FOLR1 gene and FOLR2 gene.@*RESULTS@#Mothers who took folate in the periconceptional period were observed a decreased risk of CHD [adjusted odds ratio (aOR)=0.58, 95% CI 0.35 to 0.95]. Our study also found that polymorphisms of maternal FOLR1 gene at rs2071010 (G/A vs G/G: aOR=0.67, 95% CI 0.47 to 0.96) and FOLR2 gene at rs514933 (T/C vs T/T: aOR=0.60, 95% CI 0.43 to 0.84; C/C vs T/T: aOR=0.55, 95% CI 0.33 to 0.90; the dominant model: T/C+ C/C vs T/T: aOR=0.59, 95% CI 0.43 to 0.81; and the addictive model: C/C vs T/C vs T/T: aOR=0.70, 95% CI 0.56 to 0.88) were significantly associated with lower risk of CHD [all P<0.05, false discovery rate P value (FDR_P)<0.1]. Besides, significant interaction between periconceptional folate supplements and rs2071010 G→A (aOR=0.59, 95% CI 0.41-0.86) and rs514933 T→C (aOR=0.52, 95% CI 0.37 to 0.74) on CHD risk were observed (all P<0.05, FDR_P<0.1).@*CONCLUSIONS@#Periconceptional folate supplements, polymorphisms of FOLR1 gene and FOLR2 gene and their interactions are significantly associated with risk of CHD. However, more studies in different ethnic populations with a larger sample and prospective designs are required to confirm our findings.

Impact of in vitro fertilization-embryo transfer on adverse pregnancy outcomes: A prospective cohort study / 中南大学学报(医学版)

To evaluate whether the in vitro fertilization-embryo transfer (IVF-ET) procedures could increases the risks of adverse pregnancy outcomes (APOs) in offspring.
 Methods: A hospital-based prospective cohort design was conducted, which contained a control group of singleton pregnancies with indicators of subfertility who were still conceived naturally after using simple medical treatment (e.g. minimal medical intervention or ovulation induction), and an exposure group consisted of singleton pregnancies who had a history of infertility and IVF-ET treatment. All factors different between two groups in the univariate analysis were included in the multivariable logistic regression to evaluate the independent effect of IVF-ET procedures themselves on APOs.
 Results: After controlling for confounding factors by using multivariate logistic regression analysis, our results showed that pregnancies after IVF-ET experienced a higher risk of preterm birth (OR=1.28, 95% CI 1.05 to 1.56), low birth weight (OR=1.69, 95% CI 1.27 to 2.31), perinatal mortality (OR=5.33, 95% CI 2.44 to 11.81), and congenital malformations (OR=1.83, 95% CI 1.12 to 2.94).
 Conclusion: The IVF-ET operational factors may increase the risk of APOs.

Therapeutic effect of one-day outpatient on gestational diabetes mellitus patients / 中南大学学报(医学版)

Objective:To study the effect of one-day outpatient intervention on gestational diabetes mellitus (GDM) patients,and to explore the pregnancy outcome relevant to GDM patients and their fetus.Methods:The GDM patients were divided into two groups according to their own intention to the one-day outpatient.According to systematic sampling method,we chose 200 GDM patients from the above 2 groups,respectively.The 200 GDM patients in the control group were matched the observation group with the age and gestational age,then the pregnancy outcome was tracked.Results:The control level and success rate for the two hours blood sugar after breakfast and hemoglobin A1c (HbA1c) in the observation group were better than those in the control group (P<0.001).The maternal complication rate (46.50%) and neonatal complication rate (21.50%) in the observation group were lower than those in the control group (71.50%,41.50%;P<0.001).The maternal complications rate of fetal distress,premature and the neonatal complications rate of fetal macrosomia,neonatal respiratory distress syndrome (NRDS),low weight,congenital heart disease,neonatal pneumonia,and rate in neonatal NICU were significantly lower than those in the control group (P<0.05).Conclusion:One-day outpatient intervention could control blood sugar effectively,reduce the maternal and neonatal complications.It is worth promoting.

Analysis of mortality among children under 5 years old in Hunan in 2013 / 中南大学学报(医学版)

OBJECTIVE@#To analyze the main causes and characteristics for death among children under 5 years old so as to provide the basis for taking strategic measures for child survival, development, protection.
@*METHODS@#The data of 5 747 dead children, who were under 5 years old in different cities of Hunan Province in 2013, were retrospectively analyzed. Descriptive statistic methods were used to analyze the causes and characteristics of death among the children. Chi-square test was used to analyze the differences of mortality rate.
@*RESULTS@#In 2013, the under-5 mortality rate (U5MR) was 7.00‰. By linear trend chi-square test, the U5MR from 2002 to 2013 showed a tendency toward decrease (P<0.05). Among the death causes, drowning was the major one and it accounted for 13.35% of death, following by congenital heart disease, premature birth or low birth weight, pneumonia and accidental suffocation, with a ratio at 12.65%, 11.66%, 10.82%, and 8.13%, respectively. After chi-square test, there were differences in U5MR in the cities of Hunan Province in 2013 (χ2=163.185, P<0.05).
@*CONCLUSION@#Compared with previous data, the U5MR in 2013 is decreased significantly. There are differences in U5MR in the cities, and there are also difference in U5MR between city and rural area in Hunan Province in 2013. Among the death causes for children under 5 years old in Hunan Province in 2013, drowning is in the major one, and pneumonia is the fourth one.