The association of pre-pregnancy body mass and weight gain during pregnancy with macrosomia: a cohort study / 中华预防医学杂志

Objective@#To examine the association of pre-pregnancy body mass and weight gain during pregnancy with macrosomia. @*Methods@#From January 2015 to December 2015, a total of 20 477 pregnant women were recruited by probabilistic proportional scale sampling with simple randomization in Sichuan, Yunnan and Guizhou Provinces. Basic information of pregnant women, weight gain during pregnancy and weight of newborn were collected. A multiple logistic regression model was used to assess the association between the pre-pregnancy body mass and gestational weight gain indicators with macrosomia. @*Results@#20 321 mother-infant were included in the final analysis. 20 321 pregnant women were (30.09±4.10) years old and delivered at (39.20±1.29) weeks, among which 12 341 (60.73%) cases were cesarean delivery. The birth weight of 20 321 infants were (3 292.26±431.67) grams, and 970 (4.77%) were macrosomia. The multiple logistic regression model showed that after adjusting for the age of women, compared to the normal weight group in the pre-pregnancy, the overweight and obesity group elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI: 1.69−2.35) and 4.05 (95%CI: 3.05−5.39), respectively. After adjusting for the age, the pre-pregnancy BMI, delivery weeks, delivery mode and infant′s gender, compared to the weight-gain appropriate group, higher weight gain rate in the mid-pregnancy and excessive total gestational weight gain elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI: 1.66−2.39) and 1.80 (95%CI: 1.55−2.08), respectively. @*Conclusion@#The overweight before pregnancy, obesity before pregnancy, the rate of weight gain in the second trimester and the high total weight gain during pregnancy could increase the risk of macrosomia.

Relations between pregestational body mass index, gestational weight gain and birth weight of neonates among women in the Southwest areas of China: A prospective cohort study / 中华流行病学杂志

Objective To explore the effects of both pre-gestational BMI and gestational weight gain (GWG) on the birth weight of neonates.Methods A total of 5 395 pregnant women were selected from the Southwest areas of China (Sichuan/Yunnan/Guizhou) and were divided into groups as pre-gestational underweight,normal weight,overweight and obesity,according to the WHO Recommendation on BMI Classification.Guidelines on Pregnancy weight were adopted from the Institute of Medicine to confirm the accuracy of GWG.Multinomial logistic regression model was used to assess the associations between pregestational BMI and GWG,on the birth weight of the neonates.Results After adjusting for related confounders,low pre-gestational BMI appeared as a risk factor for SGA (OR=1.91,95％CI:1.47-2.50),and was also associated with the decreased risk of LGA (OR=0.55,95％CI:0.47-0.66).Inadequate GWG was both associated with the increased risk of delivering SGA (OR=1.57,95％CI:1.21-2.03) and the decreased risk of LGA (OR=0.48,95％CI:0.41-0.57).Pre-gestational overweight/obesity (OR=1.85,95％CI:1.58-2.17) and excessive GWG (OR=1.87,95％CI:1.67-2.11) were both positively associated with the risks on LGA.Data from the stratified analysis indicated that inadequate GWG was positively associated with the risk of SGA among underweight or normal weight women (all P＜0.05),but not with those overweight/obese women.Conclusions Pre-gestational BMI and GWG were important influencing factors on the birth weight of neonates.Health education programs for pregnant women should be intensified and gestational weight gain should also be reasonably under control.

Relations between pregestational body mass index, gestational weight gain and birth weight of neonates among women in the Southwest areas of China: A prospective cohort study / 中华流行病学杂志

Objective To explore the effects of both pre-gestational BMI and gestational weight gain (GWG) on the birth weight of neonates.Methods A total of 5 395 pregnant women were selected from the Southwest areas of China (Sichuan/Yunnan/Guizhou) and were divided into groups as pre-gestational underweight,normal weight,overweight and obesity,according to the WHO Recommendation on BMI Classification.Guidelines on Pregnancy weight were adopted from the Institute of Medicine to confirm the accuracy of GWG.Multinomial logistic regression model was used to assess the associations between pregestational BMI and GWG,on the birth weight of the neonates.Results After adjusting for related confounders,low pre-gestational BMI appeared as a risk factor for SGA (OR=1.91,95％CI:1.47-2.50),and was also associated with the decreased risk of LGA (OR=0.55,95％CI:0.47-0.66).Inadequate GWG was both associated with the increased risk of delivering SGA (OR=1.57,95％CI:1.21-2.03) and the decreased risk of LGA (OR=0.48,95％CI:0.41-0.57).Pre-gestational overweight/obesity (OR=1.85,95％CI:1.58-2.17) and excessive GWG (OR=1.87,95％CI:1.67-2.11) were both positively associated with the risks on LGA.Data from the stratified analysis indicated that inadequate GWG was positively associated with the risk of SGA among underweight or normal weight women (all P＜0.05),but not with those overweight/obese women.Conclusions Pre-gestational BMI and GWG were important influencing factors on the birth weight of neonates.Health education programs for pregnant women should be intensified and gestational weight gain should also be reasonably under control.

Correlation between sleep lasting time and blood glucose control in patients with gestational diabetes mellitus / 重庆医学

Objective To investigate the relationship between sleep status and blood glucose control in the patients withgestational diabetes mellitus (GDM).Methods The pregnant women and parturients clinically newly diagnosed as GDM without starting insulin or glibenclamide treatment were included in this study.The subjects were instructed to correctly use the glucometer and comply with the GDM dietary principles.All subjects recorded the sleep log for consecutive 7 d,including the time going to bed and wake time.The linear mixed model was used to analyze the relationship between the sleep lasting time with morning fasting blood glucose and postprandial 1 h blood glucose level.Results The complete sleep logs of consecutive 7 d and blood glucose detection values were finally collected from 65 subjects.The sleep duration shortening had significantly negative correlation with fasting and postprandial 1 h bloodglucose levels.After adjusting age,gestational age and BMI,every increase 1 h of sleep lasting time,the fasting blood glucose level was significantly decreased,there was significant correlation between them[-2.13 mg/dL,95 ％CI(3.98,-0.20)],meanwhile postprandial glucose level was also decreased,they were significant correlation as well[lunch-4,62 mg/dL,95％CI (-8.75,-0.50) vs.dinner-6.07 mg/dL,95％CI(-9.40,-2.73)].Conclusion The sleep lasting time shortening is closely correlated with poor glucose control in the patients with GDM.Informing GDM patients the importance of sufficient sleep,meanwhile early finding and treating the patients with existing sleep disorder can optimize their blood glucose control level.

Clinical analysis of 19 pregnancies complicated listeriosis / 中华妇产科杂志

Objective To analyze the clinical characteristics and perinatal outcomes of listeriosis during pregnancy. Methods From July 2010 to April 2017, 70 131 women delivered in West China Second University Hospital.Nineteen cases were confirmed as listeriosis.The clinical symptoms,laboratory results,pathogens,placenta pathology and perinatal outcomes were analyzed retrospectively. Results The median age of the 19 cases was 29.7 (19.0-42.0) years old. The median time before diagnosis was 4.8 (0.5-19.0) days. The main clinical symptoms at first visits were high fever (17/19), increased white blood cells (18/19), abdominal pain (12/19). Listeria was found in samples of mother′s blood (11/19), vaginal secretions(15/19),placenta(1/19),neonatal blood(4/19),neonatal phlegm(5/19)and neonatal ear secretions (1/19),respectively.Inflammation of placenta was identified in all 19 cases.Among the 19 cases,1 was gradeⅠ chorioamnionitis,4 was grade Ⅱ,5 was grade Ⅲand 9 was grade Ⅵ. Only 4 newborn survived after therapy,and others suffered perinatal death,including 8 cases of intrauterine death,3 cases of miscarriage and 6 cases of treatment failure. Conclusions Listeriosis has characteristics of acute onset, quick development and high morbidity during pregnancy. The empiric use of antibiotics might not cover listeria. The understanding of listeriosis should be improved.

Association of prostasin gene rs12597511 polymorphism with outcomes of pregnancy with severe preeclampsia / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association of prostasin gene rs12597511 polymorphism with clinical features and pregnancy outcomes among patients with severe preeclampsia.</p><p><b>METHODS</b>Clinical manifestations, pregnancy outcomes and the genotypes of 179 patients with severe preeclampsia [early-onset group (≤34 gestational weeks): 79 cases; Late-onset group (>34 gestational weeks): 100 cases] and 222 normal-term pregnant women (control group) were collected.</p><p><b>RESULTS</b>In the early-onset group, the patients with TC or CC genotype at rs12597511 had higher incidences of total complications, liver dysfunction, neonatal asphyxia, neonatal intracranial hemorrhage and perinatal mortality compared with those with TT genotype (P>0.05). Multiple logistic regression analysis showed that the complication rates of severe preeclampsia patients are closely related to TC or CC genotypes, 24 h urinary protein and gestational weeks of onset (OR=1.049, 95% CI:1.007-1.093, P=0.021; OR=1.031, 95% CI: 0.350-0.883, P=0.013; OR=0.733, 95% CI: 0.566-0.950, P=0.019), and the perinatal mortality is related to gestational weeks at delivery (OR=0.542, 95% CI: 0.331-0.887, P=0.015).</p><p><b>CONCLUSION</b>Polymorphism of the prostasin gene is closely associated with poor pregnancy outcomes of early-onset severe preeclampsia.</p>

Prostasin gene polymorphism at rs12597511 is associated with severe preeclampsia in Chinese Han women / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Preeclampsia, characterized by hypertension and proteinuria, is a multifactorial disease associated with shallow invasion of trophoblast cells and inadequate spiral artery remodeling. Trophoblast and tumor cells have similar invasion mechanism. Prostasin is closely related to tumor development, invasion and metastasis and influences blood pressure through activating epithelial sodium channel. The effect of prostasin on the pathogenesis of preeclampsia remains unclear. This study investigated the association of prostasin gene at rs12597511 with severe preeclampsia.</p><p><b>METHODS</b>A single nucleotide polymorphism, rs12597511, was tested with polymerase chain reaction and restrictionfragment length polymorphism analyses in 179 severe preeclampsia patients and 222 normal pregnant women.</p><p><b>RESULTS</b>The frequencies of TC + CC genotypes were significantly higher in severe preeclampsia group compared with in control group (the adjusted odds ratio was 2.030, 95% confidence interval 1.195-3.449, P = 0.009). The C allele of rs12597511 was present significantly more often among women with severe preeclampsia (P = 0.001). Genotyping analysis showed that the C allele of rs12597511 could confer a risk for severe preeclampsia.</p><p><b>CONCLUSION</b>The higher frequency of C allele of prostasin gene at rs12597511 is associated with severe preeclampsia.</p>

Association between osteoprotegerin gene polymorphisms and severe pre-eclampsia in Chinese women / 中华妇产科杂志

Objective To investigate the potential association between 163A/G and 950T/C polymorphisms of osteoprotegerin(OPG)gene and severe pre-eclampsia.Methods Eighty-five severe preeclamptic patients and 81 normal term pregnant women(as control group)were recruited from the Department of Obstetrics and Gynecology,West China Second University Hospital,Sichuan University during the period from July 2007 to March 2009,and they were all Han population living in Chengdu,China.Genotype and allele frequencies of 163A/G and 950T/C were determined by the PCR-restriction fragment length polymorphism(RFLP)assay.Clinical and biochemical parameters for different alleles between the patients and controls were compared for statistical significance respectively,such as blood pressure,serum creatinine and 24-hour urine protein.Results The observed and expected genotype counts were consistent with Hardy-Weinberg equilibrium.No significant differences were found in the genotype and allele frequencies of 163A/G and 950T/C polymorphisms between the two groups(P ＞ 0.05).However,in the preeclamptic group,serum creatinine was significantly higher in women with the AG + GG genotypes [(76 ±24)μmol/L]compared with AA genotype[(56 ± 18)μmol/L].Reversely,birth weight was lower in the AG + GG genotypes[(2040 ± 721)g]than those in the AA genotype[(2520 ± 810)g],and the P ＜0.05,respectively.In the severe pre-eclampsia,950T/C TT genotype carriers exhibited significantly higher systolic blood pressure[(153 ± 16)mm Hg(1 mm Hg =0.133 kPa)]and 24-hour urine protein [(4.0±2.5)g]compared with TT + TC carriers[(145 ±17)mm Hg,(2.9±1.8)g],respectively,furthermore the P ＜ 0.05.Conclusions In severe pre-eclampsia,carriers with G allele at position 163A/G has more genetic predisposition than A allele carriers,as well as 950T/C T allele carriers compared with C carriers.Taken together,this study suggested that OPG gene polymorphisms might be associated with some clinical parameters of severe pre-eclampsia.