Association between dietary quality and bone mass among middle-aged and elderly people in Gansu Province / 西安交通大学学报(医学版)

【Objective】 To evaluate the dietary quality with the dietary balance index (DBI_16) and the association between dietary quality and bone mass among middle-aged and elderly people in Gansu Province so as to provide evidence for improving dietary quality and bone health status of Gansu population. 【Methods】 Based on the information of the type and quantity of food intake and the bone mass of middle-aged and elderly people aged 35 years and above collected by the Gansu Project in the Regional Ethnic Cohort Study in Northwest China, DBI_16 was used to evaluate the intake level of cereals, vegetables, fruits, milk, beans, fish and shrimp, eggs and other foods, and the degree of inadequate, excessive and unbalanced dietary intake of the participants. Multiple linear regression was used to evaluate the associations of three component indexes of DBI_16, high bound score (DBI_HBS), low bound score (DBI_LBS), diet quality distance (DBI_DQD), and seven single indexes of DBI_16 with bone mass. 【Results】 Analyses of the dietary and bone mass data of 11,840 participants showed that 44.8% of participants consumed excessive amounts of cereals compared to the dietary recommendation. 96.3%, 90.6%, 90.1%, 71.9%, 95.1% and 60.3% of participants’ intake of vegetables, fruits, milk, soybeans, fish and shrimp, and eggs, respectively, were inadequate. 47.7% participants consumed less than 10 types of food. 2.3% participants’ DBI_LBS levels were appropriate. 54.7% participants’ DBI_HBS levels were appropriate. Only 1.2% participants’ DBI_DQD reached a balanced level. The bone mass level in the study population was (2.5±0.6) kg [(2.8±0.5) kg for men and (2.3±0.5) kg for women]. After adjusting for sociodemographic characteristics, lifestyle, total dietary energy intake and body mass index, DBI_LBS and DBI_DQD were negatively associated with bone mass [β and 95% CI was -0.002 01 (-0.003 62--0.000 40) and -0.001 76 (-0.003 09--0.000 43), respectively]. 【Conclusion】 Dietary intake imbalance is common among middle-aged and elderly people in Gansu Province, and the more severe the dietary intake imbalance, the lower the bone mass level.

Prevalence, associated factors and patterns of multimorbidity of non-communicable diseases among adults in Shaanxi Province / 西安交通大学学报(医学版)

【Objective】 To estimate the prevalence, associated factors and patterns of multimorbidity of non-communicable diseases among adults in Shaanxi Province so as to provide evidence for the prevention and control of non-communicable diseases. 【Methods】 We used the data of adults aged 18 years and older collected in the baseline survey of Shaanxi Project in the Regional Ethnic Cohort Study in Northwest China. Multinomial logistic regression was used to explore the associated factors for multimorbidity. Exploratory factor analysis was used to extract patterns of multimorbidity. 【Results】 The prevalence of multimorbidity was 10.7% among the 44 442 participants. Age increase, being males, urban residence, and being overweight or obesity were positively associated with multimorbidity. Compared with women, men had a higher risk of multimorbidity. The OR and 95% CI was 1.25 (1.12-1.39). The risk of multimorbidity increased with age among adults. Compared with participants aged 18.0-34.9 years, the ORs and 95% CIs of those aged 35.0-44.9, 45.0-54.9, 55.0-64.9, and ≥65.0 years were 4.73 (3.47-6.46), 15.61 (11.60-21.00), 41.39 (30.76-55.70) and 90.04 (66.58-121.77), respectively. The primary multimorbidity patterns among adults in Shaanxi were cardiovascular-metabolic multimorbidity (5.4%), viscero-articular multimorbidity (1.0%), and respiratory multimorbidity (0.3%). 【Conclusion】 More than one in ten adults in Shaanxi Province had multimorbidity, and the predominant pattern of multimorbidity was cardiovascular-metabolic multimorbidity. The prevention and control of non-communicable diseases should be reinforced in middle-aged and older people, males, people living in the urban, and overweight or obese people. More attention should be paid to the prevention and control of cardiovascular-metabolic diseases.

Evaluation of diet quality among pregnant women in Shaanxi Province by Diet Balance Index for Pregnancy / 西安交通大学学报(医学版)

【Objective】 To evaluate the diet quality of pregnant women in Shaanxi Province by Diet Balance Index for Pregnancy (DBI_P) and investigate the influencing factors. 【Methods】 By using a multi-stage stratified random sampling method, 7375 pregnant women in 30 districts (counties) of Shaanxi Province were recruited. A structured questionnaire was adopted to collect general information in pregnancy, and a semi-quantitative food frequency questionnaire was used to obtain dietary information in pregnancy. DBI_ P was used to evaluate the diet quality during pregnancy, and the factors influencing diet quality were assessed by multiple linear regression. 【Results】 More than 50% pregnant women had inadequate intakes of dairy products, fish and shrimp, meat and poultry, vegetables, eggs, fruits and diet variety. More than 69% pregnant women had excessive intakes of cooking oil, cereals and salt. The average values of high bound score, low bound score, and diet quality distance were 12.9, 19.5, and 32.5, respectively. The proportions of medium inadequate, excessive, and imbalance of dietary intakes were 20.3%, 22.55%, and 40.8%, respectively. DBI_LBS during pregnancy was negatively correlated with childbearing age, education level, family per capita annual income, antenatal examination frequency and folic acid supplementation, but positively correlated with living in southern and northern Shaanxi, residing in rural areas, being farmers, and drinking alcohol. DBI_HBS during pregnancy was negatively correlated with living in southern and northern Shaanxi, but positively correlated with active/passive smoking and drinking strong tea. DBI_DQD during pregnancy was negatively correlated with education level, family per capita annual income, antenatal examination frequency and folic acid supplementation, but positively correlated with living in southern Shaanxi, residing in rural areas, being farmers, parity, active/passive smoking, and drinking strong tea and coffee. 【Conclusion】 The dietary intake of pregnant women in Shaanxi Province was insufficient and unbalanced, and the dietary quality was affected by sociodemographic and life behavior factors during pregnancy. Nutritional intervention measures should be targeted.

Comparison of different obesity indices in predicting risk of hypertension among adults in Gansu Province / 西安交通大学学报(医学版)

【Objective】 To compare the ability of body mass index （BMI）， body fat percentage （BFP）， waist circumference （WC）， waist-to-height ratio （WHtR）， visceral fat index （VFI） and the combinations of two kinds of obesity indices to predict the risk of hypertension. 【Methods】 Data collected in the baseline survey of “Gansu Province’s Urban and Rural Natural Population Cohort Establishment and Tumor Follow-up Study” were analyzed. Area under the curve （AUC） of ROC curve with covariates was used to analyze and compare the effects of individual obesity evaluation index and the combination of two kinds of obesity indices in predicting the risk of hypertension. 【Results】 Analyses of data of 20，079 adults showed that the AUC of BMI， WC， WHtR， BFP and VFI was 0.636， 0.604， 0.615， 0.614 and 0.619， respectively. AUC of the combination of BMI and WC （0.643） was higher than that of BMI （0.636）； however， the change rate of AUC was only 1.09%. AUC of the combinations of WC， WHtR and VFI， the three central obesity evaluation indices， and BFP， a general obesity evaluation index， were lower than that of BMI. The optimal cutoff value for BMI was 24.2 kg/m2. 【Conclusion】 The effect of BMI in predicting the risk of hypertension is better than that of BFP， WC， WHtR and VFI. The effects of the combinations of the two kinds of obesity evaluation indices are not better than that of BMI. To prevent and control hypertension， adults should keep their BMI under overweight.

Association of gestational diabetes mellitus and blood glucose level during the second trimester with neonatal birth weight: A study based on birth cohort / 西安交通大学学报(医学版)

【Objective】 To explore the association of gestational diabetes mellitus (GDM) and blood glucose level with birth weight of the newborns in Northwest China. 【Methods】 Pregnant women in their first trimester who joined the birth cohort of Northwest Women and Children’s Hospital from July 2018 to July 2019 were consecutively enrolled. We collected their basic demographic characteristics, lifestyle behavior and other data. We followed up the results of the OGTT test and pregnancy outcomes. The generalized linear model was used to analyze the effects of GDM and blood glucose levels on the birth weight of newborns. 【Results】 A total of 2 422 subjects were included in this study, and 656 (27.09%) pregnant women had GDM during pregnancy. Pregnant women with GDM increased the birth weight (β=50.00, 95% CI: 17.48-82.51), Z-value (β=0.11, 95% CI: 0.03-0.19) and Z Centile value (β=3.22, 95% CI: 0.88-5.55), and increased the risk of macrosomia (OR=1.54, 95% CI: 1.04-2.28). Abnormal FPG value during the second trimester would increase the risk of macrosomia and LGA. With the increase of OGTT blood glucose value in the second trimester, the birth weight value and the incidence of macrosomia and LGA showed an upward trend. 【Conclusion】 Pregnancy in women with GDM might increase the birth weight of newborns and the risk of macrosomia, especially FPG. We should vigorously control the blood glucose level of GDM patients to promote the health of mothers and infants.

Effects of gestational diabetes mellitus and mid-pregnancy blood glucose levels on gestational weeks based on birth cohort study / 西安交通大学学报(医学版)

【Objective】 To explore the effects of gestational diabetes mellitus (GDM) and mid-pregnancy blood glucose levels on gestational weeks in Northwestern China. 【Methods】 For this prospective cohort study, we recruited the first-trimester pregnant women who underwent obstetrical examinations at Northwest Women’s and Children’s Hospital from July 2018 to July 2019 as the cohort. We investigated their socio-demographic characteristics and risk factors of adverse pregnancy outcomes. Additionally, we collected the OGTT test results of pregnant women in mid-pregnancy and followed up their pregnancy outcomes. The relationship of GDM and blood glucose levels with gestational weeks was analyzed by using the generalized linear model. 【Results】 A total of 2 434 subjects were included in this study. There were 668 pregnant women with GDM, with a ratio of 27.44%. GDM in pregnant women shortened the gestational weeks (β=-0.17, 95% CI: -0.28—-0.05). Fasting blood glucose, OGTT-1 h blood glucose, and OGTT-2 h blood glucose increased by 1 mmol/L; gestational weeks were shortened by 0.17 (95% CI: -0.28—-0.05), 0.05 (95% CI: -0.09—-0.02) and 0.07 (95% CI: -0.12—-0.03). Fasting blood glucose and OGTT-1 h blood glucose abnormalities shortened gestational weeks by 0.18 (95% CI: -0.31—-0.05) and 0.28 (95% CI: -0.47—-0.10) respectively. An increase by 1 mmol/L or abnormality of fasting blood glucose would increase preterm delivery risk by 1.44 (95% CI: 1.01-2.06) and 1.73 times (95% CI: 1.10-2.69), respectively. 【Conclusion】 GDM in pregnant women may shorten their gestational weeks; the abnormal and elevated fasting blood glucose, in particular, would increase the risk of preterm delivery. Therefore, we should carry out active health education to control the blood glucose and other risk factors of GDM patients and promote healthy pregnancy.

Association between fatty acid consumption and hypertension among rural residents in Hanzhong of Shaanxi Province / 西安交通大学学报(医学版)

【Objective】 To evaluate the associations of total fat and fatty acid consumption with the risk of hypertension among rural residents in Hanzhong, Shaanxi Province. 【Methods】 A cross-sectional survey on dietary status with a semi-quantitative food frequency questionnaire was conducted among rural residents aged between 18 and 80 years old in Hanzhong of Shaanxi. Multivariate log-binomial regression models and restricted cubic spline were used to explore the associations of dietary total fat, saturated fatty acid, polyunsaturated fatty acid and monounsaturated fatty acids with hypertension and as well as association between dose and response. 【Results】 A total of 2241 individuals were included, with 774 males and 1467 females. Monounsaturated fatty acid accounted for 51.9% of total dietary fat intake, while the other two fatty acids for 48.1%. The intake of dietary fat and any fatty acid in men was significantly in men higher than in women (P<0.001). Results of multivariable log-binomial regression indicated that after adjustment of energy, socio-demographic and lifestyles, the risk of hypertension reduced significantly in Q4 group, compared with that in Q1 (PR: 0.71, 95% CI: 0.54-0.92; P-trend: 0.022) in females. A nonlinear dose-response relationship between monounsaturated fatty acids and hypertension was detected by restricted cubic spline in women (Pnon-linear<0.01). No association was observed of total fat, saturated fatty acid and polyunsaturated fatty acid with hypertension regardless of the gender. 【Conclusion】 In women, increased consumption of monounsaturated fats might play a positive role in reducing the risk of hypertension. Further research is warranted to verify the rationality of causal inference and break-point.

The association between the frequency of prenatal care in childbearing aged women and risk of small for gestational age among neonatal twins in Shaanxi Province / 中华预防医学杂志

Objective@#To explore the association between the frequency of prenatal care in childbearing aged women and risk of small for gestational age (SGA) among neonatal twins in Shaanxi Province.@*Methods@#From July to December 2013, a total of 30 027 childbearing aged women, who were pregnant from January 2010 to November 2013 and had definite outcomes, were selected from 30 districts (counties) of Shaanxi Province by using the multi-stage random sampling method. The questionnaires with a face-to-face survey method were used to retrospectively collect demographic information, pregnancy history, lifestyle during pregnancy, disease history, nutritional supplements, and health care during pregnancy. Information on the gestational age and birth weight of the newborn were obtained by consulting the medical certificate of birth and were registered as twin A and twin B by birth order. Finally, 356 childbearing aged women and their twin babies with complete data were included in the analysis. A generalized estimation equation model was used to analyze the association between the frequency of prenatal care and the risk of SGA among neonatal twins.@*Results@#The age of childbearing aged women was (27.44±4.68) years old, of which 79.49% (283 women) were rural residents and 44.38% (158 women) had seven or more times prenatal care. The gestational age and birth weight were (37.64±2.51) weeks and (2 510±497) g, respectively. The prevalence of SGA was 51.40% (183/356) for twin A and 53.37% (190/356) for twin B, respectively. The prevalence of SGA was 44.30% (70/158) for twin A with seven or more times prenatal care and 42.41% (67/158) for twin B with seven or more times prenatal care, which was lower than that for twins with less than seven times prenatal care, respectively [57.07% (113/198) and 62.12% (123/198)] (P values were 0.017 and <0.001). The results of generalized estimation equation model suggested that compared to those with less than seven times prenatal care, after adjusting for parity, birth order, place of residence, maternal age, occupation, education, family wealth index, passive smoking, pregnancy-induced hypertension syndrome, folic acid, and iron supplement during perinatal period, and gender of the newborn, the OR (95%CI) of risk of SGA among childbearing aged women with seven or more times prenatal care was 0.60 (0.40-0.91).@*Conclusion@#Seven or more times prenatal care could reduce the risk of SGA among neonatal twins in Shanxi Province.

Analysis on chronic diseases and risk factors of adult residents in Shaanxi province / 中华流行病学杂志

Objective@#To explore the prevalence of chronic diseases and related risk factors in Shaanxi province.@*Methods@#Multi-stage stratified cluster random sampling was used to collect the sample from permanent residents in 10 national surveillance points in Shaanxi province in 2015. Behavioral risk factors (smoking, drinking, diet and physical activity) were investigated by face-to-face interviews and biological risk factors (BMI, blood pressure, blood glucose and blood lipid) were collected by physical measurements and laboratory tests. Designed weight, no response weight and post hierarchical weight were taken into account in the data analysis. Binary logistic regression models were used to examine the pair-wise associations among 8 risk factors.@*Results@#A total of 6 174 persons were included in the analysis. The following weighted prevalence were noticed in Shaanxi province in 2015, that including current smoking as 28.19%, harmful use of alcohol as 6.20%, inadequate intake of vegetables and fruits as 55.62%, physical inactivity as 19.56%, overweight and obesity as 46.82%, hypertension as 31.12%, raised fasting blood glucose as 4.27%, and raised total cholesterol as 20.96%. Eight risk factors were found to be associated with each other. The mean numbers of risk factors were 2.41 per male and 1.85 per female, 1.94 per urban resident and 2.28 per rural resident.@*Conclusions@#Risk factors for chronic diseases among adults aged 18 or older were more than the national levels in Shaanxi province in 2015. Male and rural residents presented more risk factors than their counterparts. Correlations between risk factors implied that a combined package of interventions was needed to reduce these risk factors.

Relationship between preterm birth of infant and medication during pregnancy in women of childbearing age in Shaanxi / 中华流行病学杂志

Objective@#To understand the relationship between medication during pregnancy and single live preterm birth of infant in women of childbearing age in Shaanxi province.@*Methods@#A cross-sectional design was used in this study and stratified multistage random sampling method was used. A questionnaire survey was conducted in the childbearing-aged women selected through multi stage stratified random sampling in Shaanxi during 2010 to 2013. Qualitative datum was described by percentage and measurement datum was described by mean±standard deviation. Logistic regression analysis was done to evaluate the relationship between medication during pregnancy and preterm birth of infant.@*Results@#The overall incidence rate of premature birth was 2.7% in Shaanxi. Among the 28 841 mothers participating in this study, the proportion of medication use at any time during pregnancy was 15.8%, and the most commonly used drug was cold medicine (5.9%). After adjusting all confounding factors, the multivariable logistic regression analysis results showed that taking hormone medicine (OR=2.23, 95%CI: 1.19-4.18), antihypertensive medicine (OR=7.74, 95%CI: 4.28-13.95) and other medicines (OR=2.15, 95%CI: 1.60-2.89) during early pregnancy were the risk factors for preterm delivery, the risk was 2.23 times, 7.74 times and 2.15 times higher compared with those taking no these medicines.@*Conclusion@#Using hormone medicine, antihypertensive medicine and other medicines during pregnancy increased the risk for preterm delivery in women of childbearing age in Shaanxi.

Association between congenital heart disease and maternal disease in early pregnancy in women of childbearing age / 中华流行病学杂志

Objective@#To investigate the relationship between maternal disease in early pregnancy of women of childbearing age and congenital heart disease of neonates.@*Methods@#A cross-sectional design was used in this study and stratified multistage random sampling method was used. A questionnaire survey was conducted in the childbearing-aged women during 2010-2013 in Shaanxi province. Propensity score (PS) matched (1∶1) analysis was used to match participants with diseases to those without disease in early pregnancy. Through the control of the confounders step by step, a logistic regression model was established to evaluate the ORs of congenital heart disease according to the independent variable of maternal disease.@*Results@#A total of 28 680 pairs of mothers and infants were included in this study, the proportion of the women with disease in early pregnancy was 20.25% (5 807). After PS matching, 5 436 pairs were matched. After adjusting all confounding factors, the multivariable logistic regression analysis results showed that maternal disease (OR=1.86, 95%CI: 1.23-2.81), especially cold (OR=2.19, 95%CI: 1.46-3.28), gynecological disease (OR=4.74, 95%CI: 2.03-11.09) and diabetes (OR=14.00, 95%CI: 1.64-119.21), in early pregnancy were the risk factors for congenital heart disease of neonate.@*Conclusion@#In women of childbearing age, disease in early pregnancy, especially cold, gynecological disease and diabetes, can increase the risk of congenital heart disease in neonates.

Study on the association of dietary patterns of Shaanxi women of childbearing age during pregnancy with adverse pregnancy outcomes from 2010 to 2012 / 中华预防医学杂志

Objective@#To analyze the types of dietary patterns of women during pregnancy in Shaanxi and their association with adverse pregnancy outcomes.@*Methods@#Data were derived from a cross-sectional program named "The prevalence and risk factors of birth defects in Shaanxi Province" from July to November in 2013. A multi-stage stratified random sampling method was used to extract 15 980 women of childbearing age who met the inclusion exclusion criteria from Shaanxi Province. The questionnaire obtained information such as the pregnancy outcome and the food intake of the study subjects during pregnancy. The dietary pattern was extracted by factor analysis, and the each dietary pattern of subjects were divided into T1-T3 groups according to the factor score. The effects of each dietary pattern on major adverse pregnancy outcomes were estimated by unconditional logistic regression model.@*Results@#Four dietary patterns were established:vegetarian pattern, balanced pattern, traditional pattern, and processing pattern. The multivariate logistic regression model results showed that compared with the vegetarian pattern T2 group, the T1 group had lower risk of low birth weight (OR=0.56, 95%CI: 0.41-0.83), and the T3 group had higher risk of low birth weight in offspring (OR=2.32, 95%CI: 1.59-3.89); compared with the traditional pattern T2 group, the T3 group had higher risk of premature (OR=2.62, 95%CI: 1.58-5.01); compared with the balanced pattern T2 group, the T3 group had a lower risk of spontaneous abortion (OR=0.73, 95%CI: 0.36-0.89); compared with the processing pattern T2 group, the T3 group had a higher risk of spontaneous abortion (OR=1.97, 95%CI: 1.36-3.34) and higher risk of stillbirth (OR=2.96, 95%CI: 1.49-6.26), and the T1 group had a lower risk of stillbirths in offspring (OR=0.52, 95%CI: 0.33-0.83).@*Conclusion@#The women of childbearing age in Shaanxi have different dietary patterns, and there may be a correlation between dietary patterns and adverse pregnancy outcomes.

Interaction between pregnancy-induced hypertension and history of preterm birth on the risk of small for gestational age / 中华流行病学杂志

Objective@#To investigate the interaction of pregnancy-induced hypertension and history of preterm birth on the risk of small for gestational age.@*Methods@#Stratified multistage random sampling method was used to choose samples from 30 districts and counties of Shaanxi province. Information on childbearing-age women with their children between January 2010 and November 2013 was retrospectively collected through face-to-face questionnaire survey. The childbearing-aged women were in pregnancy or having had definite outcomes of pregnancy. Enumeration data were described by percentage, and measurement data were described by Mean±SD, and χ2 test was used to compare the rates. Unconditional logistic regression analysis was performed to estimate the interaction between pregnancy-induced hypertension and history of preterm birth on the risk of small for gestational age, and by using small for gestational age as dependent variables, pregnancy-induced hypertension and history of preterm birth as independent variables. Confounding factors were under control. Firstly, the association between pregnancy-induced hypertension and small for gestational age has been analyzed in primiparas, secondly, interaction of pregnancy-induced hypertension and history of preterm birth on the risk of small for gestational age has been analyzed in multiparas.@*Results@#A total of 25 751 women of childbearing age and their children were recruited. 60.55% (15 592/25 751) were primiparas, 39.45% (10 159/25 751) were multiparas, the rate of history of preterm birth was 1.89% (192/10 159) for multiparas. The incidence rates of pregnancy-induced hypertension and small for gestational age were 1.55% and 15.49% in pregnant woman (400/25 751) and their newborns (3 990/25 751). Unconditioned logistic regression analysis showed that compared with woman without pregnancy-induced hypertension, primiparas with pregnancy-induced hypertension had increased risk of small for gestational age (OR=1.43, 95%CI: 1.02-2.00, P=0.041). Regarding multiparas, the main effect of pregnancy-induced hypertension had a positive correlation with small for gestational age (OR=1.34, 95%CI: 0.91-1.96), but there was no statistical significance (P=0.138). The main effect of history of preterm birth was positively correlated with small for gestational age (OR=1.61, 95%CI: 1.13-2.31, P=0.009). The interaction term "pregnancy-induced hypertension×history of preterm birth" was positively associated with risk of small for gestational age (OR=5.93, 95%CI: 1.19-29.61, P=0.030).@*Conclusions@#Pregnancy-induced hypertension was associated with increased risk for small for gestational age in both primiparas and multiparas, and history of preterm birth further increased risk for small for gestational age in pregnant women with pregnancy-induced hypertension, indicating that there was multiplication interaction between pregnancy-induced hypertension and history of preterm birth.

Association between congenital heart disease and medication taken during pregnancy among women of childbearing age / 中华流行病学杂志

Objective To analyze the relationship between medication taken during pregnancy and congenital heart disease of the newborns.Methods A large cross-sectional survey was conducted between August and November 2013.A questionnaire survey was conducted among the childbearing aged women,selected through multistage stratified random sampling in Shaanxi from 2010 to 2013.All of the childbearing aged women under study were in pregnancy and with definite pregnancy outcomes.Multivariable Poisson regression was conducted for data analyses.Results A total of 28 680 cases were included in this study.The proportion of medication taken at any time during pregnancy was 16.0％,and the prevalence of congenital heart disease among the newborns was 67.9/10 000.After adjustment for factors as general demographic characteristic,history of heart disease and drug allergy and the situation of disease during pregnancy of these women,results from the multivariable Poisson regression showed that,factors as taking drugs (RR=1.95,95％ CI:1.42-2.68),cold medicine (RR=l.68,95％ CI:1.07-2.64),antibiotics (RR=1.90,95％ CI:1.25-2.90),salicylates (RR=5.01,95％CI:1.84-13.64) and antifungal drugs (RR=10.22,95％CI:3.25-32.19)during pregnancy were all related to congenital heart disease,and with the history of taking cold medicine (RR =1.90,95 ％ CI:1.01-3.61),antibiotics (RR =2.18,95 ％ CI:1.17-4.06),salicylates (RR =6.07,95％CI:1.45-25.41),antifungal drugs (RR=21.01,95％CI:4.17-105.87) and other drugs (RR=2.31,95％CI:1.19-4.47) during early pregnancy.These factors were with higher risks for congenital heart disease.Conclusion Women of childbearing age who took cold medicine,antibiotics,salicylic acid drugs,antifungal drugs and other drugs during early pregnancy would increase the risks related to congenital heart diseases.

A propensity score-matched study on relationship between maternal respiratory infection in early pregnancy and gestational age / 中华流行病学杂志

Objective To explore the association between maternal respiratory infection in early pregnancy and gestational age of single live birth.Methods A face to face questionnaire survey was conducted among child bearing aged women in 30 counties (district) of Shaanxi province selected through stratified multistage sampling.Propensity score (PS) matched (1 ∶ 1) analysis was used to match participants with respiratory infections to those without respiratory infections.A multilevel linear model was used to investigate the association between respiratory infections and gestational age.Through the control of the confounders step by step,three models were established in this study:model 1 for the variable of respiratory infections before PS matching,model 2 was adjusted for variables in model 1 plus some other individual differences of mother and baby,and model 3 for the variable of respiratory infections after PS matching.Results Of 28 848 child bearing aged women surveyed,3 676 (12.74％) had respiratory infections in early pregnancy.After PS matching,2 762 pairs were matched.Analysis with model 1 indicated that a decrease of 0.111 week (P＜0.001) in gestational age was associated with a respiratory infection during the first trimester.Analysis with model 2 and model 3 indicated that a decrease of 0.058 week (P=0.025) and a decrease of 0.076 week (P=0.036) were associated with respiratory infection during the fast trimester,respectively.Conclusion The respiratory infection during the first trimester was associated with the decrease of the gestational age of newborn.

Effect of interpregnancy interval of childbearing aged women on birth weight of single live birth neonates / 中华流行病学杂志

Objective To understand the effect of interpregnancy interval (IPI) of childbearing aged women on the birth weight of single live birth neonates in Shaanxi province.Methods A questionnaire survey was conducted among the childbearing aged women selected through multistage stratified random sampling in Shaanxi during 2010-2013,all the childbearing aged women had definite pregnancy outcomes.The interpregnancy interval of the childbearing aged women and the birth weight of the newborns were used as the independent variables and dependent variables respectively in multiple linear regression model and quantile regression model,and confounding factors were controlled.Results A total of 13 063 women at childbearing age and their infants were investigated.The incidence of low birth weight and macrosomia was 3.54％ and 7.62％ respectively.Multiple linear regression analysis showed that there was no significant difference in birth weight among different IPI group and control group.Quantile regression analysis showed when birth weight was at 5 percentiles,the difference in birth weight between newborns whose mothers had short interpregnancy interval (＜12 months) and those in control group was significant,when the birth weight was ≥90 percentiles,the birth weights of newborns whose mothers had long interpregnancy interval (60-119 months) were higher than those in control group,the difference was significant.As the increase of the percentiles of birth weight,the extent of changes gradually increased.Conclusion The analysis indicated that both short (＜12 months) and long (60-119 months) interpregnancy interval would had negative effects on birth weights of newborns.Therefore,planning for pregnancy is important for having a good perinatal outcome.

Association between congenital heart disease and medication taken during pregnancy among women of childbearing age / 中华流行病学杂志

Objective To analyze the relationship between medication taken during pregnancy and congenital heart disease of the newborns.Methods A large cross-sectional survey was conducted between August and November 2013.A questionnaire survey was conducted among the childbearing aged women,selected through multistage stratified random sampling in Shaanxi from 2010 to 2013.All of the childbearing aged women under study were in pregnancy and with definite pregnancy outcomes.Multivariable Poisson regression was conducted for data analyses.Results A total of 28 680 cases were included in this study.The proportion of medication taken at any time during pregnancy was 16.0％,and the prevalence of congenital heart disease among the newborns was 67.9/10 000.After adjustment for factors as general demographic characteristic,history of heart disease and drug allergy and the situation of disease during pregnancy of these women,results from the multivariable Poisson regression showed that,factors as taking drugs (RR=1.95,95％ CI:1.42-2.68),cold medicine (RR=l.68,95％ CI:1.07-2.64),antibiotics (RR=1.90,95％ CI:1.25-2.90),salicylates (RR=5.01,95％CI:1.84-13.64) and antifungal drugs (RR=10.22,95％CI:3.25-32.19)during pregnancy were all related to congenital heart disease,and with the history of taking cold medicine (RR =1.90,95 ％ CI:1.01-3.61),antibiotics (RR =2.18,95 ％ CI:1.17-4.06),salicylates (RR =6.07,95％CI:1.45-25.41),antifungal drugs (RR=21.01,95％CI:4.17-105.87) and other drugs (RR=2.31,95％CI:1.19-4.47) during early pregnancy.These factors were with higher risks for congenital heart disease.Conclusion Women of childbearing age who took cold medicine,antibiotics,salicylic acid drugs,antifungal drugs and other drugs during early pregnancy would increase the risks related to congenital heart diseases.

A propensity score-matched study on relationship between maternal respiratory infection in early pregnancy and gestational age / 中华流行病学杂志

Objective To explore the association between maternal respiratory infection in early pregnancy and gestational age of single live birth.Methods A face to face questionnaire survey was conducted among child bearing aged women in 30 counties (district) of Shaanxi province selected through stratified multistage sampling.Propensity score (PS) matched (1 ∶ 1) analysis was used to match participants with respiratory infections to those without respiratory infections.A multilevel linear model was used to investigate the association between respiratory infections and gestational age.Through the control of the confounders step by step,three models were established in this study:model 1 for the variable of respiratory infections before PS matching,model 2 was adjusted for variables in model 1 plus some other individual differences of mother and baby,and model 3 for the variable of respiratory infections after PS matching.Results Of 28 848 child bearing aged women surveyed,3 676 (12.74％) had respiratory infections in early pregnancy.After PS matching,2 762 pairs were matched.Analysis with model 1 indicated that a decrease of 0.111 week (P＜0.001) in gestational age was associated with a respiratory infection during the first trimester.Analysis with model 2 and model 3 indicated that a decrease of 0.058 week (P=0.025) and a decrease of 0.076 week (P=0.036) were associated with respiratory infection during the fast trimester,respectively.Conclusion The respiratory infection during the first trimester was associated with the decrease of the gestational age of newborn.

Effect of interpregnancy interval of childbearing aged women on birth weight of single live birth neonates / 中华流行病学杂志

Objective To understand the effect of interpregnancy interval (IPI) of childbearing aged women on the birth weight of single live birth neonates in Shaanxi province.Methods A questionnaire survey was conducted among the childbearing aged women selected through multistage stratified random sampling in Shaanxi during 2010-2013,all the childbearing aged women had definite pregnancy outcomes.The interpregnancy interval of the childbearing aged women and the birth weight of the newborns were used as the independent variables and dependent variables respectively in multiple linear regression model and quantile regression model,and confounding factors were controlled.Results A total of 13 063 women at childbearing age and their infants were investigated.The incidence of low birth weight and macrosomia was 3.54％ and 7.62％ respectively.Multiple linear regression analysis showed that there was no significant difference in birth weight among different IPI group and control group.Quantile regression analysis showed when birth weight was at 5 percentiles,the difference in birth weight between newborns whose mothers had short interpregnancy interval (＜12 months) and those in control group was significant,when the birth weight was ≥90 percentiles,the birth weights of newborns whose mothers had long interpregnancy interval (60-119 months) were higher than those in control group,the difference was significant.As the increase of the percentiles of birth weight,the extent of changes gradually increased.Conclusion The analysis indicated that both short (＜12 months) and long (60-119 months) interpregnancy interval would had negative effects on birth weights of newborns.Therefore,planning for pregnancy is important for having a good perinatal outcome.

Relationship between exposure to air pollutants during pre-pregnancy or early pregnancy and birth defects in Xi'an, 2013-2015: a case crossover study / 中华流行病学杂志

Objective To understand the levels of exposure to traffic-related air pollutants including nitrogen dioxide (NO2),PM10 and PM2.5,and the relationship between the exposure to air pollutants during pre-pregnancy or early pregnancy and birth defects.Methods Data on air pollution and birth defects from 2013 to 2015 was collected.A case-crossover design was employed to analyze the exposure-response relationship between traffic-related air pollutants and birth defects.Results A total of 4 235 pregnant women were studied.During the study period,the daily average concentrations of ambient NO2,PM10 and PM25 appeared as 60.83 μg/m3,104.94 μg/m3 and 103.88 μ.tg/m3,respectively,with the concentration of PM2.5 larger than the 2nd version of Standard National Ambient Air Quality Standard.In addition,there were strong correlations seen between each of the pollutants (P＜0.01).After adjustment for the influence of meteorological factors,it was found that the exposure to high level of NO2 and PM10 during pre-pregnancy or early pregnancy increased the risk on birth defects (P＜0.05).Conclusion Levels of exposure to adverse environmental factors during pre-pregnancy or early pregnancy could increase the risk of birth defects,suggesting that in these sensitive periods,women should try to avoid being exposed to high concentration of traffic-related air pollutants as NO2,PM10 etc.in order to reduce the risk of birth defects.